Ismail Ayah, Moore Catherine, Alshishani Natasha, Yaseen Khalid, Alshehri Mansour Abdullah
Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdul Aziz University: Jeddah, Saudi Arabia.
J Phys Ther Sci. 2017 Dec;29(12):2228-2235. doi: 10.1589/jpts.29.2228. Epub 2017 Dec 13.
[Purpose] To investigate the effectiveness of cognitive-behavioural therapy (CBT) and pain coping skills training (PCST) on pain level in adults with osteoarthritis of the knee (KOA) in comparison with usual care. [Subjects and Methods] Five databases were systematically searched for relevant randomised controlled trials (RCTs) according to the selected eligibility criteria (inception to June 7, 2016). PEDro scale was used to assess the validity of included studies. [Results] Four studies met the inclusion criteria and all studies had high methodological quality. The total number of participants was 665 across the four included studies. All participants had been diagnosed with KOA (clinical and radiographic evaluation). The majority of the population were female (71.13%). The interventions utilised were: CBT, CBT for insomnia (CBT-I), PCST, and PCST combined with behavioral weight management (BWM) in one study and with exercise in another study. The outcome measure for pain in KOA was the WOMAC scale. Overall, three studies have reported clinical improvement in KOA pain perception after 12-month follow-up time point. [Conclusion] This review has recognised the need for future studies that have rigorous methodological quality, and investigate the effect of mutual CBT and PCST protocols on KOA pain and pain-related functional and psychological abilities.
[目的] 与常规护理相比,探讨认知行为疗法(CBT)和疼痛应对技能训练(PCST)对膝骨关节炎(KOA)成人患者疼痛程度的有效性。[对象与方法] 根据选定的纳入标准(起始至2016年6月7日),系统检索五个数据库以查找相关随机对照试验(RCT)。使用PEDro量表评估纳入研究的有效性。[结果] 四项研究符合纳入标准,所有研究均具有较高的方法学质量。四项纳入研究的参与者总数为665人。所有参与者均经诊断患有KOA(临床和影像学评估)。大多数人群为女性(71.13%)。所采用的干预措施包括:CBT、失眠认知行为疗法(CBT-I)、PCST,以及一项研究中PCST与行为体重管理(BWM)相结合,另一项研究中PCST与运动相结合。KOA疼痛的结局指标为WOMAC量表。总体而言,三项研究报告了在12个月随访时间点后KOA疼痛感知的临床改善情况。[结论] 本综述认识到未来研究需要具备严格的方法学质量,并研究相互的CBT和PCST方案对KOA疼痛以及与疼痛相关的功能和心理能力的影响。