循证改良后膝关节康复课程的回顾性评估

Dr Laran Chetty
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摘要

膝关节疼痛是一种常见的肌肉骨骼疾病,对世界各地的卫生系统造成了巨大的社会经济负担。治疗膝关节疼痛的传统策略是锻炼。然而,越来越多的人认识到,包括应对和自我管理的教育策略,以改善社会心理结果。目的:本评估的目的是通过比较课前和课后结果测量得分,比较纳入循证教育成分的修订后膝关节康复课程(2021- 2022)与未纳入循证教育成分的先前膝关节康复课程(2020 - 2021)的有效性。方法:采用膝关节损伤和骨关节炎结局评分(oos)和下肢功能量表(LEFS),从2020-21年和2021-22年两组参与者中对英国伦敦北部NHS信托的膝关节康复课程进行回顾性评估。两个班级的数据分别进行分析,然后进行比较。满意度分数是通过参与者在每节课结束时完成的问卷来获取的。使用Excel统计软件(XLSTAT)软件包对数据进行分析。结果:2020-21和2021-22班分别有46例和52例患者参加。当单独分析时,两个班级的kos和LEFS均有显著改善,但比较时无显著差异。2020-21级平均满意度为87.2%,2021-22级平均满意度为91.7%。结论:在膝关节康复课程中加入循证教育部分,包括应对和自我管理策略,结果测量得分有所改善,但不能认为优于仅由运动部分组成的课程。
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A retrospective evaluation of a knee rehabilitation class following evidence-based modifications
Knee pain is a common musculoskeletal disorder and contributes a large socio-economic burden to health systems around the world. The traditional strategy to manage knee pain has been exercise. However, there is growing recognition to include coping and self-management educational strategies to improve psychosocial outcomes. Purpose: The purpose of this evaluation was to compare the effectiveness of a revised knee rehabilitation class that incorporated an evidence-based educational component (2021-22) to the previous knee rehabilitation class that did not incorporated an evidence-based educational component (2020–21) by comparing pre-class and post-class outcome measurement scores. Method: A retrospective evaluation of the knee rehabilitation classes at an NHS Trust in North London, United Kingdom was conducted using the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Lower Extremity Functional Scale (LEFS) from two cohorts of participants from 2020-21 and 2021-22. Data from the two classes were analysed separately and then compared. Satisfaction scores were captured using a questionnaire which participants completed at the end of each class. Data were analysed using the Statistical Software for Excel (XLSTAT) package. Results: A total of 46 and 52 patients attended the 2020-21 and 2021-22 classes respectively. Both classes showed significant improvements in KOOS and LEFS when analysed separately, but no significant difference when compared. The 2020-21 class had a mean satisfaction score of 87.2%, and the 2021-22 class had a mean satisfaction score of 91.7%. Conclusion: The addition of an evidence-based educational component incorporating coping and self-management strategies in a knee rehabilitation class showed improvement in outcome measurement scores but cannot be considered superior to a class which consisted of an exercise component only.
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