Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.
Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands.
Scand J Rheumatol. 2024 Sep;53(5):335-344. doi: 10.1080/03009742.2024.2352965. Epub 2024 Jun 4.
Chronic nonbacterial osteitis (CNO) is a rare bone disease causing pain and functional impairment. We aimed to explore the application of physical therapy (PT) for adult CNO from the patients' and primary care therapists' perspective.
Cross-sectional study among the Dutch adult CNO cohort (1992-present). A survey on PT-use for axial spondylarthritis was adapted for CNO. Patients using PT in the past 2 years (recent PT-users) were asked about modalities, perceived effects, satisfaction, and preferences for provision. Their current physical therapists were invited to complete a self-developed survey covering therapy details and educational preferences.
80/199 invited patients and 14/16 invited therapists completed the survey respectively. 41 (51%) patients used PT for CNO in the preceding 2 years, 14 (18%) used PT >2 years back, and 25 (31%) never used PT. Recent PT-users (n=41) reported diverse treatment modalities, involving massage (61%), joint mobilizations (44%), breathing exercises (49%), muscle strengthening (32%) and counselling through of home-exercises (46%) and pain education (32%). 64% of all patients desired greater emphasis from physicians regarding the role of PT. Most therapists would appreciate referral letters with CNO-specific information (93%), and consultations with specialized therapists (86%).
In this study, two-third of adult CNO patients had -ever or recently- used PT, which involved variable therapeutic modalities. Most patients were receptive to a larger role of PT in CNO-management and most therapists preferred CNO-specific information to optimize their care. These findings provide a foundation for the development and systematic evaluation of CNO-specific PT.
慢性非细菌性骨炎（CNO）是一种罕见的骨骼疾病，可导致疼痛和功能障碍。我们旨在从患者和初级保健治疗师的角度探讨物理治疗（PT）在成人 CNO 中的应用。
横断面研究纳入荷兰成人 CNO 队列（1992 年至今）。对用于治疗强直性脊柱炎的 PT 使用情况进行了调查，并对 CNO 进行了改编。在过去 2 年内使用过 PT 的患者（最近使用 PT 的患者）被问及治疗方式、感知效果、满意度以及提供偏好。邀请他们目前的物理治疗师填写一份自我开发的调查问卷，涵盖治疗细节和教育偏好。
共邀请了 199 名患者中的 80 名和 16 名治疗师中的 14 名完成了调查。41 名（51%）患者在过去 2 年内曾因 CNO 使用过 PT，14 名（18%）患者在 2 年前使用过 PT，25 名（31%）患者从未使用过 PT。最近使用 PT 的患者（n=41）报告了多种治疗方式，包括按摩（61%）、关节松动术（44%）、呼吸练习（49%）、肌肉强化（32%）以及家庭锻炼指导（46%）和疼痛教育（32%）。所有患者中有 64%希望医生更加强调 PT 的作用。大多数治疗师希望收到带有 CNO 具体信息的转诊信（93%）和与专门治疗师的咨询（86%）。
在这项研究中，三分之二的成人 CNO 患者曾经或最近使用过 PT，涉及多种治疗方式。大多数患者对 PT 在 CNO 管理中发挥更大作用持接受态度，大多数治疗师希望提供 CNO 特定信息以优化治疗。这些发现为开发和系统评估 CNO 特定的 PT 提供了基础。
