Application Of Exercise Intervention Based On Enpowerment Theory In Elderly Patients With Knee Osteoarthritis

Objective:On the basis of in-depth understanding of the hindrance factors of rehabilitation exercise in elderly patients with knee osteoarthritis,an individual intervention program based on empowerment theory was developed,and the clinical application effect of the program in elderly patients with knee osteoarthritis was evaluated in order to improve their exercise self-efficacy and exercise compliance,and promote the functional rehabilitation of knee joints in the elderly.Methods:1.From November 2019 to January 2020,eight elderly patients with knee osteoarthritis were selected from the outpatient clinic of Shanxi Acupuncture Hospital,and phenomenological research,the semi-structured interview method and purpose sampling was used to interview the patients with knee osteoarthritis.The data were analyzed and sorted out by Colaizzi method to insightly understand the hindrance factors of rehabilitation exercise in elderly patients with knee osteoarthritis.2.Combined with literature review and previous research results,according to the Clinical practice Guide for exercise treatment of knee Osteoarthritis,the first draft of rehabilitation exercise program suitable for elderly patients with knee osteoarthritis was formulated and demonstrated by experts through Delphi method.Finally determine the rehabilitation exercise program suitable for elderly patients with knee osteoarthritis.3.From October 2020 to January 2021,44 elderly patients with knee osteoarthritis were selected from two communities in Xiaodian District of Taiyuan City by convenience sampling.They were given exercise intervention based on empowerment theory for 12 weeks.Before and after the intervention,the exercise self-efficacy scale,visual analog pain score scale,five sitting tests,protractor,WOMAC osteoarthritis finger scale and other evaluation tools were used to evaluate the patients’ exercise self-efficacy,pain degree,lower limb muscle strength,knee joint activity and WOMAC joint function at the three time points before and after intervention,the 4th week and 12 th week of intervention,using the evaluation tools such as exercise self-efficacy scale,visual analogue pain scale,five sitting tests,protractor and WOMAC osteoarthritis finger scale.The exercise compliance scale was used to evaluate the patients’ exercise compliance at the 2nd,4th,6th,8th,10 th and 12 th week of intervention.Results:1.Analysis on the hindrance factors of rehabilitation exercise: through the analysis and extraction of interview data,six themes of hindering factors of rehabilitation exercise in elderly patients with knee osteoarthritis were summed up :14 sub-themes : personal factors(including lack of professional knowledge of rehabilitation exercise,lack of motivation for rehabilitation exercise,negative emotional influence,lack of interest in rehabilitation exercise,lack of perception of the expected effect),disease-related factors(pain fear,limitation of complications),related factors of rehabilitation exercise program(rehabilitation exercise program is difficult to remember),medical staff factors(lack of attention to rehabilitation exercise,lack of professional guidance),family support and peer support factors(lack of court support and peer support),environmental factors(bad weather,constrained community resources).2.Rehabilitation exercise program demonstration: After the first round of expert letter inquiry,according to the expert opinion,delete an action,and adjust the action content description and exercise volume of rehabilitation exercise.After the second round of expert letter inquiry,the positive coefficient of experts is 100%,and the authority coefficient(Cr)is 0.85.Finally,four movements are formed,such as sitting joint range of motion training,hip abduction and adduction,quadriceps training in sitting position,and hamstring training in sitting position.This exercise program is in line with the principles of science,safety,simplicity and ease.3.Effect of intervention: From the 2nd week to the 10 th week of the intervention,the overall exercise compliance showed an upward trend,and the score of exercise compliance decreased after the 10 th week,but it was still higher than that of the second week of the intervention,and the difference was statistically significant(P<0.05).The results of single factor repeated measurement showed that the score of motor self-efficacy and range of motion of knee joint in elderly patients with knee osteoarthritis increased with time,and the difference was statistically significant(P<0.05).The pain score,5 times sitting time and knee joint function score of elderly patients with knee osteoarthritis decreased with time,and the difference was statistically significant(P<0.05).The scores of motor self-efficacy,pain,range of motion and knee function in elderly patients with knee osteoarthritis were compared between the 4th week and before intervention,12 th week and4 th week,12 th week and pre-intervention in elderly patients with knee osteoarthritis.The difference was statistically significant(P<0.05).There was no significant difference in the sitting and standing time between the 4th week and the 4th week of intervention(P> 0.05),but there was significant difference between the 12 th week of intervention and the 4th week of intervention,the 12 th week of intervention and before intervention(P<0.05).Conclusion:1.The factors that hinder the rehabilitation exercise of elderly patients with knee osteoarthritis include personal factors,disease-related factors,rehabilitation exercise program-related factors,medical staff factors,family support and peer support factors,environmental factors and so on.It is suggested that when formulating the knee joint rehabilitation exercise program for the elderly,we should fully consider the above obstacles,actively carry out health education,strengthen professional supervision and guidance,and fully mobilize the social support network in order to improve their exercise adherence.2.The exercise intervention scheme based on empowerment theory can improve the sense of exercise self-efficacy and exercise compliance of elderly patients with knee osteoarthritis,and has a good effect in relieving knee joint pain,enhancing lower limb muscle strength,increasing joint range of motion and so on.It significantly promoted the improvement of knee joint function in patients with knee osteoarthritis.