CLAUDIA HELENA DE AZEVEDO CERNIGOY

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Instituto de Ortopedia e Traumatologia, Hospital das Clínicas, Faculdade de Medicina
LIM/41 - Laboratório de Investigação Médica do Sistema Músculoesquelético, Hospital das Clínicas, Faculdade de Medicina

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    PARQVE - PROJECT ARTHRITIS RECOVERING QUALITY OF LIFE BY MEANS OF EDUCATION - A PILOT STUDY IN BRAZIL
    (2013) REZENDE, M. U.; CAMPOS, G. C.; PAILO, A. F.; FRUCCHI, R.; PASQUALIN, T.; HISSADOMI, M. I.; BRITO, N. L.; FARIAS, F. E.; MONTEIRO, A. P.; SILVA, C. A.; CERNIGOY, C. H.
    Purpose: The primary objective was to evaluate the improvement of pain and function of patients with knee OA exposed to a multidisciplinary education program. Secondary Objectives were to evaluate patients’ weight loss and increase in physical activity. Methods: Two hundred and twenty-two patients (54 men and 168 women) with knee OA were randomly divided into four groups. Patients underwent pre-assessment and two days of workshops with a multidisciplinary team composed of psychologists; nutritionist; social workers; physiotherapists; occupational therapists and orthopedic surgeons. Patients answered evaluation questionnaires (VAS, WOMAC, LEQUESNE) at inclusion and one year after classes. Three groups participated in two workshops with varying time interval between each workshop (Group 1, 3 months apart; Group 2, 2 months apart; Group 3, 1 month apart. Group 4, control, only received handouts and video as all patients. Patients responded how many times a week they exercised during the year.To compare the means between the groups in the assessments of VAS, WOMAC, Lequesne and BMI, ANOVA was used with repeated measures. To compare the average weekly exercises between groups ANOVA was used. The Tukey test was used for multiple comparisons when significance was found. The data were processed in SPSS V. 18.0 and the significance level used for the tests was α = 0.05. Data are presented as mean (standard deviation) at baseline and after 1 year. Results: Baseline VAS was 53.33 (±27.45) in Group 1, 64.58 (±25.96) in Group 2; 57.81 (±24.91); Group 3; and 55.70 (±26.71) in Group 4. At one year the average VAS was according to groups: 1: 55.81(±22.90); 2: 52.42(±25.93); 3: 52.87(±21.78); 4: 57.27(±24.72). There was a difference between groups after one year (p=0.03) but the Tukey test was not able to verify which group was different. Baseline WOMAC was 1:43.37(±19.15); 2: 46.69(±18.65); 3: 45.33(±18.33); 4:42.33(±18.68) and at one year: 1:43.29(±18.08); 2: 42.33(±20.86); 3: 42.65(±13.67); 4:43.97(±19.43). There was no difference between groups (p=0.53).Baseline LEQUESNE: 1:12.16(6.29); 2: 13.46(9.57); 3: 11.81(4.08); 4: 11.89(4.40) and at one year 1: 11.74(4.05); 2: 11.41(4.63); 3: 11.68(3.62); 4: 11.86(4.30) also showed no difference (p=0.53). Patientes from group 4 exercised less average 1.34(±2.11) times a week than the others: 1: 2.96 (±2.52) p=0.00; 2: 2.75(±2.58); p=0.01; 3: 2.76(±2.95); p=(0.015). BMI was measured at baseline and after a year. There were significant defference between groups: (1 and 4) average =-7.19; CI95%=[-9.94; -4.44]; p=0.00; (2 and 4) average = -4.60; CI95%= [-7.35; -1.849]; p=0.000; (3 and 4) average = -3.55; CI95%= [-6.27; -0.83]; p=0.00. Conclusions: The educational program (handouts, video, and workshops) diminished BMI and increased physical activity of the subjects. Participating in the workshops did not improve functional measures but diminished pain more than just receiving handouts.