School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.
Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands.
Ann Rheum Dis. 2018 Sep;77(9):1251-1260. doi: 10.1136/annrheumdis-2018-213585. Epub 2018 Jul 11.
Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.
定期进行身体活动(PA)越来越多地被推荐给患有风湿和肌肉骨骼疾病以及一般人群。我们评估了 PA 的公共卫生建议是否适用于患有炎症性关节炎(IA;类风湿关节炎和脊柱关节炎)和骨关节炎(髋关节/膝关节 OA)的人群,以便为临床实践中的 PA 提供循证建议和指导。遵循了 EULAR 制定建议的标准化操作程序。来自 16 个国家的一个工作组(TF)(包括风湿病学家、其他医学专家和内科医生、健康专业人员、患者代表、方法学家)举行了两次会议。在第一次 TF 会议上,确定并定义了 13 个支持系统文献综述(SLR)的研究问题。在第二次会议上,在制定建议、研究议程和教育议程之前,提出并讨论了 SLR 证据。TF 制定并同意了针对 IA 和 OA 患者的 4 项总体原则和 10 项 PA 建议。TF 成员之间的平均一致性得分在 9.8 到 8.8 之间。鉴于其有效性、可行性和安全性的证据,PA 被倡导作为这些疾病整个过程中标准护理的组成部分。最后,TF 就相关的研究和教育议程达成了一致。这些建议基于证据和专家意见,为 PA 干预措施的制定、实施和评估以及在 IA 和 OA 患者中的推广提供指导。建议在考虑个体需求和国家卫生系统的情况下实施这些建议。
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