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个体化运动处方和个体化建议对髋或膝关节骨关节炎患者的随访:一项随机对照试验。

Follow-up of individualised physical activity on prescription and individualised advice in patients with hip or knee osteoarthritis: A randomised controlled trial.

机构信息

Department of Public Health and Caring Sciences, General Practice, Uppsala University, Uppsala, Sweden.

Centre for Research and Development, Uppsala University/ Region Gävleborg, Gävle, Sweden.

出版信息

Clin Rehabil. 2024 Jun;38(6):770-782. doi: 10.1177/02692155241234666. Epub 2024 Feb 26.

Abstract

OBJECTIVE

Compare the long-term effects of two different individualised physical activity interventions in hip or knee osteoarthritis patients.

DESIGN

Randomised, assessor-blinded, controlled trial.

SETTING

Primary care.

SUBJECTS

Patients with clinically verified hip or knee osteoarthritis, <150 min/week with moderate or vigorous physical activity, aged 40-74.

INTERVENTION

The advice group (n = 69) received a 1-h information and goalsetting session for individualised physical activity. The prescription group (n = 72) received information, goalsetting, individualised written prescription, self-monitoring, and four follow-ups.

MAIN MEASURES

Physical activity, physical function, pain and quality of life at baseline, 6, 12 and 24 months.

RESULTS

There were only minor differences in outcomes between the two groups. For self-reported physical activity, the advice group had improved from a mean of 102 (95% CI 74-130) minutes/week at baseline to 214 (95% CI 183-245) minutes/week at 24 months, while the prescription group had improved from 130 (95% CI 103-157) to 176 (95% CI 145-207) minutes/week (p = 0.01 between groups). Number of steps/day decreased by -514 (95% CI -567-462) steps from baseline to 24 months in the advice group, and the decrease in the prescription group was -852 (95% CI -900-804) steps (p = 0.415 between groups). Pain (HOOS/KOOS) in the advice group had improved by 7.9 points (95% CI 7.5-8.2) and in the prescription group by 14.7 points (95% CI 14.3-15.1) from baseline to 24 months (p = 0.024 between groups).

CONCLUSIONS

There is no evidence that individualised physical activity on prescription differs from individualised advice in improving long-term effects in patients with hip or knee osteoarthritis.

摘要

目的

比较两种不同个体化体力活动干预措施对髋或膝关节骨关节炎患者的长期效果。

设计

随机、评估者盲、对照试验。

地点

初级保健。

受试者

经临床证实患有髋或膝关节骨关节炎、每周中度或剧烈体力活动<150 分钟、年龄 40-74 岁的患者。

干预

建议组(n=69)接受 1 小时的信息和目标设定会议,以进行个体化体力活动。处方组(n=72)接受信息、目标设定、个体化书面处方、自我监测和 4 次随访。

主要测量指标

基线、6、12 和 24 个月时的体力活动、身体功能、疼痛和生活质量。

结果

两组之间的结果只有微小差异。对于自我报告的体力活动,建议组从基线时的平均 102 分钟(95%置信区间 74-130)增加到 24 个月时的 214 分钟(95%置信区间 183-245),而处方组从基线时的 130 分钟(95%置信区间 103-157)增加到 176 分钟(95%置信区间 145-207)分钟/周(两组间 p=0.01)。从基线到 24 个月,建议组每天的步数减少了-514 步(95%置信区间-567-462),而处方组减少了-852 步(95%置信区间-900-804)(两组间 p=0.415)。建议组的疼痛(HOOS/KOOS)从基线改善了 7.9 分(95%置信区间 7.5-8.2),而处方组改善了 14.7 分(95%置信区间 14.3-15.1),从基线到 24 个月(两组间 p=0.024)。

结论

没有证据表明,处方个体化体力活动与髋或膝关节骨关节炎患者的长期效果改善不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18e5/11059830/764ce61d4d54/10.1177_02692155241234666-fig1.jpg

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