基于ICF核心分类组合的膝骨关节炎康复治疗效果研究

关键词：ICF核心分类组合  膝骨关节炎  康复方案  随机对照研究

Keywords:ICF core set  knee osteoarthritis  rehabilitation program  randomized controlled trial

摘要：

      摘要 目的：探讨基于ICF核心分类组合的膝骨关节炎康复治疗方案相对一般康复治疗方案是否具有优越性。 方法：2022年2—12月就诊于北京大学第三医院康复科的膝骨关节炎患者225例，按照随机数字表法分为对照组（n=75）、试验一组（n=75）和试验二组（n=75）。对照组患者接受膝骨关节炎一般康复治疗方案，试验一组患者接受基于ICF简明核心分类组合的KOA康复治疗方案，试验二组患者接受基于ICF完整核心分类组合的KOA康复治疗方案，共治疗12周。比较三组患者在治疗后1、2、3、6个月时的WOMAC量表、HSS量表和SF-36评分。 结果：共获得197例病例完整随访资料。三组WOMAC评分均随时间显著下降（P＜0.001），试验二组、对照组在治疗后6个月时，疼痛、僵硬、功能及总分均较治疗前有显著改善，而试验一组中僵硬评分在治疗后6个月无显著降低。三组HSS评分均随时间显著升高（P＜0.001），其中试验二组与其他两组相比，治疗后6个月时“减分项目”较前明显改善（P=0.005）。三组在SF-36中，生理机能、生理职能、一般健康状况、社会功能、情感职能、精神健康的评分均随时间显著上升；其中在躯体疼痛评分上，试验一组和试验二组均较前升高，而对照组无明显改善；在精力评分方面，试验一组和对照组随时间显著上升，而试验二组无显著改善。 结论：与一般康复治疗方案相比，基于ICF-OA完整核心分类组合的KOA康复治疗方案能更好的改善膝骨关节炎患者的整体功能和生存质量。

Abstract:

      Abstract Objective：To explore whether the knee osteoarthritis treatment program based on ICF core set is superior to general rehabilitation treatment program. Method： A prospective randomized control trial was conducted in 225 patients with knee osteoarthritis who had been admitted from department of rehabilitation, Peking University Third Hospital from February 2022 to December 2022. The patients were randomly divided into control group (n=75)， trial group Ⅰ(n=75) and trial group Ⅱ(n=75). Patients in the control group received general rehabilitation treatment program for knee osteoarthritis. Patients in the trial group Ⅰ received the rehabilitation program based on the ICF concise core set while patients in trial group Ⅱ received the rehabilitation program based on the ICF complete core set. All patients were treated for 12 weeks. WOMAC scores, HSS scores and SF-36 scores were compared among the three groups at 1, 2, 3 and 6months after treatment. Result： 197 patients completed the trial. WOMAC scores among three groups decreased significantly over time (P<0.001). Pain, stiffness, function and total score were significantly improved in trial group Ⅱ and control group at 6 months after treatment, while stiffness score in trial group Ⅰ did not decrease significantly at 6 months after treatment. The HSS scores of the three groups were significantly increased with time(P<0.001)， and the "subtraction items" of the trial group Ⅱ were significantly improved compared with the other two groups at 6 months after treatment (P=0.005). The scores of physical functioning, role-physical, general health, social functioning, role-emotional and mental health in SF-36 of the three groups increased significantly over time. The scores of bodily pain in trial group Ⅰ and trial group Ⅱ were higher than before, but the control group had no significant improvement. In terms of vitality score, trial group Ⅰ and control group increased significantly over time, while trial group Ⅱ had no significant improvement. Conclusion： The rehabilitation program based on the complete ICF-OA core set can better improve the overall function and quality of life for people with knee osteoarthritis than general rehabilitation treatment program.