Objective

To explore clinicians’ attitudes and beliefs about physical activity and exercise therapy as treatment for individuals with knee and/or hip osteoarthritis (OA).

Method

This was a scoping review, mapping available knowledge about the topic derived from qualitative research designs and methods. A comprehensive search of selected databases (MEDLINE, EMBASE; CINAHL; Web of Science) was conducted and data were analysed thematically.

Results

Twelve articles met inclusion criteria. Thematic analysis identified three interrelated main themes: 1) Understandings of OA and its trajectory and management; 2) Attitudes to activity and exercise as part of OA management; 3) Clinicians' perceived knowledge of and expertise in OA management. Findings highlight that many clinicians involved in knee/hip OA management, particularly general practitioners and physiotherapists, perceive OA to be a low priority ‘wear-and-tear’ disease with expected progression of symptoms, making joint replacement surgery eventually inevitable. Further, many clinicians appear to lack knowledge about and interest in physical activity and exercise therapy in the management of knee/hip OA, and seem to show uncertainty about the effectiveness and safety of physical activity and exercise therapy on joint health.

Conclusion

Clinicians’ attitudes and beliefs about physical activity and exercise therapy in OA seem to reflect an outdated narrative which describes OA as a wear-and-tear disease with inevitable disease progression to joint replacement surgery. Clinicians need to adopt a contemporary narrative, which accurately reflects current knowledge and evidence-based practice, thereby ensuring consistent utilisation of exercise therapy as first-line care as recommended in OA guidelines.

中文翻译：

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临床医生对体育活动和运动疗法治疗膝关节和/或髋关节骨关节炎的信念和态度：范围审查

客观的

探讨临床医生对体育活动和运动疗法作为治疗膝关节和/或髋关节骨关节炎 (OA) 个体的态度和信念。

方法

这是一项范围界定审查，从定性研究设计和方法中得出有关该主题的可用知识。对选定的数据库（MEDLINE、EMBASE；CINAHL；Web of Science）进行了全面搜索，并对数据进行了专题分析。

结果

十二篇文章符合纳入标准。主题分析确定了三个相互关联的主题： 1) 对 OA 及其轨迹和管理的理解；2) 作为 OA 管理一部分的活动和锻炼的态度；3) 临床医生对 OA 管理的认知和专业知识。研究结果表明，许多参与膝关节/髋关节 OA 管理的临床医生，特别是全科医生和物理治疗师，认为 OA 是一种低优先级的“磨损”疾病，具有预期的症状进展，使得关节置换手术最终不可避免。此外，许多临床医生似乎对身体活动和运动疗法在膝/髋关节 OA 的管理方面缺乏知识和兴趣，并且似乎对身体活动和运动疗法对关节健康的有效性和安全性表示不确定。

结论

临床医生对 OA 中体力活动和运动疗法的态度和信念似乎反映了一种过时的叙述，将 OA 描述为一种磨损性疾病，疾病不可避免地会发展为关节置换手术。临床医生需要采用当代叙事，准确反映当前的知识和循证实践，从而确保始终如一地使用运动疗法作为 OA 指南中推荐的一线护理。