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职业治疗干预对成年类风湿关节炎患者的有效性:一项系统评价

Effectiveness of Occupational Therapy Interventions for Adults With Rheumatoid Arthritis: A Systematic Review.

作者信息

Siegel Patricia, Tencza Melissa, Apodaca Beverly, Poole Janet L

机构信息

Patricia Siegel, OTD, OTR/L, CHT, is Lecturer II, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque.

Melissa Tencza, MOTS, is Student, Occupational Therapy Graduate Program, University of New Mexico, Albuquerque.

出版信息

Am J Occup Ther. 2017 Jan/Feb;71(1):7101180050p1-7101180050p11. doi: 10.5014/ajot.2017.023176.

Abstract

OBJECTIVE

We reviewed the efficacy of occupational therapy-related interventions for adults with rheumatoid arthritis.

METHOD

We examined 51 Level I studies (19 physical activity, 32 psychoeducational) published 2000-2014 and identified from five databases. Interventions that focused solely on the upper or lower extremities were not included.

RESULTS

Findings related to key outcomes (activities of daily living, ability, pain, fatigue, depression, self-efficacy, disease symptoms) are presented. Strong evidence supports the use of aerobic exercise, resistive exercise, and aquatic therapy. Mixed to limited evidence supports dynamic exercise, Tai Chi, and yoga. Among the psychoeducation interventions, strong evidence supports the use of patient education, self-management, cognitive-behavioral approaches, multidisciplinary approaches, and joint protection, and limited or mixed evidence supports the use of assistive technology and emotional disclosure.

CONCLUSION

The evidence supports interventions within the scope of occupational therapy practice for rheumatoid arthritis, but few interventions were occupation based.

摘要

目的

我们回顾了针对成年类风湿性关节炎患者的职业治疗相关干预措施的疗效。

方法

我们审查了2000年至2014年发表并从五个数据库中识别出的51项一级研究(19项身体活动研究,32项心理教育研究)。仅关注上肢或下肢的干预措施未被纳入。

结果

呈现了与关键结局(日常生活活动、能力、疼痛、疲劳、抑郁、自我效能感、疾病症状)相关的研究结果。有力证据支持有氧运动、抗阻运动和水疗的使用。证据不一至有限支持动态运动、太极拳和瑜伽。在心理教育干预措施中,有力证据支持患者教育、自我管理、认知行为方法、多学科方法和关节保护的使用,有限或证据不一支持辅助技术和情感表露的使用。

结论

证据支持类风湿性关节炎职业治疗实践范围内的干预措施,但基于职业的干预措施很少。

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