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Core 1 - Offered to everyone - Information
We can treat OA |
Progression is far from inevitable and can be reversed |
Self-management strategies |
Exercise, weight loss, suitable footwear, thermotherapy and pacing |
Adjacent Paracetamol & topical NSAIDs
If paracetamol or topical NSAIDs are insufficient for pain relief for people with osteoarthritis, then the addition of opioid analgesics should be considered. |
Adjacent - Nutraceuticals
Blueberries |
Montomerency Cherrry Juice |
Turmeric |
Biologics
Platlet Rich Plasma (PRP) |
Anti-inflammatories |
Stem Cell Therapies |
Potential tissue re-growth |
Nerve Growth factor antibodies |
Anti-inflammatories and analgesia |
Fibroblast Growth Factor |
Chondroprotective |
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Core 2 - Offered to everyone - Exercise
Aerobic |
Stationary cycling, and walking, yoga and Tai Chi |
Strengthening |
Knee OA usually presented with hip muscle weakness and likely to have loading on the inside of knee joint |
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Hip strengthening exercises tend to improve the mechanics of your lower limb and reduce stress on the knee |
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Unclear weather weight-bearing or non-weight-bearing is most effective. But ld increase the diversity of therapy and possibly improve compliance |
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A meta-analysis reported no evidence that the type of strengthening contraction(isometric, isotonic or isokinetic) influences the outcom. |
Balance |
A randomized study demonstrated that the addition of kinaesthesia and balance exercises to a strengthening program did not offer any additional improvemen |
Dose |
High-intensity training might result in greater strength gains than lowintensity training but could potentially overload the joint and exacerbate symptoms such as pain and swelling |
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High-resistance strength training > low-resistance, even with both groups experiencing the same overall work |
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Core 3 - Offered to everyone - Obestity
Goal Setting |
The distinction between losing weight and maintaining weight loss, and the importance of developing skills for both; advise them that the change from losing weight to maintenance typically happens after 6 to 9 months of treatment |
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Realistic targets for outcomes other than weight loss, such as increased physical activity and healthier eating |
Self-Care |
If a person (or their family or carers) does not feel this is the right time for them to take action, explain that advice and support will be available in the future whenever they need it. Provide contact details so that the person can get in touch when they are ready and voluntary organisations and support groups and how to contact them. |
Psycological |
self-monitoring of behaviour and progress |
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stimulus control & slowing rate of eating |
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Ensuring social support & assertiveness |
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Problem solving, cognitive restructuring (modifying thoughts) reinforcement of changes |
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Cognitive restructuring (modifying thoughts) reinforcement of changes |
Diet |
Diets that have a 600 kcal/day deficit (that is, they contain 600 kcal less than the person needs to stay the same weight) or that reduce calories by lowering the fat content (low-fat diets), in combination with expert support and intensive follow‑up, are recommended for sustainable weight loss |
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Do not routinely use very-low-calorie diets (800 kcal/day or less) to manage obesity (defined as BMI over 30). |
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Be mindful very-low-calorie diets (800 kcal/day or less) to manage obesity (defined as BMI over 30) are unlikely to be nutritionally complete |
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