髋关节和/或膝关节 OA 患者疼痛、身体功能和参与度变化的预后因素:系统综述。

IF 3.7 2区 医学 Q1 RHEUMATOLOGY Arthritis Care & Research Pub Date : 2024-09-03 DOI:10.1002/acr.25428
Bastiaan Cijs, Ruben Stekelenburg, Cindy Veenhof, Jesper Knoop, Tim Boymans, Mariëtte de Rooij, Corelien Kloek
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引用次数: 0

摘要

研究目的本研究旨在系统综合有关膝关节和/或髋关节 OA 患者疼痛、身体功能和参与度任一方向变化(即恶化或改善)的预后因素的文献:方法:对前两篇综述中的研究进行全文筛选,以纳入本次综述。此外,还在五个数据库中进行了广泛的文献检索。标题/摘要筛选采用主动学习程序进行。纳入标准包括确诊为膝关节和/或髋关节OA的患者,因变量为疼痛、身体功能或参与度。潜在的相关预后因素作为自变量进行测量。研究的方法学质量按照海登标准进行评估:本系统综述共纳入 31 项研究。在膝关节 OA 患者中,疼痛恶化与较低的身体功能相关(强证据),与较高的体重指数、种族和较高的合并症计数相关(中等证据)。同样,膝关节 OA 患者的疼痛改善与基线疼痛减轻有关(中等证据)。在膝关节和/或髋关节 OA 患者中,身体机能的恶化与较高的体重指数、较多的疼痛、较多的髋关节疼痛、较高的合并症数量、较多的回避活动(强证据)和种族(中等证据)有关。在膝关节 OA 患者中,身体机能的改善与活力的提高有关(中等证据)。至于其余的预后因素,与结果相关的证据不足、不确定或不一致。在髋关节OA患者中,只有三项预测身体机能变化的因素证据不足:本综述涵盖了与疼痛、身体功能和参与度的任一方向变化(即恶化或改善)相关的预后因素。结果与其他综述一致。未来的研究应更加重视髋关节OA患者,并将参与作为一项结果。
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Prognostic Factors and Changes in Pain, Physical Functioning, and Participation in Patients With Hip and/or Knee Osteoarthritis: A Systematic Review.

Objective: This study aimed to systematically synthesize literature on prognostic factors of changes in either direction (ie, worsening or improvement) in pain, physical functioning, and participation in patients with knee and/or hip osteoarthritis (OA).

Methods: Studies included in two preceding reviews underwent full-text screening for inclusion in the current review. Additionally, an extensive literature search was conducted in five databases. Title/abstract screening was performed using an active learning program. Inclusion criteria comprised patients diagnosed with knee and/or hip OA, with the dependent variable assessing pain, physical functioning, or participation. Potential associated prognostic factors were measured as independent variables. The methodologic quality of studies was assessed with the Hayden criteria.

Results: A total of 31 studies were included in this systematic review. In patients with knee OA, pain worsening was associated with lower physical functioning (strong evidence) and with higher body mass index, ethnicity, and a higher comorbidity count (moderate evidence). Also, in patients with knee OA, pain improvement was associated with less pain at baseline (moderate evidence). In patients with knee and/or hip OA, worsening of physical functioning exhibited associations with higher body mass index, more pain, more hip pain, a higher comorbidity count, higher avoidance of activities (strong evidence), and ethnicity (moderate evidence). In patients with knee OA, improvement in physical functioning showed an association with higher vitality (moderate evidence). Regarding the remaining prognostic factors, there is weak, inconclusive, or inconsistent evidence for an association with the outcomes. In patients with hip OA, only weak evidence was found for three factors predicting a change in physical functioning.

Conclusion: This review encompasses prognostic factors associated with changes in either direction (ie, worsening or improvement) in pain, physical functioning, and participation. The results are consistent with other reviews. Future research should place a stronger emphasis on patients with hip OA and participation as an outcome.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
期刊最新文献
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