非洲髋、膝和手部骨关节炎最佳证据康复方案的实施:令人担忧的问题。
Implementation of best-evidence rehabilitation for hip, knee and hand osteoarthritis in Africa: A cause for concern.
作者信息
Keller Monique M, Sankah Beatrice
机构信息
Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, 7 York Street, Parktown, 2193, Gauteng, South Africa.
Department of Sports and Exercise Science, School of Allied Health Sciences, University of Cape Coast, Ghana.
出版信息
Osteoarthr Cartil Open. 2025 Mar 29;7(2):100606. doi: 10.1016/j.ocarto.2025.100606. eCollection 2025 Jun.
IMPORTANCE
Evidence-based practice recommendations and guidelines highlight the benefits of exercise, physical activity, weight management, and education for self-management, which are effective in the management of osteoarthritis (OA). However, the uptake among African health professionals remain poor. The objective of this commentary is to highlight the disparity between current best-evidence rehabilitation practices and African health professionals' practices amidst the high prevalence of OA.
OBSERVATIONS
The World Health Organization emphasizes the importance of physical activity in light of the rising OA prevalence in the ageing population, with the burden of comorbid disease negatively impacting the ageing population's quality of life. The concern is that even though the physical activity directive from the World Health Organisation clearly outlines the physical activity targets and best-evidence recommendations and guidelines for managing patients with OA, African health professionals' uptake remain low, potentially to the disadvantage of patients.
CONCLUSIONS AND RELEVANCE
Increasing OA prevalence with subpar rehabilitation may result in lower quality of life and function for individuals diagnosed with hip, knee, hand and other joint OA, leading to a substantial financial burden on the individual, family, community, stakeholders and governmental levels. Development of African context-specific evidence-based rehabilitation guidelines and improved training on current guidelines by universities and professional societies are needed. Policy makers prioritizing OA as a pertinent burden of disease is lacking in Africa. A multidisciplinary team approach is needed where early referral to physiotherapists is emphasized.
重要性
循证实践建议和指南强调了运动、体育活动、体重管理以及自我管理教育的益处,这些对骨关节炎(OA)的管理有效。然而,非洲卫生专业人员对这些建议的采纳率仍然很低。本评论的目的是强调在OA高患病率的情况下,当前最佳循证康复实践与非洲卫生专业人员实践之间的差距。
观察结果
鉴于老龄化人口中OA患病率不断上升,世界卫生组织强调体育活动的重要性,合并症负担对老龄化人口的生活质量产生负面影响。令人担忧的是,尽管世界卫生组织的体育活动指令明确概述了管理OA患者的体育活动目标以及最佳循证建议和指南,但非洲卫生专业人员的采纳率仍然很低,这可能对患者不利。
结论与相关性
康复水平欠佳导致OA患病率上升,可能会降低髋、膝、手和其他关节OA患者的生活质量和功能,给个人、家庭、社区、利益相关者和政府层面带来巨大经济负担。需要制定针对非洲情况的循证康复指南,并由大学和专业协会加强对现行指南的培训。非洲缺乏将OA作为相关疾病负担加以优先考虑的政策制定者。需要采用多学科团队方法,强调早期转诊给物理治疗师。
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