Brief time-based activity pacing instruction as a singular behavioral intervention was not effective in participants with symptomatic osteoarthritis.
Brief time-based activity pacing instruction as a singular behavioral intervention was not effective in participants with symptomatic osteoarthritis.
复制标题
简短的基于时间的活动节奏指导作为单一的行为干预对于有症状的骨关节炎参与者无效。
DOI：
10.1097/j.pain.0000000000000549
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发表时间：
2016
期刊：
影响因子：
7.4
通讯作者：
Williams,DavidA
中科院分区：
文献类型：
--
作者：
Murphy,SusanL;Kratz,AnnaL;Kidwell,Kelley;Lyden,AngelaK;Geisser,MichaelE;Williams,DavidA
下肢骨关节炎(OA)是一种常见的致残原因，其症状会影响活动能力和参与活动。针对骨性关节炎症状的行为自我管理通常被推荐；但这些干预措施没有得到充分利用，在应用中不标准化，有时在临床护理的背景下也不可用。对于慢性疼痛患者，康复专业人员可能会选择将活动起搏指导作为一种行为策略来管理症状。活动起搏被广泛用于与其他药物和行为干预相结合，但尚未被研究为针对OA患者的单一行为干预。这项研究的目的是评估职业治疗师提供的、基于时间的活动起搏计划对有症状的膝关节或髋关节骨关节炎患者的疼痛、疲劳和身体功能的治疗效果。进行了一项三臂随机对照试验，193人被随机分为量身定制活动起搏、一般活动起搏或常规护理组。在基线后10周和6个月进行评估。使用线性混合模型，安大略省西部大学和麦克马斯特大学骨性关节炎指数疼痛评分随着时间的推移而变化，普通护理组和常规护理组下降最多；只有常规护理组在6个月内疼痛减轻。在10周时，定制和一般活动起搏组报告的起搏行为频率高于常规护理组，但在6个月时起搏无法持续。这项试验不支持将基于时间的起搏作为膝盖骨或髋关节骨性关节炎患者的单一行为策略。
Osteoarthritis (OA) of the lower extremities is a prevalent cause of disability in which symptoms interfere with mobility and activity participation. Behavioral self-management for OA symptomatology is commonly recommended; but these interventions are underutilized, unstandardized in application, and at times, unavailable in the context of clinical care. For people with chronic pain, rehabilitation professionals may select to apply activity pacing instruction as one behavioral strategy to manage symptoms. Activity pacing is widely used in combination with other pharmacological and behavioral interventions but has not been studied as a singular behavioral intervention for people with OA. The purpose of this study was to evaluate the effectiveness of an occupational therapistdelivered, time-based activity pacing program for treatment of pain, fatigue, and physical function in people with symptomatic knee or hip OA. A 3-arm randomized controlled trial was conducted in which 193 people were randomized into tailored activity pacing, general activity pacing, or usual care arms. Assessments were done at 10 weeks and 6 months after baseline. Using linear mixed models, Western Ontario and McMaster Universities Osteoarthritis Index pain scores changed over time, decreasing the most in the general and usual care groups; only the usual care group had decreased pain over 6 months. The tailored and general activity pacing groups reported higher frequency of pacing behaviors than the usual care group at 10 weeks, but pacing was not sustained at 6 months. This trial does not support the use of time-based pacing as a singular behavioral strategy for people with knee or hip OA.