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Osteoarthritis: physical medicine and rehabilitation—nonpharmacological management

Arthrose: Physikalische Medizin und Rehabilitation – nichtmedikamentöses Management

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Summary

Osteoarthritis (OA) is the most common joint disease, mainly affecting middle-aged and elderly persons. People with OA of the knee or hip experience pain and deconditioning that may lead to disability. Treatment goals include pain control, maximizing functional independence, and improving quality of life within the constraints imposed by both OA and comorbidities. Exercise is a core recommendation in all nonpharmacological guidelines for the management of patients with knee or hip OA; it is supposed to ameliorate pain and maybe function as well. Therapeutic ultrasound, neuromuscular as well as transcutaneous electrostimulation, pulsed magnetic field therapy, low-level laser therapy, thermal agents, acupuncture, and assistive devices such as insoles, canes, and braces can be used additionally in a multimodal therapeutic program. They may positively influence pain and function, mobility, and quality of life in patients suffering from OA of the lower limbs.

Zusammenfassung

Arthrose ist eine degenerative Gelenkserkrankung, welche Menschen mittleren und höheren Alters betreffen kann. Eine Arthrose der Knie- und Hüftgelenke bedeutet meist nicht nur Schmerz und Bewegungseinschränkung, sondern eventuell auch den Verlust der Selbständigkeit. Daher ergeben sich die Therapieziele 1) Reduktion der Schmerzen, 2) Erhalt der Selbständigkeit und 3) Verbesserung der Lebensqualität. Eventuell vorhandene Begleiterkrankungen oder -umstände müssen in der Therapieplanung berücksichtigt werden. Alle Richtlinien zur nichtmedikamentösen Behandlung der Hüft- und Kniearthrose empfehlen durchwegs Bewegungstherapie zur Verbesserung von Schmerz und eventuell auch Funktion. Zusätzlich haben sich therapeutischer Ultraschall, neuromuskuläre Elektrostimulation, transkutane elektrische Nervenstimulation, Magnetfeldtherapie, Lasertherapie, Wärmebehandlungen und Akupunktur als effektiv erwiesen. Einlagenversorgung und die Verordnung von Hilfsmitteln wie Schienen oder Gehhilfen ergänzen das therapeutische Spektrum. Solch ein multimodales Management beeinflusst Schmerz, Funktion, Mobilität und Lebensqualität von PatientInnen mit Arthrose der unteren Extremitäten im positiven Sinne.

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Authors and Affiliations

  1. Abteilung für Physikalische Medizin und Rehabilitation, Herz Jesu Krankenhaus, Baumgasse 20A, 1030, Vienna, Austria

    Regina Stemberger

  2. Universitätsklinik für Physikalische Medizin und Rehabilitation, MUW, AKH Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria

    Katharina Kerschan-Schindl

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Correspondence to Regina Stemberger.

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Stemberger, R., Kerschan-Schindl, K. Osteoarthritis: physical medicine and rehabilitation—nonpharmacological management. Wien Med Wochenschr 163, 228–235 (2013). https://doi.org/10.1007/s10354-013-0181-9

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