Best-practice clinical management of flares in people with osteoarthritis: A scoping review of behavioral,lifestyle and adjunctive treatments |
| |
| Institution: | 1. Institute of Bone and Joint Research, Kolling Institute, The University of Sydney, Sydney, Australia;2. Department of Rheumatology, Royal North Shore Hospital, Sydney, Australia;3. Macquarie University, Sydney, Australia;4. Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK;5. Université de Lorraine, Nancy, France;6. Haywood Academic Rheumatology Centre, Haywood Hospital, Midlands Partnership NHS Foundation Trust, Staffordshire, UK;1. Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton T6G 2G3, Alberta, Canada;2. CARE Arthritis, CARE Arthritis Ltd. 316 Windermere Road NW Unit 210, Edmonton T6W 2Z8, Alberta, Canada;3. Department of Radiology and Diagnostic Imaging, University of Alberta Hospital, 2A2.41 WC Mackenzie Health Sciences Centre, 8440 112 Street NW, T6G 2B7, Medical Imaging Consultants, 202-11010 - 101 Street NW, T5H 4B9, Edmonton, Alberta, Canada;4. Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Valdemar Hansen Vej 17, 2600 Glostrup, Copenhagen, Denmark;5. Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark;6. Practice Buchsbaum, Schaffhausen, Switzerland;2. The University of Sydney, Institute of Bone and Joint Research, The Kolling Institute, Sydney Medical School, Sydney, Australia;3. Musculoskeletal Health Sydney, University of Sydney, Sydney, Australia;4. Department of Chiropractic, Macquarie University, Sydney, Australia;5. Spine Service, Department of Orthopaedic Surgery, St. George & Sutherland Clinical School, University of New South Wales Australia, Kogarah, Sydney, Australia;6. Department of General Practice, Erasmus MC, Rotterdam, the Netherlands;11. Institute for Health and Society, Department of General Practice, University of Oslo, Oslo, Norway;12. Department of Rheumatology, Royal North Shore Hospital, Sydney, New South Wales, Australia;8. Department of Family Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts;9. Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Stockholm, Sweden;10. Universite de Lorraine, CHRU Nancy, Inserm, CIC1433-Epidemiologie Clinique, Nancy, France;112. Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark;123. Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, School of Health Sciences, Melbourne, The University of Melbourne, Victoria, Australia;84. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, Brazil;95. McMaster University School of Rehabilitation Science Hamilton, Ontario, Canada;106. Faculty of Health Sciences, The University of Sydney, Sydney, Australia;1111. Department of Health Sciences, Faculty of Science, Vrije Universiteit, Amsterdam Movement Science research institute, Amsterdam, the Netherlands;1212. Musculoskeletal Disorders and Physical Workload, National Research Centre for the Working Environment, Copenhagen, Denmark;88. Department of Medical and Health Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden;99. Department of Physiotherapy and Exercise Science, Curtin University, Perth, Australia;1010. Seattle Epidemiologic Research and Information Center (ERIC) and Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington;11112. New England Baptist Hospital, Boston, Massachusetts;12123. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts;884. Division of Rheumatology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland |
| |
| Abstract: | IntroductionTransient episodes of increased pain, stiffness or swelling are common in people with osteoarthritis (OA). Yet, evidence-based management strategies for lessening the impact of OA flares are rarely covered in clinical guidelines and have been identified as a gap by clinicians delivering OA care. We aimed to identify evidence on behavioral, lifestyle or other adjunctive flare management strategies that could be used by clinicians or consumers.Materials and methodsA literature search between 1990-2020 was performed in three databases using a scoping methodology. We included qualitative or quantitative studies, and reviews that examined OA flare management, or that reported OA flare outcomes at timepoints ≤2 weeks post-intervention. Outcomes included any physical or psychological OA outcome treatable with a therapeutic intervention.ResultsWe included 9 studies, all of which examined the relationship between therapeutic exercise/ physical activity and OA flares. All studies reported pain outcomes at the knee. Two also included the hip. Only two studies examined specific management strategies for OA flares. Both favorably reported the benefits of undertaking an exercise program modified accordingly during an episode, but the quality of the evidence was low.DiscussionThis scoping review highlights the paucity of evidence available on non-pharmacological treatments of OA flare management that could influence clinical practice. At present, there is no robust evidence to support or reject any specific therapies for OA flare management in clinical practice. Future work is needed, particularly around outcomes beyond pain, trajectories of symptom improvement, and for joints other than the knee. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
