摘要
目的评价结构化健康教育及运动处方治疗对膝关节骨关节炎(knee osteoarthritis,KOA)的短期疗效。方法前瞻性队列研究,以问卷链接的形式向符合3年入组年限的162例KOA患者发放问卷,内容包括:膝关节损伤和骨关节炎评分(knee injury and osteoarthritis score,KOOS)、膝关节疼痛视觉模拟评分(visual analogue scale,VAS)、间歇性持续骨关节炎疼痛(intermittent and constant osteoarthritis pain,ICOAP)评分、自我效能评分。数据回收整理后,采用重复测量资料的混合线性模型来对比分析各项指标的基线与3、36个月的变化趋势,以评价结构化健康教育结合运动处方治疗KOA的短期疗效。结果数据回收整理得出有完整基线、3个月及36个月数据的109例,问卷随访完成率67.3%。运动治疗干预后36个月数据与基线数据对比临床指标变化趋势,KOOS疼痛评分由基线的(70.8±1.7)分改善至36个月的(79.7±1.8)分,差异有统计学意义(P<0.05);KOOS症状评分由基线(66.8±2.0)分改善至36个月的(74.9±2.1)分,差异有统计学意义(P<0.05);KOOS日常功能评分由基线(81.7±1.4)分改善至36个月(87.0±1.5)分,差异有统计学意义(P<0.05);KOOS运动功能评分由基线(47.4±2.8)分改善至36个月的(55.0±2.9)分,差异有统计学意义(P<0.05);KOOS生活质量评分由基线的(46.6±2.1)分改善至36个月时的(63.5±2.2)分,差异有统计学意义(P<0.05)。KOOS五项评分均有差异有统计学意义(F=14.548、8.102、11.394、5.687、25.942,均P<0.05);其余指标:左膝VAS疼痛评分、右膝VAS疼痛评分、ICOAP评分、自我效能-疼痛评分、自我效能其他症状评分等均有显著改善(F=17.643、26.791、8.290、4.052、3.654,均P<0.05)。结论结构化健康宣教结合运动处方治疗中老年KOA患者对其膝关节疼痛、功能、自我效能等方面具有短期疗效。
Objective To evaluate the long-term effect of structured patient education and exercise therapy for knee osteoarthritis(KOA).Methods Prospective cohort study,162 patients with KOA were consecutively recruited from May 2016 to December 2019 to receive structured patient education and exercise therapy and were followed up 3 years after the recruitment.All the patients received two 1-hour educational courses and exercise therapy twice per week for six weeks under the supervision of physicians or physical therapists.Knee injury and osteoarthritis score(KOOS),visual analog score of pain(VAS),intermittent and constant OA pain(ICOAP),self-efficacy for arthritis were queried at 3-month and 36-month follow-up visit.We fitted linear mixed-effects models to examine the difference in scores between baseline and 3-month and 36-month visits.Results 109(67.3%)patients finished both 3-month and 36-month follow-up visits.The KOOS pain score increased from 70.8±1.7 at baseline to 79.7±1.8 at 36 months(P<0.05).The KOOS symptom score increased from 66.8±2.0 at baseline to 74.9±2.1 at 36 months(P<0.05).The KOOS daily function score increased from 81.7±1.4 at baseline to 87.0±1.5 at 36 months(P<0.05).KOOS motor function score increased from 47.4±2.8 at baseline to 55.0±2.9 at 36 months(P<0.05).The quality of life score of KOOS increased from 46.6±2.1 at baseline to 63.5±2.2 at 36 months(P<0.05).Compared with the baseline data,there were statistically significant improvements in all subscales of KOOS in 36 months after exercise therapy intervention(F=14.548,8.102,11.394,5.687 and25.942,P<0.05).VAS pain score of left knee,VAS pain score of right knee,ICOAP score,self-efficacy pain score and other symptoms were also significantly improved(F=17.643,26.791,8.290,4.052 and 3.654,P<0.05).Conclusion Structured patient education and exercise therapy are effective in improving knee pain and function as well as self-efficacy until as long as 36 months.
作者
李志坤
刘强
邢丹
王锴
张立毅
林剑浩
Li Zhikun;Liu Qiang;Xing Dan;Wang Kai;Zhang Liyi;Lin Jianhao(Department of Orthopaedics,People's Hospital of Peking University 100044)
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2021年第21期1561-1568,共8页
Chinese Journal of Orthopaedics
基金
国家自然科学基金(81902247
81672183)
科技部国家重点研发计划(2020YFC2004904)
北京市科技计划(D171100003217002
Z181100001618020)。
关键词
骨关节炎
膝
健康教育
运动疗法
调查和问卷
队列研究
Osteoarthritis,knee
Health education
Exercise therapy
Surveys and questionnaires
Cohort study
