股関節 osteoarthritisにおける運動療法後の疼痛および機能における最小重要変化と最小臨床重要差
Yareni Guerrero1,2, Fiona Dobson3, Venkatesha Venkatesha1,4
1Sydney Musculoskeletal Health, The Kolling Institute, The University of Sydney, Sydney, New South Wales, Australia.
Objective:
The objective of this study was to estimate the minimal important change (MIC) and minimal clinically important difference (MCID) for pain and physical function in individuals with hip osteoarthritis (OA) following a physiotherapist-guided exercise intervention.
Methods:
Secondary analysis from a randomised controlled trial of 196 adults with hip OA allocated one of two 9-month exercise programs. Patient reported outcomes measures for hip pain severity (Numeric Rating Scale [NRS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC] pain subscale) and physical function (WOMAC physical function subscale, patient-specific functional scale [PSFS]) were collected at baseline, 3 and 9 months. Global ratings of change in pain and physical function at 3 and 9 months served as anchors.
Results:
MIC estimates were 2.1-points and 2.4-points for NRS pain at 3 and 9 months, respectively; 2.8-points and 3.0-points for WOMAC pain at 3 and 9 months, respectively; 8.7-points and 8.3-points for WOMAC physical function at 3 and 9 months, respectively; and -2.1-points and -2.0-points for PSFS at 3 and 9 months respectively. The MCID estimates were 2.0-points and 2.4-points for NRS pain at 3 and 9 months, respectively; 2.8-points and 3.0-points for WOMAC pain at 3 and 9-months, respectively; 9.2-points and 8.3-points for WOMAC physical function at 3 and 9 months, respectively; and -3.5-points and -0.7-points for PSFS at 3 and 9 months, respectively.
Conclusion:
This study provides robust, context-specific MIC and MCID estimates for outcomes in hip OA following exercise. These values can inform the interpretation and design of exercise-based clinical trials for hip OA.
