Center for treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway
Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center (LUMC), Leiden, Netherlands.
Ann Rheum Dis. 2024 May 15;83(6):730-740. doi: 10.1136/ard-2023-225041.
INTRODUCTION: Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed. METHODS: The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed. RESULTS: The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0-10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work. CONCLUSIONS: The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.
简介:髋和膝关节骨关节炎(OA)越来越常见,对个人和社会都有重大影响。非药物治疗被认为是减少疼痛、改善功能和生活质量的重要手段。2013 年发布了 EULAR 关于髋和膝关节 OA 的非药物核心管理的建议。鉴于随后有大量研究,需要进行更新。
方法:遵循 EULAR 建议的标准操作程序。成立了一个由 25 名成员组成的多学科工作组,代表 14 个欧洲国家。工作组就更新的 11 个研究问题达成一致的搜索策略。系统文献综述涵盖了 2012 年 1 月 1 日至 2022 年 5 月 27 日的数据。讨论了检索到的证据,制定了更新的建议,并制定了研究和教育议程。
结果:修订后的建议包括两个总体原则和八项基于证据的建议,包括(1)个体化、多组分管理计划;(2)信息、教育和自我管理;(3)运动锻炼并适当调整剂量和进度;(4)运动锻炼的方式;(5)保持健康体重和减轻体重;(6)鞋类、助行器和辅助设备;(7)工作相关建议;(8)行为改变技术以改善生活方式。对建议的平均共识程度在 9.2 到 9.8 之间(0-10 分制,10 分为完全同意)。研究议程突出了与这些干预措施相关的领域,包括依从性、采用率以及对工作的影响。
结论:根据研究证据和专家意见制定了 2023 年更新的建议,以指导髋和膝关节 OA 的最佳管理。
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