基于社区的轻中度膝骨关节炎有氧步行方案的实施：知识转化随机对照试验：第二部分：临床结果。
The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis: a knowledge translation randomized controlled trial: part II: clinical outcomes.
机构信息
Public Health, specialization in Epidemiology, University Research Chair, School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada.
出版信息
BMC Public Health. 2012 Dec 12;12:1073. doi: 10.1186/1471-2458-12-1073.
BACKGROUND
Osteoarthritis (OA) is the most common joint disorder in the world, as it is appears to be prevalent among 80% of individuals over the age of 75. Although physical activities such as walking have been scientifically proven to improve physical function and arthritic symptoms, individuals with OA tend to adopt a sedentary lifestyle. There is therefore a need to improve knowledge translation in order to influence individuals to adopt effective self-management interventions, such as an adapted walking program.
METHODS
A single-blind, randomized control trial was conducted. Subjects (n = 222) were randomized to one of three knowledge translation groups: 1) Walking and Behavioural intervention (WB) (18 males, 57 females) which included the supervised community-based aerobic walking program combined with a behavioural intervention and an educational pamphlet on the benefits of walking; 2) Walking intervention (W) (24 males, 57 females) wherein participants only received the supervised community-based aerobic walking program intervention and the educational pamphlet; 3) Self-directed control (C) (32 males, 52 females) wherein participants only received the educational pamphlet. One-way analyses of variance were used to test for differences in quality of life, adherence, confidence, and clinical outcomes among the study groups at each 3 month assessment during the 12-month intervention period and 6-month follow-up period.
RESULTS
The clinical and quality of life outcomes improved among participants in each of the three comparative groups. However, there were few statistically significant differences observed for quality of life and clinical outcomes at long-term measurements at 12-months end of intervention and at 6- months post intervention (18-month follow-up). Outcome results varied among the three groups.
CONCLUSION
The three groups were equivalent when determining the effectiveness of knowledge uptake and improvements in quality of life and other clinical outcomes. OA can be managed through the implementation of a proven effective walking program in existing community-based walking clubs.
TRIAL REGISTRATION
Current Controlled Trials IRSCTNO9193542.
背景
骨关节炎（OA）是世界上最常见的关节疾病，似乎在 80%以上 75 岁以上的人群中普遍存在。虽然散步等体育活动已被科学证明可以改善身体机能和关节炎症状，但 OA 患者往往采取久坐的生活方式。因此，需要改善知识转化，以影响个人采取有效的自我管理干预措施，例如适应性步行计划。
方法
进行了一项单盲、随机对照试验。将受试者（n=222）随机分为三个知识转化组之一：1）步行和行为干预（WB）（18 名男性，57 名女性），包括监督下的社区有氧运动与行为干预相结合，并附有步行益处的教育小册子；2）步行干预（W）（24 名男性，57 名女性），其中参与者仅接受监督下的社区有氧运动计划干预和教育小册子；3）自我指导控制（C）（32 名男性，52 名女性），其中参与者仅收到教育小册子。在 12 个月干预期间和 6 个月随访期间的每个 3 个月评估中，使用单向方差分析来测试研究组之间的生活质量、依从性、信心和临床结果的差异。
结果
在三个比较组中的每个组中，参与者的临床和生活质量结果均有所改善。然而，在干预结束时的 12 个月和干预结束后 6 个月（18 个月随访）的长期测量中，生活质量和临床结果的差异很小。结果因三组而异。
结论
在确定知识获取的有效性以及生活质量和其他临床结果的改善方面，三组是等效的。OA 可以通过在现有的社区步行俱乐部中实施经过验证的有效步行计划来管理。
试验注册
当前对照试验 IRSCTNO9193542。
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