Physical exercise supervised or not by a physiotherapist in the treatment of lower-limb osteoarthritis. Elaboration of French clinical practice guidelines

Delarue, Y.; Branche, B. de; Anract, Philippe; Revel, Michel; Rannou, François

doi:10.1016/j.annrmp.2007.09.002

Cited by 18 publications

(4 citation statements)

References 47 publications

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“…Supervised exercise programs for knee OA are often felt to achieve better outcomes in terms of reduction of pain and short-term incapacity compared to non-supervised programs [37]. …”

Section: Discussionmentioning

confidence: 99%

Web-based therapeutic exercise resource center as a treatment for knee osteoarthritis: a prospective cohort pilot study

Brooks

Beaulieu

Severson

et al. 2014

BMC Musculoskelet Disord

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BackgroundAlthough 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.MethodsSixty 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).ResultsFifty 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/m2). 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).ConclusionThis 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.

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“…Supervised exercise programs for knee OA are often felt to achieve better outcomes in terms of reduction of pain and short-term incapacity compared to non-supervised programs [37]. …”

Section: Discussionmentioning

confidence: 99%

Web-based therapeutic exercise resource center as a treatment for knee osteoarthritis: a prospective cohort pilot study

Brooks

Beaulieu

Severson

et al. 2014

BMC Musculoskelet Disord

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“…If psychosocial factors such as fear of movement or catastrophising cognitions underlie a disabled, sedentary lifestyle, then consider a multidisciplinary intervention including cognitive-behavioural therapy [44 p802-803] Manage uncertainty Addressing uncertainties about prognosis or outcomes (1, 2.7) [ 41 ] Clinicians are encouraged to continually provide their patients with necessary information about OA disease progression and self-care techniques and to promote hope, optimism, and a positive expectation of benefit from treatment [41 p1583] -- Share decisions Engaging patient in discussion and decision-making. Including planning care with patients and tailoring plan to diverse characteristics, including patient characteristics, preferences, circumstances (e.g., finances) (22, 61.1) [ 9 , 10 , 36 , 37 , 39 – 45 , 47 , 49 – 55 , 65 – 69 ] Treatment decisions should be made in light of all circumstances presented by the patient [54 p4] Each health professional must decide with each patient the most appropriate management plan at a particular time and for that location. Many patient-centred factors are important in determining the selection of treatments for individual patients with knee OA—for example, psychosocial factors and OA status; comorbid disease and drugs; patient beliefs about their knee OA; patient beliefs and preferences for its management; and previous patient experiences of treatments and health professionals.…”

Section: Resultsmentioning

confidence: 99%

Identifying strategies that support equitable person-centred osteoarthritis care for diverse women: content analysis of guidelines

Abuwa,

Abbaticchio,

Theodorlis

et al. 2023

BMC Musculoskelet Disord

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Introduction Women are disproportionately impacted by osteoarthritis (OA) but less likely than men to access early diagnosis and management, or experience OA care tailored through person-centred approaches to their needs and preferences, particularly racialized women. One way to support clinicians in optimizing OA care is through clinical guidelines. We aimed to examine the content of OA guidelines for guidance on providing equitable, person-centred care to disadvantaged groups including women. Methods We searched indexed databases and websites for English-language OA-relevant guidelines published in 2000 or later by non-profit organizations. We used manifest content analysis to extract data, and summary statistics and text to describe guideline characteristics, person-centred care (PCC) using a six-domain PCC framework, OA prevalence or barriers by intersectional factors, and strategies to improve equitable access to OA care. Results We included 36 OA guidelines published from 2003 to 2021 in 8 regions or countries. Few (39%) development panels included patients. While most (81%) guidelines included at least one PCC domain, guidance was often brief or vague, few addressed exchange information, respond to emotions and manage uncertainty, and none referred to fostering a healing relationship. Few (39%) guidelines acknowledged or described greater prevalence of OA among particular groups; only 3 (8%) noted that socioeconomic status was a barrier to OA care, and only 2 (6%) offered guidance to clinicians on how to improve equitable access to OA care: assess acceptability, availability, accessibility, and affordability of self-management interventions; and employ risk assessment tools to identify patients without means to cope well at home after surgery. Conclusions This study revealed that OA guidelines do not support clinicians in caring for diverse persons with OA who face disadvantages due to intersectional factors that influence access to and quality of care. Developers could strengthen OA guidelines by incorporating guidance for PCC and for equity that could be drawn from existing frameworks and tools, and by including diverse persons with OA on guideline development panels. Future research is needed to identify multi-level (patient, clinician, system) strategies that could be implemented via guidelines or in other ways to improve equitable, person-centred OA care. Patient or public contribution This study was informed by a team of researchers, collaborators, and thirteen diverse women with lived experience, who contributed to planning, and data collection, analysis and interpretation by reviewing study materials and providing verbal (during meetings) and written (via email) feedback.

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“…Ces mêmes résultats suggèrent qu'il est préférable de débuter les programmes d'exercices sous la conduite d'un kinésithérapeute puis de les poursuivre seul à domicile avec une observance aussi bonne que possible. Le type d'exercices physiques, son intensité et sa fréquence doivent être personnalisés [11].…”

Section: Rééducation Programme D'exercicesunclassified

Place du médecin de médecine physique et de réadaptation dans la prise en charge de la gonarthrose non opérée

Collado

Bensoussan

Viton

et al. 2011

Lett Med Phys Readapt

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Physical exercise supervised or not by a physiotherapist in the treatment of lower-limb osteoarthritis. Elaboration of French clinical practice guidelines

Cited by 18 publications

References 47 publications

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

Identifying strategies that support equitable person-centred osteoarthritis care for diverse women: content analysis of guidelines

Place du médecin de médecine physique et de réadaptation dans la prise en charge de la gonarthrose non opérée

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