The Parker Institute, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark; Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg and Frederiksberg, Denmark.
Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark.
Knee. 2020 Dec;27(6):1848-1856. doi: 10.1016/j.knee.2020.09.007. Epub 2020 Nov 13.
Physical inactivity is a global problem and patients with knee osteoarthritis (OA) are predisposed to inactivity and its health-related consequences. Current guidelines recommend exercise as primary treatment but whether this affects time spent physically inactive is unknown. The objective was to investigate changes in physical inactivity among individuals with knee OA following an educational and exercise program.
Pragmatic prospective cohort study performed in six physical therapy clinics in Denmark offering a nationwide education and exercise program for knee OA. The program consists of physiotherapy guided education and group-based or home exercise sessions, performed biweekly for approximately eight weeks. The exercises target knee and hip joint stability as well as focus on increasing muscle strength. Primary outcome was time spent physically inactive (min/day), measured with a tri-axial accelerometer mounted on the lateral side of the thigh during the entire exercise program duration. OA symptoms were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS).
Thirty-two individuals with knee OA were analyzed. From baseline to post-intervention, no changes occurred in average time spent physically inactive (mean change: +16.2 min [95% CI -15.7 to 48.1]; P = 0.31), but statistically significant improvements in KOOS pain (+6.7 points [95% CI 2.3 to 11.0]; P = 0.0032) and KOOS function (+5.8 points [95% CI 1.9 to 9.7]; P = 0.0046) were found.
Participating and completing a widely adopted education and exercise program are not associated with spontaneous improvements in physical inactivity despite changes in self-reported pain and function. Interventions specifically targeting physical inactivity are needed. Registration number: www.clinicaltrials.gov: NCT03125954.
身体活动不足是一个全球性问题，膝骨关节炎（OA）患者易出现身体活动不足及其相关健康后果。目前的指南建议将运动作为主要治疗方法，但这是否会影响身体不活动的时间尚不清楚。本研究旨在调查接受教育和运动计划后膝骨关节炎患者身体不活动的变化。
在丹麦的六家物理治疗诊所进行了一项实用的前瞻性队列研究，这些诊所提供全国性的膝骨关节炎教育和运动计划。该计划包括物理治疗指导的教育以及基于小组或家庭的运动课程，每两周进行一次，持续约八周。运动的目的是增强膝关节和髋关节的稳定性，并侧重于增强肌肉力量。主要结局是使用安装在大腿外侧的三轴加速度计测量的整个运动计划持续期间身体不活动的时间（分钟/天）。OA 症状使用膝关节损伤和骨关节炎结果评分（KOOS）进行评估。
分析了 32 名膝骨关节炎患者。从基线到干预后，身体不活动的平均时间没有变化（平均变化：+16.2 分钟[95%CI-15.7 至 48.1]；P=0.31），但 KOOS 疼痛（+6.7 分[95%CI2.3 至 11.0]；P=0.0032）和 KOOS 功能（+5.8 分[95%CI1.9 至 9.7]；P=0.0046）显著改善。
尽管疼痛和功能自我报告发生了变化，但参与并完成广泛采用的教育和运动计划与身体不活动的自发改善无关。需要专门针对身体不活动的干预措施。注册号：www.clinicaltrials.gov：NCT03125954。
