Barnes Roline Y, Jelsma Jennifer, Parker Romy
Department of Physiotherapy, University of the Free State, South Africa.
Division of Physiotherapy, Department of Health and Rehabilitation Sciences, University of Cape Town, South Africa.
Afr J Disabil. 2019 Feb 25;8:428. doi: 10.4102/ajod.v8i0.428. eCollection 2019.
Musculoskeletal diseases consume a large amount of health and social resources and are a major cause of disability in both low- and high-income countries. In addition, patients frequently present with co-morbid chronic diseases of lifestyle. The area of musculoskeletal disease is restricted by a lack of epidemiological knowledge, particularly in low- and middle-income countries.
This pragmatic randomised controlled trial assessed the benefits of a 6-week physiotherapy intervention for middle-aged women with musculoskeletal conditions compared to usual care.
A weekly 2-h educational programme utilising a workbook, discussion group and exercise class was presented for the intervention group, while the control group received usual care. The primary outcome was health-related quality of life. Parametric and non-parametric data were used to determine the equivalence between the groups.
Twenty-two participants were randomised to the intervention and 20 to the control group. The control group demonstrated no within-group improvement in health-related quality of life items, compared to significant improvements in two items in the intervention group. The change in median utility score within the intervention group was twice as large as the change in the control group. With regard to self-efficacy, the intervention group demonstrated significant within-group changes in perceived management of fatigue and discomfort.
The positive impact of the intervention on the participants suggests that the programme should continue at the clinic in question, but should be presented at a more convenient time for participants who work, as recruitment to the study was less than anticipated. Primary health care systems in South Africa urgently need to put structures in place for effective management of the functional impact of chronic diseases of lifestyle and musculoskeletal conditions. It is time for physiotherapists and possibly other health care professionals to participate in the development of appropriate community level interventions to address the functioning and quality of life of individuals living with the diseases.
肌肉骨骼疾病消耗了大量的健康和社会资源，是低收入和高收入国家残疾的主要原因。此外，患者经常伴有生活方式相关的慢性疾病。肌肉骨骼疾病领域因缺乏流行病学知识而受到限制，特别是在低收入和中等收入国家。
这项实用随机对照试验评估了与常规护理相比，为期6周的物理治疗干预对患有肌肉骨骼疾病的中年女性的益处。
为干预组提供了一个每周2小时的教育项目，包括一本工作手册、一个讨论小组和一个健身班，而对照组接受常规护理。主要结果是与健康相关的生活质量。使用参数和非参数数据来确定两组之间的等效性。
22名参与者被随机分配到干预组，20名被分配到对照组。与干预组两项指标的显著改善相比，对照组在与健康相关的生活质量指标上没有组内改善。干预组中位数效用得分的变化是对照组的两倍。在自我效能方面，干预组在疲劳和不适的感知管理方面表现出显著的组内变化。
干预对参与者的积极影响表明，该项目应在相关诊所继续进行，但对于有工作的参与者，应在更方便的时间进行，因为该研究的招募人数低于预期。南非的初级卫生保健系统迫切需要建立有效管理生活方式慢性疾病和肌肉骨骼疾病功能影响的结构。现在是物理治疗师以及可能其他医疗保健专业人员参与制定适当的社区层面干预措施，以解决患有这些疾病的个人的功能和生活质量问题的时候了。
