Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China.
Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
J Evid Based Med. 2023 Sep;16(3):376-393. doi: 10.1111/jebm.12555. Epub 2023 Sep 24.
Knee osteoarthritis (KOA) is the most common degenerative joint disease in China, causing a huge economic burden on patients, families, and society. Standardized KOA rehabilitation treatment is an important means to prevent and treat the disease and promote the development of high-quality medical services. This guideline is updated on the basis of the 2016 and 2019 editions.
Clinical questions regarding rehabilitation assessment and treatment were selected through clinical questions screening and deconstruction, and multiple rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to grade the quality of evidence and recommendations.
The reporting of this guideline followed the standard of Reporting Items for Practice Guidelines in Healthcare (RIGHT). Taking into account patients' preferences and values and the needs of Chinese clinical practice, a total of 11 clinical questions and 28 recommendations were established. The clinical questions were grouped into two categories: KOA assessment (body function, body structure, activity and participation, quality of life, and environmental factors and clinical outcomes assessment, resulting in 9 recommendations) and KOA treatment (health education, therapeutic exercise, therapeutic modalities, occupational therapy, assistive devices, and regenerative rehabilitation approaches, resulting in 19 recommendations).
This is the first evidence-based guideline for KOA rehabilitation in China utilizing the ICF framework. This guideline provides key guidance for developing systematic, standardized, and precise rehabilitation protocols for KOA across various healthcare settings.
膝骨关节炎（KOA）是中国最常见的退行性关节疾病，给患者、家庭和社会带来了巨大的经济负担。规范化的 KOA 康复治疗是预防和治疗疾病、促进高质量医疗服务发展的重要手段。本指南是在 2016 年和 2019 年版的基础上更新的。
通过临床问题筛选和解构，以及多轮德尔菲问卷调查咨询，选择康复评估和治疗相关的临床问题。以国际功能、残疾和健康分类（ICF）为理论框架，采用推荐评估、制定与评价分级（GRADE）方法对证据质量和推荐意见进行分级。
本指南的报告遵循医疗保健实践指南报告条目（RIGHT）标准。考虑到患者的偏好和价值观以及中国临床实践的需求，共建立了 11 个临床问题和 28 条推荐意见。临床问题分为 KOA 评估（身体功能、身体结构、活动和参与、生活质量以及环境因素和临床结局评估，共 9 条推荐意见）和 KOA 治疗（健康教育、治疗性运动、治疗性手段、职业治疗、辅助器具和再生康复方法，共 19 条推荐意见）两个类别。
这是中国首个基于 ICF 框架的 KOA 康复循证指南。本指南为制定各种医疗保健环境下 KOA 系统、规范、精准的康复方案提供了关键指导。
