Bowden, JL, Kobayashi, S, Hunter, DJ, Mills, K, Peat, G ORCID: https://orcid.org/0000-0002-9008-0184, Guillemin, F, Parry, EL ORCID: https://orcid.org/0000-0003-0278-6898, Thomas, MJ ORCID: https://orcid.org/0000-0002-4951-9925 and Eyles, JP (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). 749 - 760.

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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.

Item Type: Article
Additional Information: The final version of this accepted manuscript is available directly from the publishers at https://www.sciencedirect.com/science/article/pii/S0049017221000743?via%3Dihub
Uncontrolled Keywords: Osteoarthritis; Flare; Pain exacerbation; Management; Clinical care
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system
Divisions: Faculty of Medicine and Health Sciences > School of Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 07 Jul 2021 14:18
Last Modified: 07 Jul 2021 14:18
URI: https://eprints.keele.ac.uk/id/eprint/9783

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