Web-based therapeutic exercise resource center as a treatment for knee osteoarthritis: a prospective cohort pilot study
Web-based therapeutic exercise resource center as a treatment for knee osteoarthritis: a prospective cohort pilot study
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DOI：
10.1186/1471-2474-15-158
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发表时间：
2014-05-17
影响因子：
2.3
通讯作者：
Heiderscheit, Bryan C.
中科院分区：
文献类型：
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作者：
Brooks, M. Alison;Beaulieu, John E.;Heiderscheit, Bryan C.
背景资料：虽然运动在膝关节骨关节炎（OA）治疗中的有益作用已经确立，但只有14-18%的膝关节OA患者接受初级保健提供者的运动。膝关节OA患者引用缺乏医生锻炼建议作为他们不锻炼以改善病情的主要原因。本初步研究的目的是调查使用基于网络的治疗运动资源中心（TERC）作为工具，规定力量，灵活性和有氧运动作为膝关节OA治疗的一部分。据推测，显着变化的临床结果评分将导致患者使用的TERC.Methods：65个人诊断为轻度/中度膝关节OA的基础上的症状和X光片通过门诊医生诊所。使用运动动画来促进适当的技术，TERC根据运动史、合并症和经验证的疼痛和功能测量，通过多个水平的运动强度分配和进展患者。受试者在基线和完成8周计划时完成改良的简易WOMAC（mSF-WOMAC）、世界卫生组织生活质量（WHO-QOL）和膝关节自我效能量表（K-SES），并完成用户满意度调查。结果：52名参与者完成了为期8周的项目，膝关节疼痛的平均持续时间为8.0 ± 11.0年（25名女性，61.0 ± 9.4年;体重指数，28.8 ± 6.3 kg/m2）。在研究期间，所有结局指标均有所改善：mSF-WOMAC评分降低（疼痛和功能改善）（p < .001;大效应，pr = 0.70）; WHO-QOL身体评分增加（p = .015;中等效应，pr = 0.33）; K-SES评分增加（p < .001;大效应，pr = 0.54）。研究结果与性别、年龄、BMI或症状持续时间无显著差异。患者报告非常积极的评价TERC（94%表示该网站易于使用; 90%指定的运动动画是特别有帮助的）。结论：这项试点研究表明，基于网络的TERC是可行的，有效地改善轻度/中度膝关节骨性关节炎患者的临床结局，并支持未来的研究，比较TERC目前的护理标准，如教育手册。
Background: Although beneficial effects of exercise in the management of knee osteoarthritis (OA) have been established, only 14-18% of patients with knee OA receive an exercise from their primary care provider. Patients with knee OA cite lack of physician exercise advice as a major reason why they do not exercise to improve their condition. The purpose of this pilot study was to investigate use of a web-based Therapeutic Exercise Resource Center (TERC) as a tool to prescribe strength, flexibility and aerobic exercise as part of knee OA treatment. It was hypothesized that significant change in clinical outcome scores would result from patients' use of the TERC.Methods: Sixty five individuals diagnosed with mild/moderate knee OA based on symptoms and radiographs were enrolled through outpatient physician clinics. Using exercise animations to facilitate proper technique, the TERC assigned and progressed patients through multiple levels of exercise intensity based on exercise history, co-morbidities and a validated measure of pain and function. Subjects completed a modified short form WOMAC (mSF-WOMAC), World Health Organization Quality of Life (WHO-QOL) and Knee Self-Efficacy Scale (K-SES) at baseline and completion of the 8 week program, and a user satisfaction survey. Outcomes were compared over time using paired t-tests and effect sizes calculated using partial point biserial (pr).Results: Fifty two participants completed the 8 week program with average duration of knee pain 8.0 +/- 11.0 yrs (25 females; 61.0 +/- 9.4 yrs; body mass index, 28.8 +/- 6.3 kg/m(2)). During the study period, all outcome measures improved: mSF-WOMAC scores decreased (better pain and function) (p < .001; large effect, pr = 0.70); WHO-QOL physical scores increased (p = .015; medium effect, pr = 0.33); and K-SES scores increased (p < .001; large effect, pr = 0.54). No significant differences were found in study outcomes as a function of gender, age, BMI or symptom duration. Patients reported very positive evaluation of the TERC (94% indicated the website was easy to use; 90% specified the exercise animations were especially helpful).Conclusion: This pilot study demonstrated the web-based TERC to be feasible and efficacious in improving clinical outcomes for patients with mild/moderate knee OA and supports future studies to compare TERC to current standard of care, such as educational brochures.