物理治疗和康复计划的质量以及远程康复对膝骨关节炎患者的影响。

The quality of physiotherapy and rehabilitation program and the effect of telerehabilitation on patients with knee osteoarthritis.

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey.

Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Gazi University, Ankara, Turkey.

出版信息

Clin Rheumatol. 2023 Mar;42(3):903-915. doi: 10.1007/s10067-022-06417-3. Epub 2022 Oct 24.

Abstract

OBJECTIVE

To compare the effects of telerehabilitation vs home-based exercise programs for knee osteoarthritis (KOA).

METHOD

Patients diagnosed with moderate/mild KOA were enrolled in the study and randomized into two groups. The patients in the telerehabilitation group did their exercises via video conference simultaneously, accompanied by a physiotherapist, while the patients in the control group were given a brochure showing how to do the exercises and explaining how to do each exercise. Patients completed 30-s chair stand test (30 CST), Knee Injury and Osteoarthritis Outcome Score (KOOS), Numeric Rating Scale (NRS), International Physical Activity Questionnaire Short Form (IPAQ-SF), Hospital Anxiety and Depression Scale (HADS), TAMPA Kinesiophobia Scale (TKS), Fatigue Severity Scale (FSS) twice before and after 8-week treatment, and Quality Indicators Questionnaire for Physiotherapy Management of Hip and Knee Osteoarthritis (QUIPA) and Exercise Adherence Rating Scale (EARS) after treatment only. Moreover, the number of painkillers that patients used in the last 15 days was recorded before and after treatment, and patient satisfaction with treatment was questioned after treatment.

RESULTS

Forty-eight patients were included in the study. The mean age of patients was 55.83 ± 6.93 years, and 43 (89.6%) patients were women. No significant differences were determined between groups in terms of baseline characteristics. After the 8-week follow-up, telerehabilitation group demonstrated better 30 CST, IPAQ-SF, KOOS, QUIPA, treatment satisfaction, and total and C subscale of EARS scores increment and greater NRS, HADS, TKS, and FSS score reduction than the control group. It was determined that there was a statistically significant difference between the telerehabilitation and control groups for all of the specified parameters; however, no statistically significant difference was found for the B subscale of EARS.

CONCLUSION

This study indicated that telerehabilitation is superior to self-management. Moreover, through this innovative and population specific web-based approach for KOA, a vast number of patients who have internet access could be reached. Thus, patients with KOA received effective treatment.

摘要

目的

比较远程康复与家庭运动方案治疗膝骨关节炎(KOA)的效果。

方法

将确诊为中度/轻度 KOA 的患者纳入研究并随机分为两组。远程康复组的患者通过视频会议同时进行锻炼,由物理治疗师陪同,而对照组的患者则获得一本小册子,说明如何进行锻炼以及如何进行每项锻炼。患者在治疗前和治疗后分别完成 30 秒椅子站立测试(30 CST)、膝关节损伤和骨关节炎结果评分(KOOS)、数字评分量表(NRS)、国际体力活动问卷短表(IPAQ-SF)、医院焦虑和抑郁量表(HADS)、坦帕运动恐惧量表(TKS)、疲劳严重程度量表(FSS)各两次,仅在治疗后完成物理治疗管理髋和膝关节骨关节炎质量指标问卷(QUIPA)和锻炼依从性评定量表(EARS)。此外,在治疗前后记录患者在过去 15 天内使用的止痛药数量,并在治疗后询问患者对治疗的满意度。

结果

共有 48 名患者入组。患者的平均年龄为 55.83±6.93 岁,其中 43 名(89.6%)为女性。两组在基线特征方面无显著差异。经过 8 周的随访,远程康复组在 30 CST、IPA-SF、KOOS、QUIPA、治疗满意度以及 EARS 的总评分和 C 亚评分增加方面以及 NRS、HADS、TKS 和 FSS 评分降低方面均表现出更好的改善,差异有统计学意义。与对照组相比,远程康复组在所有指定参数方面均具有统计学显著差异;然而,EARS 的 B 亚评分方面无统计学显著差异。

结论

本研究表明,远程康复优于自我管理。此外,通过这种针对 KOA 的创新和特定人群的基于网络的方法,可以接触到大量有互联网接入的患者。因此,患有 KOA 的患者得到了有效的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f41/9589787/015bf19ac6ea/10067_2022_6417_Fig1_HTML.jpg

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