Effectiveness and clinical applicability of integrated rehabilitation programs for knee osteoarthritis.
ABSTRACT Knee osteoarthritis is a common and increasing cause of pain and disability. Exercise and self-management interventions reduce pain and improve function. These interventions are usually delivered separately but, theoretically, the benefits of the physical approach of exercise and the educational approach of self-management interventions could be additive. If correct, rehabilitation programmes that integrate exercise and self-management components might be more effective. This review summarizes and comments on the clinical effectiveness, practicality, cost and implementation of recent studies of integrated rehabilitation programmes.
The programmes varied considerably in content and duration, but in general were safe and effective (improving pain, physical function and other relevant variables). The length, complexity and burden of some programmes limit their acceptability, clinical applicability and increase costs. The most recent programmes have addressed these issues producing programmes that are more clinically and cost-effective than usual care. Implementation of these programmes will require considerable effort and commitment.
Integrated rehabilitation programmes that are acceptable, clinically effective, deliverable and affordable may be the best way of managing the large and increasing number of people suffering chronic knee pain.
SourceAvailable from: J. Haxby Abbott[Show abstract] [Hide abstract]
ABSTRACT: Persistent knee pain in people over 50 years of age is often attributable to knee osteoarthritis (OA), a common joint condition that causes physical and psychological dysfunction. Exercise and pain coping skills training (PCST) can help reduce the impact of persistent knee pain, however, access to health professionals who deliver these services can be challenging. With increasing access to the Internet, remotely delivered Internet-based treatment approaches may provide alternatives for healthcare delivery. This pragmatic randomised controlled trial will investigate whether an Internet-delivered intervention that combines PCST and physiotherapist-guided exercise (PCST + Ex) is more effective than online educational material (educational control) in people with persistent knee pain.BMC Musculoskeletal Disorders 08/2014; 15(1):279. DOI:10.1186/1471-2474-15-279 · 1.90 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: This updated review outlines the influence of muscle activity on knee joint loading, describes the deficits in muscle function observed in people with knee osteoarthritis, and summarizes available evidence pertaining to the role of muscle in the development and progression of knee osteoarthritis. The review also focuses on whether muscle deficits can be modified in knee osteoarthritis and whether improvements in muscle function lead to improved symptoms and joint structure. The review concludes with a discussion of exercise prescription for muscle rehabilitation in knee osteoarthritis.Rheumatic diseases clinics of North America 02/2013; 39(1):145-76. DOI:10.1016/j.rdc.2012.11.003 · 2.59 Impact Factor
[Show abstract] [Hide abstract]
ABSTRACT: Kommentar zur Publikation von Jessep SA, Walsh NE, Ratcliffe J, Hurley MV. Long-term clinical benefits and costs of an integrated rehabilitation programme compared with outpatient physiotherapy for chronic knee pain. Physiotherapy 2009; 95: 94-102Physikalische Medizin Rehabilitationsmedizin Kurortmedizin 01/2009; 19:177-178. · 0.45 Impact Factor