Burke Colleen A, Seidler Katie J, Rethorn Zachary D, Hoenig Helen, Allen Kelli, Tabriz Amir Alishahi, Norman Katherine, Murphy-McMillan Laura K, Sharpe Jason, Joseph Letha M, Dietch Jessica R, Kosinski Andrzej S, Cantrell Sarah, Gierisch Jennifer M, Ear Belinda, Gordon Adelaide, Goldstein Karen M
Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina.
Department of Population Health Sciences, Duke University, Durham, North Carolina.
J Geriatr Phys Ther. 2024 Jan 12. doi: 10.1519/JPT.0000000000000402.
To evaluate the impact of physical rehabilitation interventions, supplemented with one or more adherence-enhancing components, on outcomes among adults with hip or knee osteoarthritis or chronic lower back pain.
Primary literature search from inception of each database to July 27, 2021, guided by relevant search terms and keywords to search titles and abstracts. All articles meeting eligibility criteria were included for data abstraction.
MEDLINE, CINAHL Complete, and Embase.
Randomized and nonrandomized trials evaluating adherence-focused intervention components conducted in addition to an index usual care or usual care-like physical rehabilitation program among adults with hip or knee osteoarthritis or chronic low back pain. Eligible studies included a comparator group of the same index physical rehabilitation intervention without the adjunctive adherence components. Included studies measured outcomes at least 3 months after the rehabilitation course.
Of the 10 studies meeting inclusion criteria, 6 interventions were delivered concurrent to an index rehabilitation program and 4 were delivered sequentially. Of the 3 studies that reported a positive effect on long-term adherence, only 1 was a low risk of bias study. There is very limited evidence of a beneficial treatment effect of adjunct adherence interventions on long-term physical function, self-efficacy, or adverse events.
We found inadequate evidence evaluating adherence-enhancing interventions for the specific promotion of long-term adherence to home rehabilitation programs. Future studies should consider testing interventions specifically built to target behavioral maintenance of home rehabilitation programs.
评估在髋或膝骨关节炎或慢性下背痛的成年人中，补充一种或多种增强依从性成分的物理康复干预措施对治疗结果的影响。
从每个数据库创建之初到2021年7月27日进行主要文献检索，以相关检索词和关键词为指导检索标题和摘要。所有符合纳入标准的文章都纳入数据提取。
MEDLINE、CINAHL Complete和Embase。
在髋或膝骨关节炎或慢性下背痛的成年人中，除了标准常规护理或类似常规护理的物理康复计划之外，评估以依从性为重点的干预成分的随机和非随机试验。符合条件的研究包括一个采用相同标准物理康复干预但没有辅助依从性成分的对照组。纳入的研究在康复疗程结束后至少3个月测量结果。
在符合纳入标准的10项研究中，6项干预措施与标准康复计划同时实施，4项依次实施。在3项报告对长期依从性有积极影响的研究中，只有1项是低偏倚风险研究。几乎没有证据表明辅助依从性干预措施对长期身体功能、自我效能或不良事件有有益的治疗效果。
我们发现评估增强依从性干预措施以具体促进长期坚持家庭康复计划的证据不足。未来的研究应考虑测试专门针对维持家庭康复计划行为而设计的干预措施。
