[Salutogenic concepts in the rehabilitation of osteoarthritis].

BACKGROUND: 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.
OBJECTIVE: To examine the ability of salutogenic concepts to improve rehabilitative management of OA.
MATERIALS AND METHODS: Review article introducing salutogenic concepts and their empiric evidence, focussing on Antonovsky's sense of coherence (SOC).
RESULTS: The SOC consists of the three components comprehensibility, manageability and meaningfulness. SOC can be quantified by SOC-13, a self-reported measurement with 13 items. Associations of the SOC with different dimensions of health (in particular with Short Form 36, 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.
CONCLUSION: 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.