Het fysiotherapeutisch handelen bij atrose aan heupen/of knie: patiëntenprofielen in de praktijk.

Pisters, M.F., Ende, C.H.M. van den, Groot, J.F. de, Veenhof, C. Het fysiotherapeutisch handelen bij atrose aan heupen/of knie: patiëntenprofielen in de praktijk. Nederlands Tijdschrift voor Fysiotherapie: 2006, 116(6), 143-149

Het voorkomen van de patiëntenprofielen uit de KNGF-richtlijn "Artrose heup-knie"in de dagelijkse handelingspraktijk van de fysiotherapeut kan in dit onderzoek niet geheel worden bevestigd. De keuze van fysiotherapeuten voor het gebruik van verrichtingen kan maar ten dele worden verklaard vanuit de probleemgebieden die bij patiënten met artrose aan de heup en/of knie op de voorgrond staan. Het fysiotherapeutisch handelen sluit grotendeels aan bij de aanbevelingen uit de richtlijn en bij bestaande wetenschappelijke evidentie. (aut. ref.)

Aim: 1. to determine the different combinations of problem areas in patients with osteoarthritis of the hip and/or knee; 2. to determine whether these problem areas are comparable with those described in the Dutch Osteoarthritis Guideline for physiotherapists, and 3. to investigate the relation between the most common combinations of problem areas and the interventions applied. Methods: in this descriptive study, primary care physiotherapists (n=26) recorded combinations of problem areas and the interventions applied to 97 patients with osteoarthritis of the hip and/or knee (A C R criteria). Descriptive statistics were used to evaluate which combinations of problem areas were recorded and which interventions were applied. Chi square statistics were used to investigate whether common combinations of problem areas were associated with the intervention applied. The relative risk was calculated if the association was significant. Results: physiotherapist recorded 15 different combinations of problem areas (patient profiles), the most common being 'disorders of movement (98%), and 'pain' (84 %). These different patient profiles could be distinguished by the presence or absence of certain problems, such as 'active inflammatory impairments', 'participation problems, and 'inadequate pain behaviour'. The most commonly applied interventions were 'exercise therapy to support physical functions' (81%), 'exercise therapy to support activities'( 74%), and 'information and advice' (56%). The choice of therapy differed for problem areas involving 'inadequate pain behaviour' or 'active inflammatory impairments'. Conclusion: The choice of physiotherapy intervention for osteoarthritis of the hip and/or knee depends in part on the combination of problem areas involved. While the most commonly used interventions were largely consistent with the literature and the recommendations of the Dutch Osteoarthritis Guideline, the occurrence of specific patient profiles in daily practice was not entirely consistent with that described in the Guideline.(aut. ref.)