Publication: Diz osteoartriti olan hastaların egzersiz programlarına uyumları nasıl artırabiliriz?: randomize kontrollü çalışma
Abstract
Giriş: Osteoartrit hastaların egzersiz tedavisine uyumlarını artırabilecek bir yöntemin sınanmasıdır. Gereç ve Yöntem: Randomize kontrollü bir müdahale çalışmasıdır. Marmara Üniversitesi Hastanesi Aile Hekimliği Kliniği'ne başvuran 64 hasta çalışmaya kabul edilmiştir. Hastaların yarısı müdahale grubuna, diğer yarısı kontrol grubuna randomize edilmiştir. Çalışmanın süresi 12 haftadır. Müdahale grubundaki katılımcılara broşür ve demonstratif olarak egzersiz eğitimleri dereceli olarak artırılarak verilmiştir. Kontrol grubuna ise egzersizleri içeren broşür verilmiştir. Hastaların uyumları hasta günlükleri, telefon takipleri ile değerlendirilmiş, her vizitte tüm katılımcıların Western Ontario and McMaster Universities (WOMAC) skorları saptanmıştır. Bulgular: Katılımcıların %98.4'i kadındır. Müdahale grubundaki katılımcıların ortalama yaşı 56.8±9.27, standart bakım grubundaki katılımcıların ortalama yaşı 52.4±10.0 saptanmıştır. Müdahale grubunun uyumu takip boyunca yüksek düzeydedir (ortanca %100). Müdahale grubundaki katılımcıların ağrı ve WOMAC skorlarında belirgin iyileşme saptanmıştır (sırası ile 43.5 (25.7–50.25), 18.5 (10.5–27.75), 16.5 (9.0–25.0), 9.5 (5.0–18.0)(p=0.0001). Kontrol grubunun egzersiz programına uyumu başlangıçta iyi olmakla beraber, uzun dönemde orta düzeye indiği görülmüştür (sırası ile 72.5 (55.0–97.5) ve 55 (25.0–85.0) (p=0.036). Kontrol grubundaki ağrı ve WOMAC skorundaki iyileşme müdahale grubundan daha düşüktür (sırası ile 36.0 (23.5–42.25), 31.5 (21.25-46.25), 27.0 (15.25–39.0) (p=0.037). Sonuç: Egzersiz eğitiminin, derecelendirilerek ve demonstrasyon ile yapılması uyumu artırabilir.
Introduction: To test the efficacy of a method which can improve compliance of osteoarthtritis patients to exercise treatment. Materials and Method: This is a randomized controlled, intervention study. Sixty-four patients who applied to the Family Medicine outpatient clinic of Marmara University Hospital were enrolled. Half of the paticipants were allocated randomly to the intervention group(IG) and the other half to the control group (CG). The study period was 12 weeks. IG was given leaflets and gradual exercise training by demonstration. CG received leaflet about exercises. We assessed participitans' adherence with patients' diaries and telephone contact. We determined WOMAC scores of the participants at each follow-up visit. Results: Of the participants 98.4% were women. Mean age was 56.8±9.27 in the IG and 52.4±10.0 in the SCG. Adherence to exercise in the IG was high (median 100%). Pain and WOMAC scores improved significantly [chronologically 43.5 (25.7–50.25), 18.5 (10.5–27.75), 16.5 (9.0–25.0), 9.5 (5.0–18.0)(p=0.0001)]. Although exercise adherence of the SCG was good initially, long-term adherence was only moderate (respectively 72.5 (55.0–97.5) and 55 (25.0–85.0)(p=0.036). Improvement of pain and WOMAC score in the SCG was lower than the IG [respectively 36.0 (23.5–42.25), 31.5 (21.25-46.25), 27.0 (15.25–39.0)(p=0.037)]. Conclusion: Gradual exercise education with demonstration might improve adherence.
Introduction: To test the efficacy of a method which can improve compliance of osteoarthtritis patients to exercise treatment. Materials and Method: This is a randomized controlled, intervention study. Sixty-four patients who applied to the Family Medicine outpatient clinic of Marmara University Hospital were enrolled. Half of the paticipants were allocated randomly to the intervention group(IG) and the other half to the control group (CG). The study period was 12 weeks. IG was given leaflets and gradual exercise training by demonstration. CG received leaflet about exercises. We assessed participitans' adherence with patients' diaries and telephone contact. We determined WOMAC scores of the participants at each follow-up visit. Results: Of the participants 98.4% were women. Mean age was 56.8±9.27 in the IG and 52.4±10.0 in the SCG. Adherence to exercise in the IG was high (median 100%). Pain and WOMAC scores improved significantly [chronologically 43.5 (25.7–50.25), 18.5 (10.5–27.75), 16.5 (9.0–25.0), 9.5 (5.0–18.0)(p=0.0001)]. Although exercise adherence of the SCG was good initially, long-term adherence was only moderate (respectively 72.5 (55.0–97.5) and 55 (25.0–85.0)(p=0.036). Improvement of pain and WOMAC score in the SCG was lower than the IG [respectively 36.0 (23.5–42.25), 31.5 (21.25-46.25), 27.0 (15.25–39.0)(p=0.037)]. Conclusion: Gradual exercise education with demonstration might improve adherence.