PROGRAMA DE AUTOGESTÃO (PARQVE) MELHORA A QUALIDADE DE VIDA NA OSTEOARTRITE GRAVE DO JOELHO

Biscaro, Raphael Carvalho; Ochoa, Pablo Gabriel Garcia; Ocampos, Guilherme Pereira; Arouca, Matheus Manolo; Camargo, Olavo Pires de; Rezende, Márcia Uchoa de

Raphael Carvalho Biscaro

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0001-6945-0606

Pablo Gabriel Garcia Ochoa

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0003-2646-9889

Guilherme Pereira Ocampos

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0003-0052-6769

Matheus Manolo Arouca

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0002-0994-9680

Olavo Pires de Camargo

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, Department of Orthopedics and Traumatology, HC-DOT/FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0002-1128-7292

Márcia Uchoa de Rezende Correspondence: Márcia Uchoa de Rezende. 333 Ovídio Pires de Campos St., Room 323B, Cerqueira Cesar, São Paulo, SP, Brazil. 05403-902 . marcia.uchoa@hc.fm.usp.br

Universidade de São Paulo, Faculty of Medicine, Hospital das Clínicas, Institute of Orthopedics and Traumatology, HC-FMUSP, São Paulo, SP, Brazil.

http://orcid.org/0000-0002-2020-9501

Correspondence: Márcia Uchoa de Rezende. 333 Ovídio Pires de Campos St., Room 323B, Cerqueira Cesar, São Paulo, SP, Brazil. 05403-902 . marcia.uchoa@hc.fm.usp.br

All authors declare no potential conflict of interest related to this article.

AUTHORS’ CONTRIBUTION: Each author contributed individually and significantly to the development of this article. RCB and PGGO: acquisition, interpretation, writing and final approvement of the manuscript. GPO and MMA: data analysis, revision and final approvement of the manuscript. OPC: revision and final approvement of the manuscript. MUR: study design, data interpretation, writing and final approvement of the manuscript.

Variable	Group		p
Variable	Control (N = 27)	Intervention (N = 38)	p
Age (years)			0,996
Mean ± SD	67.5 ± 10.3	67.5 ± 11.1
median (min.; max.)	65.5 (46; 86)	69 (34; 88)
Gender, n (%)			0.378 ^* * Chi square test.
Male	9 (30,8)	8 (21,1)
Female	18 (69,2)	30 (78,9)
Weight (Kg)			0.261
Mean ± SD	78.4 ± 14.6	82.8 ± 15.4
median (min.; max.)	78.7 (48.5; 119.7)	82 (50.7; 124.3)
BMI			0.386
Mean ± SD	31.6 ± 6.1	32.8 ± 5.3
median (min.; max.)	33 (21.5; 47.3)	32.3 (23.7; 42.7)
WOMAC pain			0.662 ^ Mann-Whitney test;
Mean ± SD	10.5 ± 3.8	11.1 ± 3.9
median (min.; max.)	12 (4; 15)	11 (5; 18)
WOMAC stiffness			0.010 ^ Mann-Whitney test;
Mean ± SD	4.3 ± 1.2	5.4 ± 1.9
median (min.; max.)	4 (2; 6)	6 (0; 8)
WOMAC function			0.242 ^ Mann-Whitney test;
Mean ± SD	36.6 ± 10	42.1 ± 9.7
median (min.; max.)	40.5 (13; 51)	40 (24; 63)
WOMAC total			0.233 ^ Mann-Whitney test;
Mean ± SD	51.4 ± 13.7	58.5 ± 13.7
median (min.; max.)	55.5 (22; 70)	54 (33; 89)
NRS			0.194
Mean ± SD	67.4 ± 17.6	74.4 ± 15.6
median (min.; max.)	67.5 (25; 100)	80 (40; 100)
Lequesne			0.315
Mean ± SD	14.2 ± 3.6	15.4 ± 3.9
median (min.; max.)	14.3 (6; 21)	14 (8.5; 21)
Ahlback Right			0.993 ^ Mann-Whitney test;
1	0 (0)	2 (6,3)
2	1 (4,3)	0 (0)
3	4 (17,4)	5 (15,6)
4	11 (47,8)	15 (46,9)
5	7 (30,4)	10 (31,3)
Ahlback Left			0.095 ^ Mann-Whitney test;
2	1 (4,5)	2 (6,7)
3	8 (36,4)	2 (6,7)
4	8 (36,4)	16 (53,3)
5	5 (22,7)	10 (33,3)
Worst Ahlback			0.383 ^ Mann-Whitney test;
3	4 (17,4)	1 (3,1)
4	10 (43,5)	17 (53,1)
5	9 (39,1)	14 (43,8)

Variable/Group	Moment				p Group	p Moment	p Interaçtion
Variable/Group	Baseline	6 months	12 months	24 months	p Group	p Moment	p Interaçtion
WOMAC pain					0.505	0.049	0.237
Control
mean ± SD	10.5 ± 3.8	10.5 ± 3.6	9.9 ± 3.2	11.3 ± 2.7
median (min.; max.)	12 (4; 15)	11 (2; 15)	10 (2; 17)	12 (5; 16)
Intervention
mean ± SD	11.1 ± 3.9	9.8 ± 3.4	9.3 ± 3.3	10.1 ± 3.3
median (min.; max.)	11 (5; 18)	9.5 (4; 17)	9 (3; 16)	10 (5; 17)
WOMAC stiffness					0.436	0.51	0.06
Control
mean ± SD	4.3 ± 1.2	5.1 ± 1.7	4.2 ± 1.5	4.8 ± 1.4
median (min.; max.)	4 (2; 6)	6 (0; 8)	5 (1; 7)	5 (1; 8)
Intervention
mean ± SD	5.4 ± 1.9	4.7 ± 1.5	4.7 ± 1.7	4.7 ± 1.7
median (min.; max.)	6 (0; 8)	5 (1; 8)	5 (0; 8)	5 (0; 7)
WOMAC function					0.612	<0.001	<0.001
Control
mean ± SD	36.6 ± 10	38.2 ± 10.8	35.9 ± 11.1	38.7 ± 10.8
median (min.; max.)	40.5 (13; 51)	41 (9; 52)	36 (10; 56)	40 (17; 59)
Intervention
mean ± SD	42.1 ± 9.7	35.6 ± 12.7	36.5 ± 12.9	36.7 ± 11.9
median (min.; max.)	40 (24; 63)	38 (7; 62)	36.5 (10; 65)	37 (14; 64)
WOMAC total					0.687	<0.001	<0.001
Control
mean ± SD	51.4 ± 13.7	53.8 ± 15.5	50.1 ± 14.9	54.6 ± 14.1
median (min.; max.)	55.5 (22; 70)	57.5 (15; 73)	49 (14; 79)	57 (26; 81)
Intervention
mean ± SD	58.5 ± 13.7	50.1 ± 16.7	50.6 ± 16.6	51.5 ± 16
median (min.; max.)	54 (33; 89)	52 (12; 85)	50 (21; 89)	53 (22; 86)

Variable	Group/ Moment	Comparisson		Average difference	Standard error	freedom degree	p	CI (95%)
Variable	Group/ Moment	Comparisson		Average difference	Standard error	freedom degree	p	Inferior	Superior
WOMAC pain		Baseline -	6 months	0.80	0.48	1	0.603	-0.48	2.07
		Baseline -	12 months	1.33	0.55	1	0.097	-0.13	2.79
		Baseline -	24 months	0.52	0.63	1	>0.999	-1.13	2.17
		6 months -	12 months	0.53	0.40	1	>0.999	-0.51	1.58
		6 months -	24 months	-0.28	0.53	1	>0.999	-1.66	1.11
		12 months -	24 months	-0.81	0.43	1	0.343	-1.93	0.31
WOMAC function	Control	Baseline -	6 months	-1.62	1.03	1	>0.999	-4.85	1.62
		Baseline -	12 months	0.69	1.30	1	>0.999	-3.37	4.75
		Baseline -	24 months	-1.72	1.54	1	>0.999	-6.54	3.10
		6 months -	12 months	2.31	1.03	1	0.701	-0.91	5.52
		6 months -	24 months	-0.11	1.41	1	>0.999	-4.52	4.30
		12 months -	24 months	-2.41	1.13	1	0.908	-5.94	1.11
	Intervention	Baseline -	6 months	9.99	1.34	1	<0.001	5.82	14.17
		Baseline -	12 months	7.95	1.49	1	<0.001	3.30	12.60
		Baseline -	24 months	8.25	1.62	1	<0.001	3.21	13.29
		6 months -	12 months	-2.04	0.89	1	0.583	-4.81	0.72
		6 months -	24 months	-1.74	1.14	1	>0.999	-5.30	1.82
		12 months-	24 months	0.30	0.89	1	>0.999	-2.49	3.09
	Baseline	Control -	Intervention	-7.84	1.87	1	0.001	-13.69	-2.00
	6 months	Control -	Intervention	3.76	1.57	1	0.462	-1.14	8.67
	12 months	Control -	Intervention	-0.59	1.53	1	>0.999	-5.37	4.19
	24 months	Control -	Intervention	2.13	1.65	1	>0.999	-3.03	7.29
WOMAC total	Control	Baseline -	6 months	-2.46	1.21	1	>0.999	-6.25	1.33
		Baseline -	12 months	1.27	1.52	1	>0.999	-3.49	6.03
		Baseline -	24 months	-2.58	1.82	1	>0.999	-8.26	3.09
		6 months -	12 months	3.73	1.21	1	0.055	-0.03	7.50
		6 months -	24 months	-0.12	1.66	1	>0.999	-5.31	5.06
		12 months-	24 months	-3.85	1.32	1	0.100	-7.98	0.28
	Intervention	Baseline -	6 months	12.84	1.56	1	<0.001	7.96	17.72
		Baseline -	12 months	11.01	1.74	1	<0.001	5.58	16.43
		Baseline -	24 months	11.03	1.89	1	<0.001	5.13	16.94
		6 months -	12 months	-1.83	1.04	1	>0.999	-5.07	1.40
		6 months -	24 months	-1,81	1.34	1	>0.999	-5.99	2.38
		12 months-	24 months	0.03	1.04	1	>0.999	-3.23	3.28
	Baseline	Control -	Intervention	-10.26	2.20	1	<0.001	-17.15	-3.38
	6 months	Control -	Intervention	5.04	1.86	1	0.193	-0.79	10.86
	12 months	Control -	Intervention	-0.53	1.81	1	>0.999	-6.17	5.11
	24 months	Control -	Intervention	3.35	1.95	1	>0.999	-2.75	9.46

Variable/Group	Moment				p_Group	p_Moment	p_Interaction
Variable/Group	Baseline	6 months	12 months	24 months	p_Group	p_Moment	p_Interaction
Weight (Kg)					0.383	0.001	0.008
Control
mean ± SD	78.4 ± 14.6	78.3 ± 14.6	76.7 ± 12.3	78.5 ± 15.8
median (min.; max.)	78.7 (48.5; 119.7)	79.4 (50.6; 120.5)	79.1 (51.3; 105.1)	78.3 (57.4; 104.3)
Intervention
mean ± SD	82.8 ± 15.4	81.6 ± 15.7	81.6 ± 15	80.9 ± 12.9
median (min.; max.)	82 (50.7; 124.3)	81.7 (45.7; 120.6)	80.6 (46.3; 119.8)	77.1 (60.1; 111)
IMC					0.708	0.668	0.717
Control
mean ± SD	31.6 ± 6.1	31.6 ± 6.3	30.9 ± 5.5	31.5 ± 5.2
median (min.; max.)	33 (21.5; 47.3)	33.8 (21; 47.7)	33.4 (22; 40.1)	32.6 (24.4; 39.9)
Intervention
mean ± SD	32.8 ± 5.3	32.3 ± 5.4	32.4 ± 5.3	32.5 ± 5
median (min.; max.)	32.3 (23.7; 42.7)	31.6 (22.4; 43.6)	32.4 (22.1; 43.8)	31 (25.8; 44.6)
NRS					0.393	0.225	0.341
Control
mean ± SD	67.4 ± 17.6	69.5 ± 20.6	63.9 ± 17.2	65.1 ± 16.1
median (min.; max.)	67.5 (25; 100)	75.5 (25; 100)	60 (24; 95)	68 (22; 92)
Intervention
mean ± SD	74.4 ± 15.6	67.3 ± 20.8	65.9 ± 18.4	67.7 ± 18.8
median (min.; max.)	80 (40; 100)	68 (10; 96)	62 (20; 97)	74 (22; 97)
Lequesne					0.627	0.158	0.544
Control
mean ± SD	14.2 ± 3.6	13.8 ± 3.4	14.3 ± 3.5	14 ± 4.1
median (min.; max.)	14.3 (6; 21)	15 (5.5; 19)	14.3 (4; 20.5)	14.5 (6; 20)
Intervention
mean ± SD	15.4 ± 3.9	13.8 ± 4.2	14.3 ± 3.8	14.3 ± 3.5
median (min.; max.)	14 (8.5; 21)	13.5 (5.5; 22.5)	14.8 (4.5; 21.5)	14.5 (6.5; 21.5)

Variable	Group/ Moment	Comparisson		Average difference	Standard error	freedom degree	p	CI (95%)
Variable	Group/ Moment	Comparisson		Average difference	Standard error	freedom degree	p	Inferior	Superior
weight	Control	Baseline -	6 months	0.07	0.30	1	>0.999	-0.86	1.01
		Baseline -	12 months	0.01	0.43	1	>0.999	-1.32	1.35
		Baseline -	24 months	0.19	0.66	1	>0.999	-1.89	2.26
		6 months -	12 months	-0.06	0.31	1	>0.999	-1.01	0.90
		6 months -	24 months	0.11	0.59	1	>0.999	-1.74	1.97
		12 months-	24 months	0.17	0.51	1	>0.999	-1.42	1.76
	Intervention	Baseline -	6 months	1.20	0.25	1	<0.001	0.42	1.99
		Baseline -	12 months	1.14	0.35	1	0.031	0.05	2.24
		Baseline -	24 months	2.39	0.44	1	<0.001	1.00	3.78
		6 months -	12 months	-0.06	0.25	1	>0.999	-0.84	0.73
		6 months -	24 months	1.19	0.37	1	0.040	0.02	2.35
		12 months-	24 months	1.25	0.27	1	<0.001	0.39	2.10
	Baseline	Control -	Intervention	-4.34	3.71	1	>0.999	-15.94	7.25
	6 months	Control -	Intervention	-3.22	3.71	1	>0.999	-14.81	8.38
	12 months	Control -	Intervention	-3.21	3.71	1	>0.999	-14.81	8.38
	24 months	Control -	Intervention	-2.14	3.74	1	>0.999	-13.82	9.54

[1] Correspondence: Márcia Uchoa de Rezende. 333 Ovídio Pires de Campos St., Room 323B, Cerqueira Cesar, São Paulo, SP, Brazil. 05403-902 . marcia.uchoa@hc.fm.usp.br

Brasil

Brasil

PROGRAMA DE AUTOGESTÃO (PARQVE) MELHORA A QUALIDADE DE VIDA NA OSTEOARTRITE GRAVE DO JOELHO

RESUMO

Objetivo:

Métodos:

Resultados:

Conclusões: