Park Mi La, Magni Nico, O'Brien Daniel W
Department of Physiotherapy, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
Active Living and Rehabilitation: Aotearoa New Zealand, Pain and Musculoskeletal Conditions Research Group, Health and Rehabilitation Research Institute, School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand.
BMC Rheumatol. 2025 May 27;9(1):63. doi: 10.1186/s41927-025-00496-w.
Osteoarthritis (OA) is a leading cause of lower limb disability worldwide, imposing significant socioeconomic and personal burden. Thus, many internationally recognised organisations have developed management guidelines for this condition. Among these, the National Institute for Health and Care Excellence (NICE) recommends four first-line approaches to osteoarthritis management: education, exercise, self-management, and weight management. Despite the development of guidelines, adherence to OA management recommendations appears to be suboptimal internationally, and little is known about guideline adherence in South Korea. This study aimed to explore whether research-based physiotherapy interventions for OA in South Korea align with the NICE guidelines.
A comprehensive search was conducted across multiple Korean and English electronic databases, including the Korea Citation Index (KCI), Korean Studies Information Service System (KISS), MEDLINE, EMBASE, CINAHL, SPORTDiscus SCOPUS, and Google Scholar. Twelve randomized controlled trials conducted in South Korea met the inclusion criteria, with sample sizes ranging from 20 to 60 participants. Participants' mean age ranged from 57 to 75 years, and their Body Mass Index (BMI) varied from 23.00 to 25.68 kg/m². The primary outcome measure was the alignment of interventions with NICE OA guidelines, assessed using a scoring system (0-2 points per study) developed specifically for this review. Additionally, the methodological quality of included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale.
Most studies had poor methodological quality (PEdro scale range: 3-5). Only 42% of the Korean studies aligned with the NICE OA recommendations. Commonly applied interventions were predominantly passive, such as heat therapy, electrotherapy, and kinesiology taping, none of which are recommended by NICE.
A discrepancy was found between research-based physiotherapy interventions for osteoarthritis in South Korea and the therapeutic approaches recommended by the National Institute for Health and Care Excellence guidelines. Factors such as a lack of evidence-based education, research, healthcare funding in South Korea, and cultural health experiences and expectations of the patients may have contributed to these findings. These results could help develop new strategies for improving osteoarthritis management in South Korea.
骨关节炎（OA）是全球下肢残疾的主要原因，带来了巨大的社会经济和个人负担。因此，许多国际认可的组织都制定了针对这种疾病的管理指南。其中，英国国家卫生与临床优化研究所（NICE）推荐了骨关节炎管理的四种一线方法：教育、运动、自我管理和体重管理。尽管制定了指南，但在国际上，对骨关节炎管理建议的依从性似乎并不理想，而韩国的指南依从性情况鲜为人知。本研究旨在探讨韩国基于研究的骨关节炎物理治疗干预措施是否符合NICE指南。
在多个韩语和英语电子数据库中进行了全面检索，包括韩国引文索引（KCI）、韩国研究信息服务系统（KISS）、MEDLINE、EMBASE、CINAHL、SPORTDiscus SCOPUS和谷歌学术。在韩国进行的12项随机对照试验符合纳入标准，样本量从20至60名参与者不等。参与者的平均年龄在57至75岁之间，体重指数（BMI）在23.00至25.68kg/m²之间。主要结局指标是干预措施与NICE骨关节炎指南的一致性，使用专门为此综述制定的评分系统（每项研究0 - 2分）进行评估。此外，使用物理治疗证据数据库（PEDro）量表评估纳入研究的方法学质量。
大多数研究的方法学质量较差（PEDro量表范围：3 - 5）。只有42%的韩国研究符合NICE骨关节炎建议。常用的干预措施主要是被动的，如热疗、电疗和肌内效贴扎，这些都不是NICE推荐的。
发现韩国基于研究的骨关节炎物理治疗干预措施与英国国家卫生与临床优化研究所指南推荐的治疗方法之间存在差异。韩国缺乏循证教育、研究、医疗保健资金以及患者的文化健康体验和期望等因素可能导致了这些结果。这些结果有助于制定改善韩国骨关节炎管理的新策略。
