KOA治疗模式的选择不取决于其疼痛、严重程度及合并症.pdfVIP

RESEARCH ARTICLE Choice of Treatment Modalities was not Infl uenced by Pain, Severity or Co-Morbidity in Patients with Knee Osteoarthritis 1 2 3 4 5 Gro Jamtvedt , Kristin Thuve Dahm , Inger Holm , Jan Odegaard-Jensen Signe Flottorp 1Norwegian Knowledge Centre for the Health Services, Oslo, and Centre for Evidence-Based Practice, University College Bergen, Bergen, Norway 2Norwegian Knowledge Centre for the Health Services, Oslo, Norway 3Section of Health Science, Faculty of Medicine, University of Oslo, and Rikshospitalet University Hospital, Oslo, Norway 4 Norwegian Knowledge Centre for the Health Services, Oslo, Norway 5Norwegian Knowledge Centre for the Health Services, Oslo, Norway Abstract Background and Purpose. Patients with knee osteoarthritis (OA) are commonly treated by physiotherapists in primary care. The physiotherapists use different treatment modalities. In a previous study, we identifi ed variation in the use of transcutaneous electrical nerve stimulation (TENS), low level laser or acupuncture, massage and weight reduction advice for patients with knee OA. The purpose of this study was to examine factors that might explain variation in treatment modalities for patients with knee OA. Methods. Practising physiotherapists prospectively collected data for one patient with knee osteoarthritis each through 12 treatment sessions.We chose to examine factors that might explain variation in the choice of treatment modalities supported by high or moderate quality evidence, and modalities which were frequently used but which were not supported by evidence from systematic reviews. Experienced clinicians proposed factors that they thought might explain the variation in the choice of these specifi c treatments. We used these factors in explanatory analyses. Results.