Associations for change in physical and psychological factors and treatment response following exercise in knee osteoarthritis: an exploratory study.

Associations for change in physical and psychological factors and treatment response following exercise in knee osteoarthritis: an exploratory study.
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DOI:
10.1002/acr.21751
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发表时间:
2012-11
影响因子:
4.7
通讯作者:
Piva, Sara R.
Piva, Sara R.
中科院分区:
医学2区
文献类型:
--
作者:
Fitzgerald, G. Kelley;White, Daniel K.;Piva, Sara R.

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了解治疗性运动后身体和心理因素的变化如何与治疗结果相关,可能对完善膝关节骨关节炎(KOA)的康复计划具有重要意义。这项研究的目的是检查这些因素的变化与KOA患者运动计划后疼痛和功能变化的相关性。152名KOA患者完成了一项运动计划,包括下肢强化,伸展,运动范围,平衡和敏捷性以及有氧运动。计算身体和心理因素从基线到2个月随访的变化,包括自我报告的膝关节不稳定、股四头肌力量、膝关节活动范围、下肢肌肉灵活性、对体力活动的恐惧、焦虑和抑郁症状。治疗应答定义为数字疼痛评定量表(NKPR)和WOMAC身体功能量表较基线至少改善20%。采用logistic回归分析,对年龄、性别、BMI、放射学严重程度和运动组进行相互校正,以检查每个因素与治疗反应的相关性。自我报告的膝关节不稳定的变化(比值比(95%CI)= 1.67(1.13,2.47)和对体力活动的恐惧(比值比(95%CI)= 0.93(0.88,1.00))是调整协变量后与治疗反应显著相关的仅有的两个因素。膝关节不稳定性的改善和对体力活动的恐惧与KOA受试者治疗性运动后积极治疗反应的几率增加相关。
Understanding how changes in physical and psychological factors following therapeutic exercise are associated with treatment outcome could have important implications for refining rehabilitation programs for knee osteoarthritis (KOA). The objective of the study was to examine the association of changes in these factors with changes in pain and function after an exercise program for people with (KOA). 152 people with KOA completed an exercise program consisting of lower extremity strengthening, stretching, range of motion, balance and agility, and aerobic exercises. Change from baseline to the 2-month follow-up was calculated for physical and psychological factors including self-reported knee instability, quadriceps strength, knee range of motion, lower extremity muscle flexibility, fear of physical activity, anxiety, and depressive symptoms. Treatment response was defined as a minimum of a 20% improvement from baseline in BOTH the Numerical Pain Rating Scale (NKPR) and the WOMAC physical function scale. The association of each factor with treatment response was examined with logistic regression mutually adjusted for age, sex, BMI, radiographic severity and exercise group. Change in self-reported knee instability (odds ratio (95%CI) = 1.67 (1.13, 2.47) and fear of physical activity (odds ratio (95%CI) = 0.93 (0.88, 1.00) were the only two factors that were significantly associated with treatment response after adjustment for covariates. Improvement in knee instability and fear of physical activity were associated with an increased odds of a positive treatment response following therapeutic exercise in subjects with KOA.
DOI: 10.2522/ptj.20100188
发表时间: 2011-04-01
期刊: PHYSICAL THERAPY
影响因子: 3.2
作者:
Fitzgerald, G. Kelley;Piva, Sara R.;Irrgang, James J.
通讯作者: Irrgang, James J.
DOI: 10.2106/00004623-199808000-00006
发表时间: 1998-08-01
影响因子: 5.3
作者:
Irrgang, JJ;Snyder-Mackler, L;Harner, CD
通讯作者: Harner, CD
DOI: 10.1177/107319119700400301
发表时间: 1997-09-01
期刊: ASSESSMENT
影响因子: 3.8
作者:
Beck, AT;Steer, RA;Kabat, M
通讯作者: Kabat, M