Clarke Simon P, Poulis Nektaria, Moreton Bryan J, Walsh Dave A, Lincoln Nadina B
a Arthritis Research UK Pain Centre, University of Nottingham , Nottingham , UK.
b School of Psychology , University of Lincoln , Lincoln , UK.
Disabil Rehabil. 2017 Apr;39(7):663-670. doi: 10.3109/09638288.2016.1160295. Epub 2016 Mar 25.
The aim was to evaluate an Acceptance commitment therapy (ACT) intervention for people with knee or hip osteoarthritis; a related aim was to compare treatment effects from Rasch-transformed and standard scales.
Participants were recruited from a research database and outpatient rheumatology and orthopaedic clinics at two hospitals. Eligible participants were randomly allocated to either intervention or usual care. Intervention comprised six-sessions of group ACT. Outcomes were assessed two and four months after randomization. Rasch-transformed and standard self-report measures were compared. Qualitative interviews also explored the acceptability of the intervention.
Of 87 people assessed for eligibility, 31 (36%) were randomized. The main reason for non-randomization was that participants received surgery. Of the 16 participants randomized to intervention, 64% completed ≥50% of the scheduled group sessions. Follow-up data was complete for 84% participants at two months and 68% at four months. Outcome analysis demonstrated important differences between the Rasch-transformed and standard scales. There were significant differences between the groups in pain. Qualitative interviews with seven participants suggested the intervention was acceptable.
ACT for osteoarthritis is likely to be an acceptable treatment option for people with osteoarthritis. Progress to a definitive trial is warranted. Rasch-transformed outcome scales are preferable in clinical trials where possible. Implications for Rehabilitation Acceptance commitment therapy (ACT) is an effective treatment for many pain conditions andcould be a useful intervention for people with osteoarthritis who have high levels of pain. Rasch analysis is a measurement technique that may enable greater precision in detectingmeaningful treatment effects in routine clinical outcomes. The ACT intervention was successful in reducing pain and sleep difficulties and there werenotable differences in effects between standard and Rasch-transformed scales. In a relatively small trial, ACT may to be an acceptable intervention for people with osteoarthritisand progress to a definitive trial is warranted.
旨在评估针对膝关节或髋关节骨关节炎患者的接受与承诺疗法（ACT）干预措施；另一个相关目的是比较Rasch转换量表和标准量表的治疗效果。
从一个研究数据库以及两家医院的门诊风湿病科和骨科诊所招募参与者。符合条件的参与者被随机分配到干预组或常规护理组。干预包括六次团体ACT治疗。在随机分组后的两个月和四个月对结果进行评估。比较了Rasch转换量表和标准自我报告测量方法。定性访谈还探讨了该干预措施的可接受性。
在87名接受资格评估的人中，31人（36%）被随机分组。未随机分组的主要原因是参与者接受了手术。在16名被随机分配到干预组的参与者中，64%完成了≥50%的预定团体治疗课程。84%的参与者在两个月时的随访数据完整，68%的参与者在四个月时的随访数据完整。结果分析表明Rasch转换量表和标准量表之间存在重要差异。两组在疼痛方面存在显著差异。对七名参与者的定性访谈表明该干预措施是可接受的。
ACT治疗骨关节炎可能是骨关节炎患者可接受的治疗选择。有必要推进到确定性试验。在可能的情况下，Rasch转换后的结果量表在临床试验中更可取。对康复的启示接受与承诺疗法（ACT）是许多疼痛病症的有效治疗方法，对于疼痛程度较高的骨关节炎患者可能是一种有用的干预措施。Rasch分析是一种测量技术，可能能够在检测常规临床结果中有意义的治疗效果方面实现更高的精度。ACT干预成功减轻了疼痛和睡眠困难，标准量表和Rasch转换量表在效果上没有显著差异。在一项相对较小的试验中，ACT可能是骨关节炎患者可接受的干预措施，有必要推进到确定性试验。
