Best-practice clinical management of flares in people with osteoarthritis : A scoping review of behavioral, lifestyle and adjunctive treatments
Journal article
Bowden, Jocelyn L., Kobayashi, Sarah, Hunter, David J., Mills, Kathryn, Peat, George, Guillemin, F., Parry, Emma, Thomas, Martin J. and Eyles, J. (2021). Best-practice clinical management of flares in people with osteoarthritis : A scoping review of behavioral, lifestyle and adjunctive treatments. Seminars in Arthritis and Rheumatism. 51(4), pp. 749-760. https://doi.org/10.1016/j.semarthrit.2021.04.017
Authors | Bowden, Jocelyn L., Kobayashi, Sarah, Hunter, David J., Mills, Kathryn, Peat, George, Guillemin, F., Parry, Emma, Thomas, Martin J. and Eyles, J |
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Abstract | Introduction: Transient episodes of increased pain, stiffness or swelling are common in people with osteoarthritis (OA). Yet, evidence-based management strategies for lessening the impact of OA flares are rarely covered in clinical guidelines and have been identified as a gap by clinicians delivering OA care. We aimed to identify evidence on behavioral, lifestyle or other adjunctive flare management strategies that could be used by clinicians or consumers. Materials and methods: A literature search between 1990-2020 was performed in three databases using a scoping methodology. We included qualitative or quantitative studies, and reviews that examined OA flare management, or that reported OA flare outcomes at timepoints ≤2 weeks post-intervention. Outcomes included any physical or psychological OA outcome treatable with a therapeutic intervention. Results: We included 9 studies, all of which examined the relationship between therapeutic exercise/ physical activity and OA flares. All studies reported pain outcomes at the knee. Two also included the hip. Only two studies examined specific management strategies for OA flares. Both favorably reported the benefits of undertaking an exercise program modified accordingly during an episode, but the quality of the evidence was low. Discussion: This scoping review highlights the paucity of evidence available on non-pharmacological treatments of OA flare management that could influence clinical practice. At present, there is no robust evidence to support or reject any specific therapies for OA flare management in clinical practice. Future work is needed, particularly around outcomes beyond pain, trajectories of symptom improvement, and for joints other than the knee. |
Keywords | Osteoarthritis; Flare; Pain exacerbation; Management; Clinical care |
Year | 01 Jan 2021 |
Journal | Seminars in Arthritis and Rheumatism |
Journal citation | 51 (4), pp. 749-760 |
Publisher | Elsevier Inc. (USA) |
ISSN | 0049-0172 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.semarthrit.2021.04.017 |
Web address (URL) | https://www.sciencedirect.com/science/article/pii/S0049017221000743?via%3Dihub |
Open access | Published as non-open access |
Research or scholarly | Research |
Page range | 749-760 |
Publisher's version | License All rights reserved File Access Level Controlled |
Output status | Published |
Publication dates | |
05 May 2021 | |
Publication process dates | |
Deposited | 19 Nov 2024 |
Additional information | © 2021 Elsevier Inc. All rights reserved. |
Place of publication | United States |
https://acuresearchbank.acu.edu.au/item/91105/best-practice-clinical-management-of-flares-in-people-with-osteoarthritis-a-scoping-review-of-behavioral-lifestyle-and-adjunctive-treatments
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