Edito of 10/06/2015
One of the 11 recommendations of the EULAR on the non-pharmacological treatment of osteoarthritis of the knee and hip (2013) concerns patient education. Its main objective is to make the self-management of the following two factors by the patient easier: the practice of a physical activity and the loss of excess weight.
It is even more effective as it takes into account the actual needs and preferences of the patient. Its success requires the involvement of various health professionals (doctors, physical therapists and nutritionists).
Physical exercise is the “hard core” of the non-pharmacological treatment of osteoarthritis. It includes muscle strengthening exercises and aerobics exercises type training..
The educational measures consist in given the patient the tools to regularly follow this physical activity. For that, the best possible compliance conditions must be achieved taking into account his/her preferences: individualised and progressive exercises, progress monitoring, motivation sustained by planning the exercises and written (information sheets on exercises) or audio-visual (vidéos) encouragements.
The physical therapist who participates in the muscle strengthening, especially pre- and post-operative prosthesis implantation, is an integral part of this education.
The measures for the reduction of excess weight are essentially nutritional: Two means are preferred: diet and assistance by a nutritionist. The diet is low in fat and sugar and rich in fruits and vegetables. The portions composing each meal are decreased in quantity.
The aid provided by a nutritionist is precious to discuss with the patient about his/her progress, difficulties and failures. This regular meeting with a nutrition specialist is one of the keys in weight loss stability.
Fernandes L, Hagen KB, Bijlsma JW, Andreassen O, Christensen P, Conaghan PG, Doherty M, Geenen R, Hammond A, Kjeken I, Lohmander LS, Lund H, Mallen CD, Nava T, Oliver S, Pavelka K, Pitsillidou I, da Silva JA, de la Torre J, Zanoli G, Vliet Vlieland TP; European League Against Rheumatism (EULAR).
EULARrecommendations for the non-pharmacological core management of hip and knee osteoarthritis.
Ann Rheum Dis. 2013 Jul;72(7):1125-35.
Société française de documentation et de recherche en médecine générale « Eduquer » pour soulager l’arthrose ? Bibliomed. juin 2011 : 630
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