Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial.
Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial.
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DOI：
10.2196/10021
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发表时间：
2018-05-09
影响因子：
7.4
通讯作者：
Bennell KL
中科院分区：
文献类型：
--
作者：
Lawford BJ;Hinman RS;Kasza J;Nelligan R;Keefe F;Rini C;Bennell KL
互联网提供的锻炼、教育和疼痛应对技能培训对膝骨性关节炎患者有效，但尚不清楚这种治疗是否更适合特定的患者亚群。其目的是探索互联网传递的干预对膝骨性关节炎患者疼痛和身体功能变化的影响的人口统计学和临床调节因素。对148名膝骨性关节炎患者的数据进行了探索性分析，这些人参加了一项随机对照试验，比较了互联网提供的锻炼、教育和疼痛应对技能培训与单独使用互联网提供的教育。主要结果是在3个月和9个月时膝关节行走时疼痛(11分数字分级量表)和身体功能(安大略省西部大学和麦克马斯特大学骨关节炎指数功能子量表)的变化。独立的回归模型以调节变量(年龄、性别、对结果的预期、自我效能[疼痛]、教育程度、就业状况、疼痛灾难、体重指数)和研究组作为协变量，包括两者之间的相互作用。在3个月时，目前受雇的干预组参与者的疼痛减轻程度显著高于对照组中的类似参与者(组间差异：平均值2.38，95%可信区间1.52-3.23数值评级量表单位；交互作用P=0.02)。此外，在干预组中，与对照组的平均0.11个数字分级单位(95%CI-0.13至0.35；交互作用P=0.02)相比，干预组在3个月时疼痛平均减少0.53(95%可信区间0.28-0.78)个单位。在互联网提供的锻炼、教育和疼痛应对技能培训计划后3个月，有工作并具有较高自我效能感的人更有可能体验到更大的疼痛改善。没有证据表明不同性别、教育水平、对治疗结果的预期、不同年龄、体重指数或灾难性疼痛倾向的影响存在差异。研究结果支持互联网提供的护理对范围广泛的膝骨性关节炎患者的有效性，但未来还需要验证性研究。澳大利亚-新西兰临床试验注册机构ACTRN12614000243617；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true(由http://www.webcitation.org/6z466oTPs)网站存档
Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI –0.13 to 0.35; interaction P=.02) for the control group. People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs)
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影响因子：
3.1
作者：
Osman, A;Barrios, FX;Grittmann, L
通讯作者：
Grittmann, L
DOI：
10.1249/mss.0b013e3181ae96a9
发表时间：
2010-01-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Cadmus, Lisa;Patrick, Marsha B.;Patrick, Donald L.
通讯作者：
Patrick, Donald L.
影响因子：
7.4
作者：
Gros, Daniel F.;Price, Matthew;Acierno, Ron
通讯作者：
Acierno, Ron
影响因子：
4.7
作者：
Murphy, Louise B.;Sacks, Jeffrey J.;Chapman, Daniel P.
通讯作者：
Chapman, Daniel P.
影响因子：
2.3
作者：
Dobson F;Hinman RS;French S;Rini C;Keefe F;Nelligan R;Abbott JH;Bryant C;Staples MP;Dalwood A;Bennell KL
通讯作者：
Bennell KL