Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France; Université Clermont Auvergne, 63003 Clermont-Ferrand, France; Unité de Nutrition Humaine, INRA, UMR 1019, CRNH Auvergne, 63000 Clermont-Ferrand, France.
Service de Médecine Physique et de Réadaptation, CHU de Clermont-Ferrand, Hôpital Nord, route de Chateaugay, BP 30056, 63118 Cébazat, France; Université Clermont Auvergne, 63003 Clermont-Ferrand, France.
Ann Phys Rehabil Med. 2016 Jun;59(3):174-183. doi: 10.1016/j.rehab.2016.02.005. Epub 2016 Apr 1.
Highlight the role of patient education about physical activity and exercise in the treatment of hip and knee osteoarthritis (OA).
Systematic literature review from the Cochrane Library, PubMed and Wiley Online Library databases. A total of 125 items were identified, including 11 recommendations from learned societies interested in OA and 45 randomized controlled trials addressing treatment education and activity/exercise for the treatment of hip and knee osteoarthritis.
In the end, 13 randomized controlled trials and 8 recommendations were reviewed (1b level of evidence). Based on the analysis, it was clear that education, exercise and weight loss are the pillars of non-pharmacological treatments. These treatments have proven to be effective but require changes in patient behaviour that are difficult to obtain. Exercise and weight loss improve function and reduce pain. Education potentiates compliance to exercise and weight loss programs, thereby improving their long-term benefits. Cost efficiency studies have found a reduction in medical visits and healthcare costs after 12 months because of self-management programs.
Among non-surgical treatment options for hip and knee osteoarthritis, the most recent guidelines focus on non-pharmacological treatment. Self-management for general physical activity and exercise has a critical role. Programs must be personalized and adjusted to the patient's phenotype. This development should help every healthcare professional adapt the care they propose to each patient. Registration number for the systematic review: CRD42015032346.
强调患者教育在髋膝关节骨关节炎（OA）治疗中的作用。
对 Cochrane 图书馆、PubMed 和 Wiley Online Library 数据库进行系统文献回顾。共发现 125 项，包括对 OA 感兴趣的学术团体的 11 项建议和 45 项针对髋膝关节骨关节炎治疗的教育和活动/运动治疗的随机对照试验。
最终，对 13 项随机对照试验和 8 项建议进行了回顾（证据水平 1b）。分析表明，教育、锻炼和减肥是非药物治疗的基石。这些治疗方法已被证明有效，但需要改变患者难以获得的行为。运动和减肥可以改善功能，减轻疼痛。教育可以增强对运动和减肥计划的依从性，从而提高其长期效益。成本效益研究发现，由于自我管理计划，12 个月后医疗就诊和医疗保健费用减少。
在髋膝关节骨关节炎的非手术治疗选择中，最新指南侧重于非药物治疗。一般体育活动和锻炼的自我管理起着关键作用。方案必须个性化，并根据患者的表型进行调整。这种发展应该有助于每一位医疗保健专业人员根据每个患者的情况调整他们所提出的护理方案。系统评价的注册号：CRD42015032346。
