Osteoarthritis Clinical Trial
Official title:
PARQVE - Project Arthritis Recovering Quality of Life by Means of Education - A Prospective Randomized Study Comparing the Educational Program With and Without Multidisciplinary Care
BACKGROUND: Osteoarthritis (OA), and particularly knee osteoarthritis (KOA) is a disorder
that greatly impairs the quality of life of patients and its incidence increases with
longevity, obesity and lower socioeconomic and educational level. It is expected that 40% of
people over 60 have symptomatic OA of the knees and hips. The core treatment of OA is
education, weight loss and increased physical activity. We create an educational program that
improved function of the patients given by the sit-to-stand 30 seconds test (STS30). However,
weight loss, an important foundation of clinical treatment, was only effective (more than 2
points in BMI) in 10% of the program participants. For greater effectiveness in weight loss
and adherence to physical activity, we prepared an intensive program with more intensive
nutritional care, psychological, physical therapy and physical trainers and compare the
existing program educators. OBJECTIVE: To compare an educational program isolated to an
educational program associated with nutritional consultations, group therapy sessions and
progressed physiotherapy sessions to sessions with physical educators in patients with KOA
and comorbidities (metabolic syndrome).
METHODS: Ninety patients with OAJ and co-morbidities (Two or more of: overweight or obesity,
hyperglycemia, dyslipidemia, hyperuricemia, high blood pressure) will be divided into two
groups: study (S) and control (C). Both groups will attend the two-day multi-professional
classes on OA with two months interval. But the study group will also make three group
consultations about nutrition, 1 extra session of group therapy with psychology team and 7
exercise sessions in groups with physical therapy and subsequently 7 sessions with physical
educators. The groups will be evaluated for weight, height (to calculate BMI), waist-hip
ratio, percentage of body fat, consumption of daily medications, WOMAC, Lequesne, IPAQ, Tampa
Scale for Kinesiophobia (TSK), Sit to stand 30 seconds test (STS30), timed-up- and-go (TUG)
and six minute test. At inclusion, six, twelve and 24 months after the classes.
Given the inclusion criteria, patients undergo pre-evaluation by the multidisciplinary group
composed of teams of orthopedic doctors, nutritionists, physical therapists, physical
educators:
Orthopedics - it is treating the patients according to the guidelines of OARSI, offering
everything we have for the treatment of OA at the Hospital das Clinicas.
Nutrition - It will measure the skinfold of all patients at baseline and at six and twelve
months. As the draw, will attend the study group at 1, 3 and 5 months after the first class
and the control group lose weight significantly less than the study group will meet the
control group after one year in the same manner than has undergone the study group .
Physiotherapy - Undertake the test and sit ups, Timed-Up-and-Go (TUG) test and Sit to stand
30 seconds test (STS30) including six, twelve and 24 months after inclusion. The
physiotherapy group will care study group sessions in a group of patients once a week for 4
weeks, 2 times a week for 1 month and 1x / month in the third month, giving exercises to be
performed daily and charging them through the registration of patients. If the results of six
and twelve months show better in the study group, the control group will do the same
interventions the study group one year later.
Physical Education - will apply the questionnaire International Physical Activity
Questionnaire, IPAQ, Tampa Scale for Kinesiophobia (TSK) and will make up test and down
stairs and evaluating short version flexibility, inclusion, six, 12 and 24 months. After
three months of exercise guided by physiotherapists, the study group will begin an exercise
program with physical education teachers to become able to carry out alone or join a gym at
the end of the sixth month of the program. It will also provide weekly classes for 1 month,
biweekly in the second month and last month in the third charging the daily activities in the
record of the patient's notebook.
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