膝关节骨关节炎患者教育与运动治疗后基线身体活动参与情况与参与者特征及结局的关联：一项澳大利亚GLA:D前瞻性队列研究。
Association of baseline physical activity participation with participant characteristics and outcomes following education and exercise-therapy in people with knee osteoarthritis: A GLA:D Australia prospective cohort study.
作者信息
Bell Emily C, Pazzinatto Marcella F, Wallis Jason A, Kemp Joanne L, Skou Søren T, O'Halloran Paul, Crossley Kay M, De Oliveira Silva Danilo, Semciw Adam I, Dundules Karen, Barton Christian J
机构信息
La Trobe Sport & Exercise Medicine Research Centre (LASEM), School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia.
School of Public Health & Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
出版信息
Musculoskeletal Care. 2023 Dec;21(4):1470-1481. doi: 10.1002/msc.1828. Epub 2023 Oct 5.
OBJECTIVES
To investigate whether participants with knee osteoarthritis classified as 'more' or 'less' physically active at baseline differ in characteristics and/or outcomes at baseline and at 3 and 12 months following the commencement of an education and exercise-therapy program.
METHODS
Prospective cohort study using the GLA:D Australia registry. The University of California, Los Angeles Physical Activity Scale (UCLA) participant data dichotomised as 'more' (≥7) or 'less' active (≤6). Groups were compared using chi-square (obesity [baseline only], comorbidity prevalence, medication consumption, fear of damage from physical activity); and linear mixed model regression (12-item Injury Osteoarthritis Outcome Score [KOOS-12], pain [visual analogue scale], health-related quality of life [QoL] [EQ-5D-5L]) statistics, adjusted for age, sex and baseline physical activity at 3 and 12 months.
RESULTS
We included 1059 participants (70% female). At baseline, 267 (25%) were classified as 'more' active, increasing to 29% and 30% at 3 and 12 months, respectively. At baseline, compared to the 'less' active group, the 'more' active group had a lower proportion of participants who were obese ('more' = 21% vs. 'less' = 44%), had comorbidities (58% vs. 74%) and consumed medications (71% vs. 85%); lower pain intensity (37 vs. 47); and higher KOOS-12 (59 vs. 50), and health-related QoL (0.738 vs. 0.665) scores. When accounting for age, sex and baseline physical activity, improvements seen in knee-related burden and health-related QoL were not different between groups at 3 or 12 months. Compared to the 'less' active group, the proportion of participants not consuming medication remained higher in the 'more' active group at 3 ('more' 45% vs. 'less' 28%) and 12 months (43% vs. 32%).
CONCLUSION
'More' active people with knee osteoarthritis were less likely to be obese, had fewer comorbidities, lower medication consumption, knee-related burden and pain intensity, and higher health-related QoL than 'less' active participants at all timepoints.
目的
调查在教育和运动治疗项目开始时，被分类为基线时身体活动“较多”或“较少”的膝骨关节炎参与者在基线、3个月和12个月时的特征和/或结果是否存在差异。
方法
使用澳大利亚GLA:D注册中心进行前瞻性队列研究。将加利福尼亚大学洛杉矶分校身体活动量表（UCLA）的参与者数据分为“较多”（≥7）或“较少”活跃（≤6）两类。使用卡方检验（肥胖[仅基线时]、合并症患病率、药物消耗、对体育活动损伤的恐惧）对两组进行比较；并使用线性混合模型回归（12项损伤性骨关节炎结局评分[KOOS-12]、疼痛[视觉模拟量表]、健康相关生活质量[QoL][EQ-5D-5L]）统计方法，对3个月和12个月时的年龄、性别和基线身体活动进行调整。
结果
我们纳入了1059名参与者（70%为女性）。在基线时，267名（25%）被分类为“较多”活跃，在3个月和12个月时分别增至29%和30%。在基线时，与“较少”活跃组相比，“较多”活跃组肥胖参与者的比例较低（“较多”=21% vs. “较少”=44%）、有合并症的比例较低（58% vs. 74%）、药物消耗较少（71% vs. 85%）；疼痛强度较低（37 vs. 47）；KOOS-12评分较高（59 vs. 50）以及健康相关生活质量评分较高（0.738 vs. 0.665）。在考虑年龄、性别和基线身体活动后，3个月或12个月时两组在膝关节相关负担和健康相关生活质量方面的改善没有差异。与“较少”活跃组相比，“较多”活跃组在3个月（“较多”45% vs. “较少”28%）和12个月（43% vs. 32%）时未服用药物的参与者比例仍然较高。
结论
在所有时间点，与“较少”活跃的膝骨关节炎参与者相比，“较多”活跃者肥胖的可能性较小，合并症较少，药物消耗较少，膝关节相关负担和疼痛强度较低，健康相关生活质量较高。
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