Salutogenic concepts in the rehabilitation of osteoarthritis

Abstract

The treatment strategies for osteoarthritis (OA) are well known from numerous studies. One of the challenges is long-term patient compliance to the recommended therapies without supervision. To examine the ability of salutogenic concepts to improve rehabilitative management of OA. Review article introducing salutogenic concepts and their empiric evidence, focussing on Antonovsky's sense of coherence (SOC). The SOC consists of the three components comprehensibility, manageability and meaningfulness. SOC can be quantified by SOC-13, a self-reported measurement with 13items. Associations of the SOC with different dimensions of health (in particular with Short Form36, SF-36) are known from cross-sectional studies. Most studies showed a stronger correlation of the mental than the physical health dimensions of SF-36 with SOC-13. This result is consistent with baseline examinations of hip and knee OA patients before rehabilitation. At the 6-month follow-up, correlations between SOC and the changes of the SF-36 scores were weak. A salutogenically orientated instruction for self-management of symptoms in cancer patients showed significant improvement in SOC. Increasing SOC can lead to health improvements on many levels, e.g. self-efficacy, reduction of fear, coping, education, resources and compliance to treatment. Empirical proof that interventional measures increasing SOC can improve the health of OA patients is currently unavailable.