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接受为期两天教育计划的膝骨关节炎患者的客观功能结果:一项前瞻性随机临床试验。

Objective functional results in patients with knee osteoarthritis submitted to a 2-day educational programme: a prospective randomised clinical trial.

作者信息

de Rezende Marcia Uchoa, de Farias Fabiane Elize Sabine, da Silva Cleidnéia Aparecida Clemente, Cernigoy Claudia Helena de Azevedo, de Camargo Olavo Pires

机构信息

Department of Orthopaedics and Traumatology, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, Brazil.

出版信息

BMJ Open Sport Exerc Med. 2017 Feb 14;2(1):e000200. doi: 10.1136/bmjsem-2016-000200. eCollection 2016.

Abstract

BACKGROUND

Although education is recommended for the treatment of knee osteoarthritis (KOA), its effectiveness in osteoarthritis (OA) remains low according to subjective questionnaires. The timed-up-and-go (TUG) and five-times-sit-to-stand tests (FTSST) reflect muscle strength and balance and could be used as objective measures of effectiveness.

AIM

To measure the effect of an educational programme in patients with KOA by TUG and FTSST and correlate these results to those of subjective questionnaires.

METHODS

Prospective randomised controlled trial of patients with KOA. Participants (n=198) were allocated into four groups. Three groups participated in 2 days of lectures with 1 (group 1), 2 (group 2) and 3-month (group 3) intervals between classes. Group 4 had no classes. Participants were asked to exercise at least three times a week. Half of the patients from all groups received bimonthly telephone calls reinforcing diet and exercise instructions. All four groups received the printed and video material presented in the classes. At baseline and at 1 year after initial assessment, patients performed the FTSST and TUG and answered WOMAC, Lequesne, SF-36 and Visual Analogue Scale questionnaires.

RESULTS

The TUG results did not change at 1 year follow-up, whereas FTSST improved (average difference of 4.66, p<0.001) irrespective of the implementation of classes or telephone calls. Both baseline and 1 year TUG and FTSST results correlated weakly (r<0.3) to the subjective functional, pain and quality of life results (p<0.001).

CONCLUSIONS

This educational programme improved function as determined by lower limb muscle strength (FTSST) irrespective of the patients' subjective non-improvement.

TRIAL REGISTRATION NUMBER

Clinical trials registration number: NCT01572051.

LEVEL OF EVIDENCE

Level 1A.

摘要

背景

尽管推荐采用教育方式治疗膝关节骨关节炎(KOA),但根据主观问卷调查,其在骨关节炎(OA)治疗中的有效性仍然较低。定时起立行走测试(TUG)和五次坐立试验(FTSST)可反映肌肉力量和平衡能力,可用作有效性的客观衡量指标。

目的

通过TUG和FTSST评估教育计划对KOA患者的影响,并将这些结果与主观问卷调查结果相关联。

方法

对KOA患者进行前瞻性随机对照试验。参与者(n = 198)被分为四组。三组参加为期2天的讲座,课程间隔分别为1个月(第1组)、2个月(第2组)和3个月(第3组)。第4组不参加课程。要求参与者每周至少锻炼三次。所有组中一半的患者每两个月会接到一次电话,强化饮食和运动指导。所有四组都收到了课堂上发放的印刷材料和视频资料。在基线期和初次评估后1年,患者进行FTSST和TUG测试,并回答WOMAC、Lequesne、SF - 36和视觉模拟量表问卷。

结果

在1年随访时,TUG结果未发生变化,而无论是否开展课程或电话指导,FTSST均有所改善(平均差异为4.66,p < 0.001)。基线期及1年时的TUG和FTSST结果与主观功能、疼痛及生活质量结果的相关性较弱(r < 0.3,p < 0.001)。

结论

无论患者主观上有无改善,该教育计划通过增强下肢肌肉力量(FTSST)改善了功能。

试验注册号

临床试验注册号:NCT01572051。

证据级别

1A 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed7d/5569271/9cb8a3129511/bmjsem-2016-000200f01.jpg

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