EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis: 2023 update

医学 物理疗法 骨关节炎 心理干预 系统回顾 多学科方法 专家意见 梅德林 物理医学与康复 替代医学 重症监护医学 护理部 社会学 法学 病理 社会科学 政治学
作者
T. Moseng,T. P. M. Vliet Vlieland,Simone Battista,David Beckwée,Vladimira Boyadzhieva,Philip G. Conaghan,Daniela Costa,Michael Doherty,Andrew Finney,Tsvetoslav Georgiev,Milena Gobbo,Norelee Kennedy,Ingvild Kjeken,Féline P B Kroon,Stefan Lohmander,Hans Lund,Christian Mallen,Karel Pavelká,I. Pitsillidou,Margaret P. Rayman,Anne Therese Tveter,Johanna E Vriezekolk,Dieter Wiek,Gustavo Zanoli,Nina Østerås
出处
期刊:Annals of the Rheumatic Diseases [BMJ]
卷期号:83 (6): 730-740 被引量:44
标识
DOI:10.1136/ard-2023-225041
摘要

Introduction Hip and knee osteoarthritis (OA) are increasingly common with a significant impact on individuals and society. Non-pharmacological treatments are considered essential to reduce pain and improve function and quality of life. EULAR recommendations for the non-pharmacological core management of hip and knee OA were published in 2013. Given the large number of subsequent studies, an update is needed. Methods The Standardised Operating Procedures for EULAR recommendations were followed. A multidisciplinary Task Force with 25 members representing 14 European countries was established. The Task Force agreed on an updated search strategy of 11 research questions. The systematic literature review encompassed dates from 1 January 2012 to 27 May 2022. Retrieved evidence was discussed, updated recommendations were formulated, and research and educational agendas were developed. Results The revised recommendations include two overarching principles and eight evidence-based recommendations including (1) an individualised, multicomponent management plan; (2) information, education and self-management; (3) exercise with adequate tailoring of dosage and progression; (4) mode of exercise delivery; (5) maintenance of healthy weight and weight loss; (6) footwear, walking aids and assistive devices; (7) work-related advice and (8) behaviour change techniques to improve lifestyle. The mean level of agreement on the recommendations ranged between 9.2 and 9.8 (0–10 scale, 10=total agreement). The research agenda highlighted areas related to these interventions including adherence, uptake and impact on work. Conclusions The 2023 updated recommendations were formulated based on research evidence and expert opinion to guide the optimal management of hip and knee OA.
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