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Marriott KA, Hall M, Maciukiewicz JM, Almaw RD, Wiebenga EG, Ivanochko NK, Rinaldi D, Tung EV, Bennell KL, Maly MR. Are the Effects of Resistance Exercise on Pain and Function in Knee and Hip Osteoarthritis Dependent on Exercise Volume, Duration, and Adherence? A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2024; 76:821-830. [PMID: 38317328 DOI: 10.1002/acr.25313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/24/2024] [Accepted: 02/01/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The purpose of this study was to determine dose parameters for resistance exercise associated with improvements in pain and physical function in knee and hip osteoarthritis (OA) and whether these improvements were related to adherence. METHODS We searched six databases, from inception to January 28, 2023, for randomized controlled trials comparing land-based, resistance exercise-only interventions with no intervention, or any other intervention. There were four subgroups of intervention duration: 0 to <3 months, 3 to 6 months, >6 to <12 months, ≥12 months. The between-group effect was calculated for immediate postintervention pain and physical function (activities of daily living [ADL] and sports/recreation [SPORT]). RESULTS For both knee and hip, data from 280 studies showed moderate benefit for pain, physical function ADL, and physical function SPORT in favor of interventions 3 to 6 months. For the knee, there was also a moderate benefit for physical function ADL in favor of interventions >6 to <12 months. From 151 knee and hip studies that provided total exercise volume data (frequency, time, duration), there was no association between volume with the effect size for pain and physical function. A total of 74 studies (69 knee, 5 hip) reported usable adherence data. There was no association between adherence with the effect size for pain and physical function. CONCLUSION In knee and hip OA, resistance exercise interventions 3 to 6 months (and for the knee >6 to <12 months) duration improve pain and physical function. Improvements do not depend on exercise volume or adherence, suggesting exercise does not require rigid adherence to a specific dose.
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Affiliation(s)
| | - Michelle Hall
- The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | | | | | | | - Emma V Tung
- The University of Waterloo, Waterloo, Ontario, Canada
| | - Kim L Bennell
- The University of Melbourne, Melbourne, Victoria, Australia
| | - Monica R Maly
- The University of Waterloo, Waterloo, Ontario, Canada
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Abujaber S, Altubasi I, Hamdan M, Al-Zaben R, Bani-Ahmad O. Physical functioning in patients with end-stage knee osteoarthritis: A cross-sectional study in Jordan using self-reported questionnaire and performance-based tests. J Back Musculoskelet Rehabil 2024:BMR230256. [PMID: 38250758 DOI: 10.3233/bmr-230256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r=-0.301, p= 0.047, and r= 0.39, p= 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r=-0.406, p= 0.010; r=-0.343, p= 0.027; respectively), while the strength of the affected side was correlated with the performed (p=< 0.001) and reported function outcomes (p= 0.007). CONCLUSION Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA).
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Affiliation(s)
- Sumayeh Abujaber
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Ibrahim Altubasi
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Mohammad Hamdan
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Raed Al-Zaben
- Department of Orthopaedic Surgery, Royal Medical Services, Amman, Jordan
| | - Omar Bani-Ahmad
- Department of Orthopaedic Surgery, Royal Medical Services, Amman, Jordan
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Fary C, Cholewa J, Abshagen S, Van Andel D, Ren A, Anderson MB, Tripuraneni K. Stepping Beyond Counts in Recovery of Total Hip Arthroplasty: A Prospective Study on Passively Collected Gait Metrics. SENSORS (BASEL, SWITZERLAND) 2023; 23:6538. [PMID: 37514832 PMCID: PMC10383890 DOI: 10.3390/s23146538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/12/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023]
Abstract
Gait quality parameters have been used to measure recovery from total hip arthroplasty (THA) but are time-intensive and previously could only be performed in a lab. Smartphone sensor data and algorithmic advances presently allow for the passive collection of qualitative gait metrics. The purpose of this prospective study was to observe the recovery of physical function following THA by assessing passively collected pre- and post-operative gait quality metrics. This was a multicenter, prospective cohort study. From six weeks pre-operative through to a minimum 24 weeks post-operative, 612 patients used a digital care management application that collected gait metrics. Average weekly walking speed, step length, timing asymmetry, and double limb support percentage pre- and post-operative values were compared with a paired-sample t-test. Recovery was defined as the post-operative week when the respective gait metric was no longer statistically inferior to the pre-operative value. To control for multiple comparison error, significance was set at p < 0.002. Walking speeds and step length were lowest, and timing asymmetry and double support percentage were greatest at week two post-post-operative (p < 0.001). Walking speed (1.00 ± 0.14 m/s, p = 0.04), step length (0.58 ± 0.06 m/s, p = 0.02), asymmetry (14.5 ± 19.4%, p = 0.046), and double support percentage (31.6 ± 1.5%, p = 0.0089) recovered at 9, 8, 7, and 10 weeks post-operative, respectively. Walking speed, step length, asymmetry, and double support all recovered beyond pre-operative values at 13, 17, 10, and 18 weeks, respectively (p < 0.002). Functional recovery following THA can be measured via passively collected gait quality metrics using a digital care management platform. The data suggest that metrics of gait quality are most negatively affected two weeks post-operative; recovery to pre-operative levels occurs at approximately 10 weeks following primary THA, and follows a slower trajectory compared to previously reported step count recovery trajectories.
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Affiliation(s)
- Camdon Fary
- Epworth Foundation, Richmond, VIC 3121, Australia
- Department of Orthopaedics, Western Hospital, Melbourne, VIC 3011, Australia
| | | | | | | | - Anna Ren
- Zimmer Biomet, Warsaw, IN 46580, USA
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John S, Esch M, Steinert M, Witte K. Relationship Between Self-Reported Function, Functional Tests and Biomechanical Parameters in Patients 12 Months After Total Hip Arthroplasty: A Preliminary Cross-Sectional Study. Indian J Orthop 2023; 57:1032-1040. [PMID: 37384004 PMCID: PMC10293490 DOI: 10.1007/s43465-023-00887-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 03/30/2023] [Indexed: 06/30/2023]
Abstract
Background/Purpose Several methods are used to evaluate the outcome of total hip arthroplasty (THA), however, their relationship at different time points after surgery is unclear. The purpose of this exploratory study was to investigate correlations between self-report function, performance-based tests (PBTs) and biomechanical parameters in patients 12 months after THA. Methods Eleven patients were included in this preliminary cross-sectional study. Hip disability and Osteoarthritis Outcome Score (HOOS) was completed for self-reported function. As PBTs, the Timed-up-and-Go test (TUG) and 30-Second-Chair-Stand test (30CST) were used. Biomechanical parameters were derived from analyses of hip strength, gait and balance. Potential correlations were calculated using Spearman correlation coefficient r. Results HOOS scores and parameters of PBTs showed moderate to strong correlations (0.3 < r < 0.7). Correlation analysis between HOOS scores and biomechanical parameters revealed moderate to strong correlations for hip strength whereas correlations with gait parameters and balance were rather weak (r < 0.3). Moderate to strong correlations were also found between parameters of hip strength and 30CST. Conclusion For THA outcome assessment 12 months after surgery, our first results indicate that self-report measures or PBTs could be used. Analysis of hip strength also appears to be reflected in HOOS and PBT parameters and may be considered as an adjunct. Given the weak correlations with gait and balance parameters, we suggest that gait analysis and balance testing should be performed in addition to PROMs and PBTs as they may provide supplementary information, especially for THA patients that are at risk for falls.
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Affiliation(s)
- Stefanie John
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Magdeburg, Germany
| | - Michael Esch
- Department of Biomechanics, Faculty of Mechanical and Process Engineering, Offenburg University of Applied Sciences, Offenburg, Germany
| | - Marvin Steinert
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Magdeburg, Germany
| | - Kerstin Witte
- Department of Sports Science, Faculty of Humanities, Otto-von-Guericke-University, Magdeburg, Germany
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Abujaber S, Altubasi I, Hamdan M, Al-Zaben R. Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan. PLoS One 2023; 18:e0286962. [PMID: 37294813 PMCID: PMC10256207 DOI: 10.1371/journal.pone.0286962] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/21/2023] [Indexed: 06/11/2023] Open
Abstract
OBJECTIVE Of the present study was to evaluate the impact of end-stage knee OA on patient's perception of their functional abilities and quality of life (QoL) using the self-reported questionnaire; the Knee Injury and Osteoarthritis Outcome Score (KOOS), and to determine the contribution of knee pain on patient's perceived outcomes. METHODS Patients with end-stage knee OA who are on the waiting list for total knee arthroplasty were recruited in this cross-sectional study. Patients were asked to fill out the KOOS questionnaire. Knee pain for both sides was quantified on a continuous scale from 0-10. Age, and anthropometric data were recorded. Descriptive statistics were calculated for patients' characteristics, and for the scores of each KOOS subscale. Hierarchical linear regression models were created to determine the contributions of knee pain on two KOOS subscales; the function in daily living (KOOS-ADL), and the knee-related quality of life (KOOS-QoL). RESULTS Patients in this study scored low across KOOS subscales (27.7% - 54.2%) with the QoL subscale being the lowest. After accounting for age and BMI, hierarchical linear regressions revealed that knee pain in both sides were determinants of self-perceived KOOS-ADLs, while only knee pain in the most-affected side significantly contributed to lower KOOS-QOL scores. CONCLUSION End-stage knee OA negatively impact the patients' perceived function and quality of life. Patients' KOOS scores were similar to those reported in other countries, with QoL being the domain most affected. Our findings demonstrate that the level of knee pain has a determinant effect on our patients' perceptions of functional abilities and QoL. As waiting-list patients, addressing knee pain with a targeted regimen prior to TKA, as well as increasing patient's awareness about knee pain management, may improve/ or minimize deterioration in perceived functional ability and QoL while awaiting TKA.
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Affiliation(s)
- Sumayeh Abujaber
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Ibrahim Altubasi
- Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Mohammad Hamdan
- Department of Special Surgery, Division of Orthopaedics, School of Medicine, The University of Jordan, Amman, Jordan
| | - Raed Al-Zaben
- Department of Orthopaedic Surgery, Royal Medical Services, Amman, Jordan
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Atukorala I, Hunter DJ. A review of quality-of-life in elderly osteoarthritis. Expert Rev Pharmacoecon Outcomes Res 2023; 23:365-381. [PMID: 36803292 DOI: 10.1080/14737167.2023.2181791] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Osteoarthritis (OA) is the commonest joint disease in the world. Although aging is not invariably associated with OA, aging of the musculoskeletal system increases susceptibility to OA. Pain and reduced function due to OA, negatively impact health-related quality of life (HRQoL) in the elderly. AREAS COVERED We searched PubMed and Google Scholar with search term "osteoarthritis' combined with terms 'elderly' 'ageing' 'healthrelated quality of life' 'burden' "prevalence 'hip osteoarthritis' 'knee osteoarthritis' 'hand osteoarthritis' to identify relevant articles. This article discusses the global impact and joint-specific burden due to OA and the challenges in assessment of HRQoL in elderly with OA. We further describe some HRQoL determinants that particularly impact elderly persons with OA. These determinants include physical activity, falls, psychosocial consequences, sarcopaenia, sexual health, and incontinence. The usefulness of physical performance measures, as an adjunct to assessing HRQoL is explored. The review concludes by outlining strategies to improve HRQoL. EXPERT OPINION Assessment of HRQoL in elderly with OA is mandatory if effective interventions/treatment are to be instituted. But existent HRQoL assessments have shortcomings when used in elderly§. It is recommended that determinants of QoL which are unique to the elderly, be examined with greater detail and weightage in future studies.
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Affiliation(s)
- Inoshi Atukorala
- Senior Lecturer in Clinical Medicine & Consultant Rheumatologist, University Medical Unit, National Hospital Sri Lanka, & Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - David J Hunter
- Florance and Cope Chair of Rheumatology, Co-Director Sydney Musculoskeletal Health Flagship, University of Sydney, Camperdown, Australia
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Nanjo K, Ikeda T, Nagashio N, Sakai T, Jinno T. Psychological factors associated with instrumental activities of daily living disability in older adults with moderate to severe knee osteoarthritis. J Back Musculoskelet Rehabil 2023:BMR220197. [PMID: 36911929 DOI: 10.3233/bmr-220197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
BACKGROUND The population of older adults with knee osteoarthritis (OA)-related disabilities is increasing globally. However, studies regarding instrumental activities of daily living (IADL) in older adults with knee OA are limited. OBJECTIVE This study investigated the psychological factors associated with IADL disability in older adults with moderate to severe knee OA. METHODS A cross-sectional study was conducted on 179 patients with knee OA aged ⩾ 65 years. The six-item short form of the Pain Catastrophizing Scale (PCS-6), the four-item short form of the Pain Self-Efficacy Questionnaire (PSEQ-4), and the fifteen-item Geriatric Depression Scale (GDS-15) were used to assess psychological factors. The participants were divided into IADL disabled and non-disabled groups. Binary logistic regression analyses were performed with the IADL disability status as the dependent variable. The PCS-6, PSEQ-4, and GDS-15 tools were included as independent variables in the logistic regression model. RESULTS Of the 179 participants, 88 (49.1%) showed disability in conducting IADL. PSEQ-4 (odds ratio = 0.90, 95%; confidence interval = 0.82-0.99, p= 0.02) was a significant independent variable among all psychological factors. CONCLUSION Even after controlling for cofounders, our study found that self-efficacy, assessed using the PSEQ-4, was related to IADL disability in older adults with moderate to severe knee OA.
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Affiliation(s)
- Keigo Nanjo
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,Department of Rehabilitation, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Takashi Ikeda
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.,School of Nursing and Rehabilitation Sciences, Showa University, Kanagawa, Japan.,Research Institute for Sport and Exercise Sciences, Showa University, Kanagawa, Japan
| | - Naoko Nagashio
- Department of Rehabilitation, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Tomoko Sakai
- Department of Rehabilitation Medicine, Tokyo Medical and Dental University Graduate School, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopedic Surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan
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Shao Z, Liang Z, Hu P, Bi S. A nomogram based on radiological features of MRI for predicting the risk of severe pain in patients with osteoarthritis of the knee. Front Surg 2023; 10:1030164. [PMID: 36843982 PMCID: PMC9944387 DOI: 10.3389/fsurg.2023.1030164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023] Open
Abstract
Methods This study aimed to develop and validate a nomogram for predicting the risk of severe pain in patients with knee osteoarthritis. A total of 150 patients with knee osteoarthritis were enrolled from our hospital, and nomogram was established through a validation cohort (n = 150). An internal validation cohort (n = 64) was applied to validate the model. Results Eight important variables were identified using the Least absolute shrinkage and selection operator (LASSO) and then a nomogram was developed by Logistics regression analysis. The accuracy of the nomogram was determined based on the C-index, calibration plots, and Receiver Operating Characteristic (ROC) curves. Decision curves were plotted to assess the benefits of the nomogram in clinical decision-making. Several variables were employed to predict severe pain in knee osteoarthritis, including sex, age, height, body mass index (BMI), affected side, Kellgren-Lawrance (K-L) degree, pain during walking, pain going up and down stairs, pain sitting or lying down, pain standing, pain sleeping, cartilage score, Bone marrow lesion (BML) score, synovitis score, patellofemoral synovitis, bone wear score, patellofemoral bone wear, and bone wear scores. The LASSO regression results showed that BMI, affected side, duration of knee osteoarthritis, meniscus score, meniscus displacement, BML score, synovitis score, and bone wear score were the most significant risk factors predicting severe pain. Conclusions Based on the eight factors, a nomogram model was developed. The C-index of the model was 0.892 (95% CI: 0.839-0.945), and the C-index of the internal validation was 0.822 (95% CI: 0.722-0.922). Analysis of the ROC curve of the nomogram showed that the nomogram had high accuracy in predicting the occurrence of severe pain [Area Under the Curve (AUC) = 0.892] in patients with knee osteoarthritis (KOA). The calibration curves showed that the prediction model was highly consistent. Decision curve analysis (DCA) showed a higher net benefit for decision-making using the developed nomogram, especially in the >0.1 and <0.86 threshold probability intervals. These findings demonstrate that the nomogram can predict patient prognosis and guide personalized treatment.
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Affiliation(s)
- Zhuce Shao
- Department of Bone and Joint, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Zhipeng Liang
- Department of Bone and Joint, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
| | - Peng Hu
- Department of Bone and Joint, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, China
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Isometric Quadriceps Exercises for Patients with Knee Osteoarthritis: A Randomized Controlled Trial Comparing Knee Joint Position Flexion versus Extension. Rehabil Res Pract 2022; 2022:2690871. [PMID: 36051506 PMCID: PMC9427309 DOI: 10.1155/2022/2690871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To compare the effect of quadriceps isometric exercises performed in two different positions in addition to the combined physical therapy program on pain, stiffness, and physical function in patients with knee osteoarthritis (OA). Methods A total of 30 patients with OA (age range 45 to 70 years) who were admitted to Istanbul Private Ekotom Medical Center, Department of Physical Medicine and Rehabilitation Outpatient Clinic, were included. The patients were randomly divided into two groups according to the type of performing the quadriceps isometric exercises as group 1 (performing in knee extension, n = 14) and group 2 (performing in knee flexion, n = 15). All patients also received a combined physical therapy program. Exercise protocols were applied six days a week for four weeks. The pain was evaluated using a 10 cm visual analog scale for pain (VAS) in rest and activity; pain, joint stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results A significant difference was found in the VAS and WOMAC scores of both groups in group comparisons (p < 0.05). When the groups were compared in terms of change values, a significant difference was found in the WOMAC stiffness score in favor of group I (p < 0.05). Discussion. It is possible to obtain positive results with quadriceps isometric exercises to reduce pain and joint stiffness and increase physical function in patients with knee OA. However, exercises performed in knee extension were found to be more effective in reducing joint stiffness.
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Ferreira AM, Salim R, Fogagnolo F, de Oliveira LFL, Riberto M, Kfuri M. The Value of a Standardized Knee Functional Assessment in Predicting the Outcomes of Total Knee Arthroplasty. J Knee Surg 2022; 35:1126-1131. [PMID: 33511585 DOI: 10.1055/s-0040-1722321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Questionnaires and physical tests are tools to determine the ability of an individual to perform tasks of the daily living. In our institution, a standardized knee performance evaluation including patient-reported outcome measures (PROMs) and physical performance tests has been applied to all patients undergoing total knee arthroplasty (TKA). Our goal was to identify which preoperative tools influence the outcomes of a TKA and if physical performance tests can be of value if used along with PROMs in predicting functional outcomes. Classification and regression tree was used to analyze which preoperative factors influence function after TKA. Western Ontario and McMaster Universities Arthritis Index (WOMAC) function (WOMAC-F), 6-minute walk test (6MWT), and timed up and go (TUG) test at the 12th postoperative month were the dependent variables. Age, body mass index, preoperative WOMAC function and pain score, muscle strength, 6MWT, and TUG test score were used as preoperative predictors of dependent variables. TUG ≤19.3 seconds and age <62 years were preoperative predictors of better scores in the WOMAC-F (5.5). Strength of extensor muscles of the nonoperated knee ≥99.43 N·m/kg and 6MWT> 328 m were preoperative predictors of a better postoperative 6MWT (499 m). TUG <12.3 seconds and 6MWT ≥421 m were preoperative predictors of better postoperative TUG (7.3 seconds). Preoperative performance in physical tests had an influence on postoperative outcome scores than PROMs after TKA. Less age, good muscular strength, greater capacity of walking, and smaller TUG times were associated with better outcomes.
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Affiliation(s)
- Aline Miranda Ferreira
- Departament of Health Care, Rehabilitation Center of the Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Rodrigo Salim
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Fabricio Fogagnolo
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Luciano Fonseca Lemos de Oliveira
- Departament of Health Care, Rehabilitation Center of the Clinics Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Marcelo Riberto
- Department of Orthopaedics and Anaesthesiology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Sao Paulo, Brazil
| | - Mauricio Kfuri
- Departament of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
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Murphy MT, Wang N, Felson DT, Nevitt MC, Lewis CE, Frey-Law L, Guermazi A, Segal NA. Association between hamstring coactivation during isokinetic quadriceps strength testing and knee cartilage worsening over 24 months. Osteoarthritis Cartilage 2022; 30:823-831. [PMID: 35307535 PMCID: PMC9450915 DOI: 10.1016/j.joca.2022.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 02/24/2022] [Accepted: 03/07/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study aimed to determine longitudinal associations, including sex-specific differences, between greater knee flexor antagonist coactivation and worsening cartilage morphology in knees with or at risk for osteoarthritis (OA). DESIGN Baseline measurements were collected at the 60-month visit of a longitudinal osteoarthritis study following community-dwelling participants (MOST). Knee flexor and extensor muscle activity were measured with surface electromyography during a maximal isokinetic knee extension task. MRI analyzed knee cartilage morphology at baseline and 24-month follow-up. Multivariable adjusted logistic regression models were used to assess associations between coactivation level and cartilage morphology worsening. RESULTS Analysis of 373 women (mean ± SD age 67.4 ± 7.3 years and BMI 29.7 ± 5.0 kg/m2) and 240 men (66.5 ± 7.8 years and 29.9 ± 4.5 kg/m2) revealed that women had greater medial (P < 0.001), lateral (P < 0.001), and combined (P < 0.001) hamstring coactivation than men. In both sexes, combined hamstring coactivation was associated with patellofemoral cartilage morphology worsening [1.23 (1.02, 1.49)] and to a less significant degree with whole knee cartilage morphology worsening [1.21 (0.98, 1.49)]. In men, greater combined hamstring coactivation was associated with increased risk for whole knee [1.59 (1.06, 2.39)] and patellofemoral [1.38 (1.01, 1.88)] cartilage morphology worsening and point estimates suggested association between medial hamstring coactivation and medial tibiofemoral cartilage morphology worsening. No significant associations were detected between greater hamstring coactivation and cartilage morphology worsening in women. CONCLUSIONS These findings suggest a longitudinal relationship between antagonist hamstring coactivation during isokinetic knee extensor testing and worsening of cartilage morphology over 24 months in men with or at risk for knee OA.
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Affiliation(s)
- M T Murphy
- Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA.
| | - N Wang
- Department of Biostatistics and Epidemiology, Boston University, Boston, MA, USA.
| | - D T Felson
- Department of Epidemiology, Boston University, Boston, MA, USA.
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, CA, USA.
| | - C E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - L Frey-Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA.
| | - A Guermazi
- Department of Radiology, Boston University, Boston, MA, USA.
| | - N A Segal
- Department of Rehabilitation Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 1046, Kansas City, KS, 66160, USA.
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Ong JH, Simic M, Eisenhuth J, Burns J, Baldwin JN, McKay MJ. Normative Reference Values for Knee Extensor Muscle Rate of Torque Development and Torque Steadiness in Adolescents and Adults. J Clin Rheumatol 2022; 28:155-161. [PMID: 35293889 DOI: 10.1097/rhu.0000000000001819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to establish reference values for rate of torque development (RTD) and muscle torque steadiness (MTS) of knee extensors across the lifespan, and evaluate if these measures are independently associated with Osteoarthritis Research Society International (OARSI)-recommended performance-based measures (6-minute walk test, 30-second chair stand test, stair climb test) and other clinical variables. METHODS In this cross-sectional observational study, knee extensor strength of 764 participants (12-89 years) from the 1000 Norms Project was assessed via fixed dynamometry. Age- and sex-stratified normative RTD (Nms-1 kg-1) and MTS (Nm kg-1) values were presented as means and 95% confidence intervals. Correlations and multiple regression analyses were calculated to identify factors (age, sex, height, weight, OARSI-recommended performance-based measures, Knee Injury and Osteoarthritis Outcome Score, vertical jump, long jump, grip strength, basic gait-related knee biomechanics) independently associated with RTD or MTS. RESULTS Age- and sex-stratified normative RTD and MTS reference values were generated. Male subjects exhibited higher RTD but poorer MTS (less steady) than female subjects across all age groups. Better performance in OARSI-recommended performance-based measures, vertical jump, long jump, and grip strength were associated with greater RTD but poorer MTS. Thirty-second chair stand test, stair climb test, vertical jump, long jump, and grip strength were independent determinants of RTD and MTS. CONCLUSIONS The RTD and MTS demonstrated associations with clinical variables relevant to knee osteoarthritis. The normative reference values generated may help identify the presence and extent of impairments in RTD and MTS associated with knee osteoarthritis and assist in developing responsive outcome measures for therapeutic trials.
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Affiliation(s)
- Jia Hui Ong
- From the School of Health Sciences, Faculty of Medicine and Health, The University of Sydney
| | - Milena Simic
- From the School of Health Sciences, Faculty of Medicine and Health, The University of Sydney
| | - John Eisenhuth
- From the School of Health Sciences, Faculty of Medicine and Health, The University of Sydney
| | | | - Jennifer N Baldwin
- Priority Research Centre for Physical Activity and Nutrition, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, Australia
| | - Marnee J McKay
- From the School of Health Sciences, Faculty of Medicine and Health, The University of Sydney
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13
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Bily W, Jauker J, Nics H, Grote V, Pirchl M, Fischer MJ. Associations between Patient-Reported and Clinician-Reported Outcome Measures in Patients after Traumatic Injuries of the Lower Limb. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19053140. [PMID: 35270830 PMCID: PMC8910334 DOI: 10.3390/ijerph19053140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 01/09/2023]
Abstract
Both clinician-reported outcome measures (CROMs) measures and patient-reported outcome measures (PROMs) are applied to evaluate outcomes in rehabilitation settings. The previous data show only a low to moderate correlation between these measures. Relationships between functional performance measures (Clinician-Reported Outcome Measures, CROMs) and Patient-Reported Outcome Measures (PROMs) were analysed in rehabilitation patients with traumatic injuries of the lower limb. A cohort of 315 patients with 3 subgroups (127 hip, 101 knee and 87 ankle region) was analysed before and after 3 weeks of inpatient rehabilitation. All three groups showed significant improvements in PROMs with low to moderate effect sizes. Moderate to high effect sizes were found for CROMs. Correlation coefficients between CROMs and PROMs were low to moderate. The performance consistency between PROMs and CROMs ranged from 56.7% to 64.1%. In this cohort of rehabilitation patients with traumatic injuries, CROMs showed higher effect sizes than PROMs. When used in combination, patient-reported outcome and performance measures contribute to collecting complementary information, enabling the practitioner to make a more accurate clinical evaluation of the patient’s condition.
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Affiliation(s)
- Walter Bily
- Department of Physical Medicine and Rehabilitation, Ottakring Clinic, Vienna Health Association, A-1160 Vienna, Austria; (W.B.); (J.J.)
| | - Jakob Jauker
- Department of Physical Medicine and Rehabilitation, Ottakring Clinic, Vienna Health Association, A-1160 Vienna, Austria; (W.B.); (J.J.)
| | - Helena Nics
- Department of Physical Medicine and Rehabilitation, Floridsdorf Clinic, Vienna Health Association, A-1210 Vienna, Austria;
| | - Vincent Grote
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1140 Vienna, Austria; (M.P.); (M.J.F.)
- Department of Physical Medicine, Rehabilitation and Occupational Medicine, Medical University of Vienna, A-1090 Vienna, Austria
- Correspondence: ; Tel.: +43-680-2199422
| | - Michael Pirchl
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1140 Vienna, Austria; (M.P.); (M.J.F.)
| | - Michael J. Fischer
- Ludwig Boltzmann Institute for Rehabilitation Research, A-1140 Vienna, Austria; (M.P.); (M.J.F.)
- Vamed Rehabilitation Center Kitzbühel, A-6370 Kitzbühel, Austria
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14
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Guaracha-Basáñez GA, Contreras-Yáñez I, Hernández-Molina G, Estrada-González VA, Pacheco-Santiago LD, Valverde-Hernández SS, Galindo-Donaire JR, Peláez-Ballestas I, Pascual-Ramos V. Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path. PLoS One 2022; 17:e0262756. [PMID: 35041692 PMCID: PMC8765619 DOI: 10.1371/journal.pone.0262756] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous models that assess quality-of-Life (QoL) in patients with rheumatic diseases have a strong biomedical focus. We evaluated the impact of COVID-19 related-health care interruption (HCI) on the physical, psychological, social relationships and environment QoL-dimensions, and explored factors associated with QoL when patients were reincorporated to the outpatient clinic, and after six-month follow-up. PATIENTS AND METHODS Study phase-1 consisted of a COVID-19 survey administered from June 24th-October 31st 2020, to outpatients with rheumatic diseases who had face-to-face consultation at outpatient clinic reopening. Study phase-2 consisted of 3 consecutive assessments of patient´s QoL (WHOQOL-BREF), disease activity/severity (RAPID-3), and psychological comorbidity/trauma (DASS-21 and IES-R) to patients from phase-1 randomly selected. Sociodemographic, disease and treatment-related information, and comorbidities were obtained. Multiple linear regression analysis identified factors associated with the score assigned to each WHOQOL-BREF dimension. RESULTS Patients included (670 for phase-1 and 276 for phase-2), had primarily SLE and RA (44.2% and 34.1%, respectively), and all the dimensions of their WHOQOL-BREF were affected. There were 145 patients (52.5%) who referred HCI, and they had significantly lower dimensions scores (but the environment dimension score). Psycho-emotional factors (primarily feeling confused, depression and anxiety), sociodemographic factors (age, COVID-19 negative economic impact, years of scholarship, HCI and having a job), and biomedical factors (RAPID-3 score and corticosteroid use) were associated with baseline QoL dimensions scores. Psycho-emotional factors showed the strongest magnitude on dimensions scores. Most consistent predictor of six-month follow-up QoL dimensions scores was each corresponding baseline dimension score, while social determinants (years of scholarship and having a job), emotional factors (feeling bored), and biomedical aspects (RAPID 3) had an additional impact. CONCLUSIONS HCI impacted the majority of patient´s QoL dimensions. Psycho-emotional, sociodemographic and biomedical factors were consistently associated with QoL dimensions scores, and these consistently predicted the QoL trajectory.
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Affiliation(s)
- Guillermo A. Guaracha-Basáñez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - Irazú Contreras-Yáñez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - Gabriela Hernández-Molina
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - Viviana A. Estrada-González
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - Lexli D. Pacheco-Santiago
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - Salvador S. Valverde-Hernández
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | - José Roberto Galindo-Donaire
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
| | | | - Virginia Pascual-Ramos
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico
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15
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Egerton T, Bolton J, Short CE, Bennell KL. Exploring changes, and factors associated with changes, in behavioural determinants from a low-cost, scalable education intervention about knee osteoarthritis: An observational cohort study. BMC Musculoskelet Disord 2021; 22:862. [PMID: 34627203 PMCID: PMC8502260 DOI: 10.1186/s12891-021-04751-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/29/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To explore the relationships between participant characteristics, perceptions of a short educational video about osteoarthritis and its management, and immediate changes in behavioural determinants for effective self-management behaviours. METHODS Seventy-eight participants with knee OA (77% female, mean age 63.0 ± 8.7) watched the 9-min video that included evidence-based content and was designed to foster empowerment to self-manage effectively. Data were collected by online questionnaire at baseline and immediately after watching the video. Associations were tested between baseline health and information processing characteristics (health literacy, need for cognition), perceptions of the video (enjoyment, helpfulness, believability, novelty and relevance) and pre-post changes in behavioural determinants (self-efficacy for managing arthritis, attitude to self-management or 'activation', and importance/confidence for physical activity). RESULTS All behavioural determinants improved immediately after watching the video. Positive perceptions were associated with greater improvements in self-efficacy for arthritis (Spearman's rho, ρ = 0.26-0.47). Greater perceived relevance was associated with increased self-rated importance of being physically active (ρ = 0.43). There were small positive associations between health literacy domains related to health information and positive viewer perceptions of the video. People with higher need for cognition may achieve greater improvement in confidence to be physically active (ρ = 0.27). CONCLUSION The educational video may help achieve outcomes important for increasing self-management behaviours in people with knee osteoarthritis. Positive perceptions appear to be important in achieving these improvements. People with lower health literacy and lower need for cognition may respond less well to this information about knee osteoarthritis delivered in this way.
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Affiliation(s)
- Thorlene Egerton
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Level 7, Alan Gilbert Building, Melbourne, Victoria, 3010, Australia.
- Physiotherapy Department, The University of Melbourne, Melbourne, Australia.
| | - Joanne Bolton
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Level 7, Alan Gilbert Building, Melbourne, Victoria, 3010, Australia
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
- Melbourne School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine, The University of Melbourne, Level 7, Alan Gilbert Building, Melbourne, Victoria, 3010, Australia
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Fernandes L, Holm CE, Villadsen A, Sørensen MS, Zebis MK, Petersen MM. Clinically Important Reductions in Physical Function and Quality of Life in Adults with Tumor Prostheses in the Hip and Knee: A Cross-sectional Study. Clin Orthop Relat Res 2021; 479:2306-2319. [PMID: 33974591 PMCID: PMC8445557 DOI: 10.1097/corr.0000000000001797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/09/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patients with a bone sarcoma who undergo limb-sparing surgery and reconstruction with a tumor prosthesis in the lower extremity have been shown to have reduced self-reported physical function and quality of life (QoL). To provide patients facing these operations with better expectations of future physical function and to better evaluate and improve upon postoperative interventions, data from objectively measured physical function have been suggested. QUESTIONS/PURPOSES We sought to explore different aspects of physical function, using the International Classification of Functioning, Disability, and Health (ICF) as a framework, by asking: (1) What are the differences between patients 2 to 12 years after a bone resection and reconstruction surgery of the hip and knee following resection of a bone sarcoma or giant cell tumor of bone and age-matched controls without walking limitations in ICF body functions (ROM, muscle strength, pain), ICF activity and participation (walking, getting up from a chair, daily tasks), and QoL? (2) Within the patient group, do ICF body functions and ICF activity and participation outcome scores correlate with QoL? METHODS Between 2006 and 2016, we treated 72 patients for bone sarcoma or giant cell tumor of bone resulting in bone resection and reconstruction with a tumor prosthesis of the hip or knee. At the timepoint for inclusion, 47 patients were alive. Of those, 6% (3 of 47) had undergone amputation in the lower limb and were excluded. A further 32% (14 of 44) were excluded because of being younger than 18 years of age, pregnant, having long transportation, palliative care, or declining participation, leaving 68% (30 of 44) for analysis. Thus, 30 patients and 30 controls with a mean age of 51 ± 18 years and 52 ± 17 years, respectively, were included in this cross-sectional study. Included patients had been treated with either a proximal femoral (40% [12 of 30]), distal femoral (47% [14 of 30]), or proximal tibia (13% [4 of 30]) reconstruction. The patients were assessed 2 to 12 years (mean 7 ± 3 years) after the resection-reconstruction. The controls were matched on gender and age (± 4 years) and included if they considered their walking capacity to be normal and had no pain in the lower extremity. Included outcome measures were: passive ROM of hip flexion, extension, and abduction and knee flexion and extension; isometric muscle strength of knee flexion, knee extension and hip abduction using a hand-held dynamometer; pain intensity (numeric rating scale; NRS) and distribution (pain drawing); the 6-minute walk test (6MWT); the 30-second chair-stand test (CST); the Toronto Extremity Salvage Score (TESS), and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The TESS and the EORTC QLQ-C30 were normalized to 0 to 100 points. Higher scoring represents better status for TESS and EORTC global health and physical functioning scales. Minimum clinically important difference for muscle strength is 20% to 25%, NRS 2 points, 6MWT 14 to 31 meters, CST 2 repetitions, TESS 12 to 15 points, and EORTC QLQ-C30 5 to 20 points. RESULTS Compared with controls, the patients had less knee extension and hip abduction strength in both the surgical and nonsurgical limbs and regardless of reconstruction site. Mean knee extension strength in patients versus controls were: surgical limb 0.9 ± 0.5 Nm/kg versus 2.1 ± 0.6 Nm/kg (mean difference -1.3 Nm/kg [95% CI -1.5 to -1.0]; p < 0.001) and nonsurgical limb 1.7 ± 0.6 Nm/kg versus 2.2 ± 0.6 Nm/kg (mean difference -0.5 Nm/kg [95% CI -0.8 to -0.2]; p = 0.003). Mean hip abduction strength in patients versus controls were: surgical limb 1.1 ± 0.4 Nm/kg versus 1.9 ± 0.5 Nm/kg (mean difference -0.7 Nm/kg [95% CI -1.0 to -0.5]; p < 0.001) and nonsurgical limb 1.5 ± 0.4 Nm/kg versus 1.9 ± 0.5 Nm/kg (-0.4 Nm/kg [95% CI -0.6 to -0.2]; p = 0.001). Mean hip flexion ROM in patients with proximal femoral reconstructions was 113° ± 18° compared with controls 130° ± 11° (mean difference -17°; p = 0.006). Mean knee flexion ROM in patients with distal femoral reconstructions was 113° ± 29° compared with patients in the control group 146° ± 9° (mean difference -34°; p = 0.002). Eighty-seven percent (26 of 30) of the patients reported pain, predominantly in the knee, anterior thigh, and gluteal area. The patients showed poorer walking and chair-stand capacity and had lower TESS scores than patients in the control group. Mean 6MWT was 499 ± 100 meters versus 607 ± 68 meters (mean difference -108 meters; p < 0.001), mean CST was 12 ± 5 repetitions versus 18 ± 5 repetitions (mean difference -7 repetitions; p < 0.001), and median (interquartile range) TESS score was 78 (21) points versus 100 (10) points (p < 0.001) in patients and controls, respectively. Higher pain scores correlated to lower physical functioning of the EORTC QLQ-C30 (Rho -0.40 to -0.54; all p values < 0.05). Less muscle strength in knee extension, knee flexion, and hip abduction correlated to lower physical functioning of the EORTC QLQ-C30 (Rho 0.40 to 0.51; all p values < 0.05). CONCLUSION This patient group demonstrated clinically important muscle weaknesses not only in resected muscles but also in the contralateral limb. Many patients reported pain, and they showed reductions in walking and chair-stand capacity comparable to elderly people. The results are relevant for information before surgery, and assessments of objective physical function are advisable in postoperative monitoring. Prospective studies evaluating the course of physical function and which include assessments of objectively measured physical function are warranted. Studies following this patient group with repetitive measures over about 5 years could provide information about the course of physical function, enable comparisons with population norms, and lead to better-designed, targeted, and timely postoperative interventions. LEVEL OF EVIDENCE Level III, therapeutic study.
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Affiliation(s)
- Linda Fernandes
- Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Christina Enciso Holm
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Allan Villadsen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Michala Skovlund Sørensen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Mette Kreutzfeldt Zebis
- Department of Midwifery, Physiotherapy, Occupational Therapy, and Psychomotor Therapy, University College Copenhagen, Copenhagen, Denmark
| | - Michael Mørk Petersen
- Musculoskeletal Tumor Section, Department of Orthopedic Surgery, University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Park S, Min S, Park SH, Yoo J, Jee YS. Influence of Isometric Exercise Combined With Electromyostimulation on Inflammatory Cytokine Levels, Muscle Strength, and Knee Joint Function in Elderly Women With Early Knee Osteoarthritis. Front Physiol 2021; 12:688260. [PMID: 34326779 PMCID: PMC8313868 DOI: 10.3389/fphys.2021.688260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022] Open
Abstract
Background and Objectives: Muscle strengthening exercise is suggested to beneficial for patients with knee osteoarthritis (OA) and electrical muscular stimulation is reported to be effective in improvement of muscle strength. This study examined whether isometric exercise combined with whole body-electromyostimulation (WB-EMS) can improve serum cytokine levels, muscle strength, and knee function in elderly women with early knee OA. Materials and Methods: This randomized controlled study included 75 participants assigned into three groups: the control group (CON), isometric exercise group (ISOM), and isometric exercise and electromyostimulation group (ISOM + EMS). The two exercise groups performed their respective programs for 8 weeks, 3 days a week, 30 min a day. The main exercises for both groups were performed continuously during the 20 min in an alternation of a 6-s contraction with a 4-s break. At pre- and post-intervention, anthropometric variables, muscle strength, Knee Injury and Osteoarthritis Outcome Score (KOOS), and blood sampling for biomarkers including interleukin-6, tumor necrosis factor-α, C-reactive protein, and resistin were performed. Results: All variables at pre-intervention showed no significant differences among the three groups. However, there were significant differences between groups for body composition, muscle strength, KOOS subscale scores, and biomarkers. ISOM + EMS group resulted in a significant reduction in body weight, fat mass, fat percentage, inflammatory cytokine levels, and increased muscle strength. An ISOM + EMS group had the best KOOS score among all groups. Conclusion: Isometric exercise combined with WB-EMS resulted in the best overall improvements in knee function and alleviating the pain and symptoms of patients with early knee OA. Further, reduced levels of inflammatory cytokines were observed. These non-pharmacologic, non-invasive interventions should be considered by healthcare specialists for elderly patients with early knee OA.
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Affiliation(s)
- Sunhee Park
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Sukyung Min
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Si-Hwa Park
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
| | - Jaehyun Yoo
- Department of Physical Education, Sahmyook University, Seoul, South Korea
| | - Yong-Seok Jee
- Research Institute of Sports and Industry Science, Hanseo University, Seosan, South Korea
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18
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Kittelson AJ, Schmiege SJ, Maluf K, George SZ, Stevens-Lapsley JE. Determination of Pain Phenotypes in Knee Osteoarthritis Using Latent Profile Analysis. PAIN MEDICINE 2021; 22:653-662. [PMID: 33367906 DOI: 10.1093/pm/pnaa398] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To identify clinical phenotypes of knee osteoarthritis (OA) using measures from the following domains: 1) multimorbidity; 2) psychological distress; 3) pain sensitivity; and 4) knee impairment or pathology. DESIGN Data were collected from 152 people with knee OA and from 31 pain-free individuals. In participants with knee OA, latent profile analysis (LPA) was applied to the following measures: normalized knee extensor strength, Functional Comorbidity Index (FCI), Pain Catastrophizing Scale (PCS), and local (knee) pressure pain threshold. Comparisons were performed between empirically derived phenotypes from the LPA and healthy older adults on these measures. Comparisons were also made between pheonotypes on pain intensity, functional measures, use of health care, and history of knee injury. RESULTS LPA resulted in a four-group solution. Compared with all other groups, group 1 (9% of the study population) had higher FCI scores. Group 2 (63%) had elevated pain sensitivity and quadriceps weakness relative to group 4 and healthy older adults. Group 3 (11%) had higher PCS scores than all other groups. Group 4 (17%) had greater leg strength, except relative to healthy older adults, and reduced pain sensitivity relative to all groups. Groups 1 and 3 demonstrated higher pain and worse function than other groups, and group 4 had higher rates of knee injury. CONCLUSION Four phenotypes of knee OA were identified using psychological factors, comorbidity status, pain sensitivity, and leg strength. Follow-up analyses supported the replicability of this phenotype structure, but future research is needed to determine its usefulness in knee OA care.
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Affiliation(s)
- Andrew J Kittelson
- School of Physical Therapy and Rehabilitation Science, University of Montana, Missoula, Montana, USA.,Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA
| | - Sarah J Schmiege
- Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA
| | - Katrina Maluf
- Physical Therapy Program, School of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
| | - Steven Z George
- Department of Orthopaedic Surgery and Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Jennifer E Stevens-Lapsley
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado, Aurora, Colorado, USA.,Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center, Denver, Colorado, USA
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19
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Dantas LO, Salvini TDF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther 2021; 25:135-146. [PMID: 33262080 PMCID: PMC7990728 DOI: 10.1016/j.bjpt.2020.08.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 08/11/2020] [Accepted: 08/19/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a chronic progressive disease that imparts a substantial socioeconomic burden to society and healthcare systems. The prevalence of knee OA has dramatically risen in recent decades due to consistent increases in life expectancy and obesity worldwide. Patient education, physical exercise, and weight loss (for overweight or obese individuals) constitute the first-line knee OA treatment approach. However, less than 40% of patients with knee OA receive this kind of intervention. There is an unmet need for healthcare professionals treating individuals with knee OA to understand the current recommended treatment strategies to provide effective rehabilitation. OBJECTIVE To guide physical therapists in their clinical decision making by summarizing the safest and most efficacious treatment options currently available, and by delineating the most traditional outcome measures used in clinical research for knee OA. CONCLUSION There is a need for healthcare providers to abandon low-quality and ineffective treatments and educate themselves and their patients about the current best evidence-based practices for knee OA.
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Affiliation(s)
- Lucas Ogura Dantas
- Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil; Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Timothy E McAlindon
- Division of Rheumatology, Allergy and Immunology, Tufts Medical Center, Boston, MA, USA.
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20
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de Mattos F, Pereira G, Bento PCB. Water-Based Exercises Performed with High-Speed Movement Improves Strength and Physical Function in Older Women with Knee Osteoarthritis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1788690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Fernanda de Mattos
- Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Gleber Pereira
- Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
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21
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Hafkamp FJ, de Vries J, Gosens T, den Oudsten BL. The Relationship Between Psychological Aspects and Trajectories of Symptoms in Total Knee Arthroplasty and Total Hip Arthroplasty. J Arthroplasty 2021; 36:78-87. [PMID: 32893058 DOI: 10.1016/j.arth.2020.07.071] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/02/2020] [Accepted: 07/27/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND This study aimed to examine different trajectories of physical symptoms in hip and knee arthroplasty patients from presurgery to 1 year postsurgery and relate this to preoperative anxiety and depressive symptoms. METHODS Patients (N = 345) completed the Hip injury and Osteoarthritis Outcome Score or the Knee injury and Osteoarthritis Outcome Score to examine their preoperative and postoperative pain, stiffness, and function, presurgery, and 3, 6, and 12 months postsurgery. Presurgery anxiety and depressive symptoms were assessed using the 7-item Generalized Anxiety Disorder Scale and the 9-item Patient Health Questionnaire. Latent trajectory analysis was used to identify different subgroups in trajectories. The step-3 method was used to assess subgroup characteristics. RESULTS The effect of time on pain, function, and stiffness was different between subgroups of patients. Knee patients belonged mainly to classes with least improvement. Least improvement in pain was characterized by a combination of high levels of both anxiety and depressive symptoms. Anxiety and depressive symptoms were independently related to less reduction in stiffness while little improvement in function was characterized by higher depressive symptoms. CONCLUSION The results of this study indicate that anxiety and depressive symptoms were significantly, but differently, related to the distinct physical symptoms examined.
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Affiliation(s)
- Frederique J Hafkamp
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
| | - Jolanda de Vries
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands; Department of Medical Psychology, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Taco Gosens
- Department of Orthopedics, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands
| | - Brenda L den Oudsten
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Tilburg University, Tilburg, The Netherlands
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22
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Kumar R, Kumar S, Kumar A. Preoperative Knee Self-Efficacy Scale as a predictor of outcome following anterior cruciate ligament reconstruction: A short-term study. JOURNAL OF ORTHOPAEDICS AND SPINE 2021. [DOI: 10.4103/joasp.joasp_32_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Coleman G, Dobson F, Hinman RS, Bennell K, White DK. Measures of Physical Performance. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:452-485. [PMID: 33091270 DOI: 10.1002/acr.24373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | - Fiona Dobson
- University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Bennell
- University of Melbourne, Melbourne, Victoria, Australia
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24
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Flowers PPE, Schwartz TA, Arbeeva L, Golightly YM, Pathak A, Cooke J, Gupta JJ, Callahan LF, Goode AP, Corsi M, Huffman KM, Allen KD. Racial Differences in Performance-Based Function and Potential Explanatory Factors Among Individuals With Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2020; 72:1196-1204. [PMID: 31254451 PMCID: PMC6935430 DOI: 10.1002/acr.24018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 06/25/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVE In individuals with knee osteoarthritis (OA), self-reported physical function is poorer in African Americans than in whites, but whether this difference holds true for objective assessments is unclear. The purpose of this study was to examine racial differences in performance-based physical function as well as potential underlying factors contributing to these racial differences. METHODS Participants with knee OA from a randomized controlled trial completed the 2-minute step test (2MST), timed-up-and-go (TUG), and 30-second chair stand (30s-CST) at baseline. Race differences in performance-based function were assessed by logistic regression. Separate models were adjusted for sets of demographic, socioeconomic, psychological health, and physical health variables. RESULTS In individuals with knee OA (n = 322; 72% women, 22% African American, mean ± SD age 66 ± 11 years, mean ± SD body mass index 31 ± 8 kg/m2 ), African Americans (versus whites) had greater unadjusted odds of poorer function (30s-CST odds ratio [OR] 2.79 [95% confidence interval (95% CI) 1.65-4.72], 2MST OR 2.37 [95% CI 1.40-4.03], and TUG OR 3.71 [95% CI 2.16-6.36]). Relationships were maintained when adjusted for demographic and psychological health covariates, but they were either partially attenuated or nonsignificant when adjusted for physical health and socioeconomic covariates. CONCLUSION African American adults with knee OA had poorer unadjusted performance-based function than whites. Physical health and socioeconomic characteristics diminished these differences, emphasizing the fact that these factors may be important to consider in mitigating racial disparities in function.
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Affiliation(s)
| | | | | | | | - Ami Pathak
- Comprehensive Physical Therapy Center, Chapel Hill, North Carolina
| | | | | | | | | | - Michela Corsi
- Northeastern Ohio Medical University, Rootstown, Ohio
| | | | - Kelli D Allen
- University of North Carolina at Chapel Hill and Durham VA Medical Center, Durham, North Carolina
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25
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Santos MGD, Damiani P, Marcon ACZ, Haupenthal A, Avelar NPCD. Influence of knee osteoarthritis on functional performance, quality of life and pain in older women. FISIOTERAPIA EM MOVIMENTO 2020. [DOI: 10.1590/1980-5918.033.ao06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Knee osteoarthritis (KOA) is a common degenerative disease in older people, causing pain, stiffness and dysfunction. Objective: To determine the influence of KOA on functional performance (FP), quality of life (QoL) and pain in older women. Method: This is a cross-sectional study, in which 50 older women diagnosed with KOA and 51 without KOA participated. Participants were assessed using FP tests: Sit-to-stand (STS); Gait speed test (GST); Timed Up and Go (TUG); 6-minute walk test (6 MWT) and the Berg Balance Scale (BBS). Pain was assessed by the visual analog scale (VAS); quality of life by applying the SF-36; and self-perception of the disease by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: No intergroup statistical differences were found in the BBS (p: 0.42), STS (p: 0.59) and 6MWT (p: 0.97). However, the KOA group showed slower GS (p < 0.00) and longer time in TUG (p < 0.00). They also presented higher pain levels (p < 0.01), worse perceived health status regarding pain, stiffness and physical function (WOMAC) (p < 0.01), as well as worse QoL indices in functional capacity, physical limitations, pain and overall health status (p < 0.010). Conclusion: The results of the study demonstrate that older women with KOA showed a decline in FP, QoL and higher pain levels.
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26
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Dubouis L, Ngueyon-Sime W, Peter W, Vallata A, Epstein J, Rat AC, Agrinier N, Terwee CB, Guillemin F. Comparison of a video versus paper questionnaire on functional limitation in lower limb osteoarthritis. BMC Musculoskelet Disord 2019; 20:507. [PMID: 31679508 PMCID: PMC6825726 DOI: 10.1186/s12891-019-2868-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 10/09/2019] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The video Animated Activity Questionnaire (AAQ) was developed to assess the impact of lower limb osteoarthritis (OA) on daily functional activities. The objective of the study was to compare the video and the HOOS/KOOS paper questionnaires and to assess the effect of order of administration. MATERIAL AND METHODS Patients recruited in the KHOALA cohort were randomized in two groups: AAQ questionnaire first (AAQ-first group) and HOOS (hip)/KOOS (knee) questionnaire first (H/KOOS-first group). Within group differences between AAQ and HOOS/KOOS scores were compared using a Student t-test. The Spearman correlation coefficient between AAQ score and HOOS/KOOS score was calculated in each group then compared, using Fisher z-transformation. RESULTS Among 200 randomized patients, 188 (65.8 years, 66.0% women) completed the questionnaires: 99 in the AAQ-first group and 89 in the H/KOOS-first group. The AAQ score was 85.9 (SD: 13.7) in the AAQ-first versus 87.8 (SD: 13.1) in the H/KOOS-first group (p = 0.34). The H/KOOS score was 72.5 (SD: 21.2) in the AAQ-first versus 73.5 (SD: 18.4) in the H/KOOS-first group (p = 0.71). The Spearman correlation coefficient between AAQ and H/KOOS in the AAQ-first was 0.84[0.77-0.89] and 0.73[0.61-0.81] in H/KOOS-first group. These correlations differed between groups significantly (p = 0.02). CONCLUSION This study found video AAQ and paper HOOS/KOOS questionnaire highly correlated, with a moderate but significant effect of order administration of video and paper questionnaires evidencing a stronger correlation when the videos were viewed first.
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Affiliation(s)
- L Dubouis
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - W Ngueyon-Sime
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - W Peter
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, the Netherlands
| | - A Vallata
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France
| | - J Epstein
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - A-C Rat
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - N Agrinier
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France.,Université de Lorraine, APEMAC, Nancy, France
| | - C B Terwee
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, de Boelelaan 1117, Amsterdam, the Netherlands
| | - F Guillemin
- CHRU-Nancy, Inserm, Université de Lorraine CIC Clinical epidemiology, Nancy, France. .,Université de Lorraine, APEMAC, Nancy, France.
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27
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Abolhasani M, Halabchi F, Honarpishe R, Cleland JA, Hakakzadeh A. Effects of kinesiotape on pain, range of motion, and functional status in patients with osteoarthritis: a randomized controlled trial. J Exerc Rehabil 2019; 15:603-609. [PMID: 31523684 PMCID: PMC6732534 DOI: 10.12965/jer.1938290.145] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 07/14/2019] [Indexed: 12/04/2022] Open
Abstract
This study aimed to determine the effects of kinesiotape (KT) on pain, range of motion, and functional status in patients with osteoarthritis of the knee. In this randomized controlled trial, patients with knee osteoarthritis, based on American College of Rheumatology criteria, and Kellgren-Lawrence grade 2 or 3 criteria were selected. Visual analogue scale and active range of motion were the primary outcome measures. Timed Up and Go test and 6-min walk test, were the secondary outcome measures. Evaluation was performed at baseline (T0), after 1 hr (T1), and after 72 hr (T2). We recruited 27 patients with osteoarthritis (age, 57.33±8.72 years; 63% female; body mass index, 29.7±4.3 kg/m2) who were randomly assigned into KT or sham-KT groups. There was a significant group by time interaction for the visual analogue scale (P< 0.001, η2=0.593), active range of motion (flexion) (P<0.001, η2=0.492), active range of motion (extension) (P<0.001, η2=0.351), 6-min walk test (P<0.001, η2=0.568), and Timed Up and Go test (P=0.026, η2=0.136). Between-group comparisons revealed significant differences between KT and sham-KT in visual analogue scale and Timed Up and Go test in T1 and T2 assessments, with changes in knee flexion (P<0.002) and extension active range of motion (P<0.010) and 6-min walk test (P<0.044) at 72-hr posttreatment. This study showed that, 1 hr of KT is an effective treatment for decreasing pain and improving active range of motion and physical function at a 72-hr follow-up in patients with osteoarthritis.
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Affiliation(s)
- Maryam Abolhasani
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Halabchi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Roshanak Honarpishe
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire, USA
| | - Joshua A Cleland
- Department of Sport, Health & Exercise Science, University of Hull, Kingston-upon-Hull, UK
| | - Azadeh Hakakzadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Sports and Exercise Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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28
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Sheng B, Huang L, Wang X, Zhuang J, Tang L, Deng C, Zhang Y. Identification of Knee Osteoarthritis Based on Bayesian Network: Pilot Study. JMIR Med Inform 2019; 7:e13562. [PMID: 31322132 PMCID: PMC6670282 DOI: 10.2196/13562] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/21/2019] [Accepted: 05/31/2019] [Indexed: 01/13/2023] Open
Abstract
Background Early identification of knee osteoarthritis (OA) can improve treatment outcomes and reduce medical costs. However, there are major limitations among existing classification or prediction models, including abstract data processing and complicated dataset attributes, which hinder their applications in clinical practice. Objective The aim of this study was to propose a Bayesian network (BN)–based classification model to classify people with knee OA. The proposed model can be treated as a prescreening tool, which can provide decision support for health professionals. Methods The proposed model’s structure was based on a 3-level BN structure and then retrained by the Bayesian Search (BS) learning algorithm. The model’s parameters were determined by the expectation-maximization algorithm. The used dataset included backgrounds, the target disease, and predictors. The performance of the model was evaluated based on classification accuracy, area under the curve (AUC), specificity, sensitivity, positive predictive value (PPV), and negative predictive value (NPV); it was also compared with other well-known classification models. A test was also performed to explore whether physical fitness tests could improve the performance of the proposed model. Results A total of 249 elderly people between the ages of 60 and 80 years, living in the Kongjiang community (Shanghai), were recruited from April to September 2007. A total of 157 instances were adopted as the dataset after data preprocessing. The experimental results showed that the results of the proposed model were higher than, or equal to, the mean scores of other classification models: .754 for accuracy, .78 for AUC, .78 for specificity, and .73 for sensitivity. The proposed model provided .45 for PPV and .92 for NPV at the prevalence of 20%. The proposed model also showed a significant improvement when compared with the traditional BN model: 6.3% increase in accuracy (from .709 to .754), 4.0% increase in AUC (from .75 to .78), 6.8% increase in specificity (from .73 to .78), 5.8% increase in sensitivity (from .69 to .73), 15.4% increase in PPV (from .39 to .45), and 2.2% increase in NPV (from .90 to .92). Furthermore, the test results showed that the performance of the proposed model could be largely enhanced through physical fitness tests in 3 evaluation indices: 10.6% increase in accuracy (from .682 to .754), 16.4% increase in AUC (from .67 to .78), and 30.0% increase in specificity (from .60 to .78). Conclusions The proposed model presents a promising method to classify people with knee OA when compared with other classification models and the traditional BN model. It could be implemented in clinical practice as a prescreening tool for knee OA, which would not only improve the quality of health care for elderly people but also reduce overall medical costs.
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Affiliation(s)
- Bo Sheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China.,Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - Liang Huang
- Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand
| | - Xiangbin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China
| | - Jie Zhuang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Lihua Tang
- Department of Mechanical Engineering, The University of Auckland, Auckland, New Zealand
| | - Chao Deng
- School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - Yanxin Zhang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fujian, China.,Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand.,School of Kinesiology, Shanghai University of Sport, Shanghai, China
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29
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Jackson T, Xu T, Jia X. Arthritis self-efficacy beliefs and functioning among osteoarthritis and rheumatoid arthritis patients: a meta-analytic review. Rheumatology (Oxford) 2019; 59:948-958. [DOI: 10.1093/rheumatology/kez219] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Revised: 04/25/2019] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objectives
The Arthritis Self-Efficacy Scale (ASES) is a widely used self-report measure of beliefs reflecting confidence in one’s capacity to function despite pain and control pain or other symptoms of arthritis. Despite evidence linking higher ASES scores to lower levels of impairment, pain and emotional distress, numerous modest, non-significant associations have also been observed. In this meta-analysis, we evaluated overall associations between ASES scores and adjustment in RA and OA samples as well as potential moderators that may explain the heterogeneity in these associations.
Method
Data from 48 samples that met all 10 inclusion criteria (N = 9222 patients) were subject to analyses.
Results
ASES scores had significant medium average effect sizes with functional impairment, pain severity and emotional distress but substantial heterogeneity was evident for each association. ASES–impairment associations were moderated by the diagnosis, ASES version and ASES subscale content: significantly larger effect sizes were found for studies that included RA patients, used the original 20-item ASES and assessed subscale content reflecting the pursuit of daily activities despite pain (i.e. functional self-efficacy) than for studies based exclusively on OA patients, the eight-item ASES and ASES pain control and other symptom subscales. Relations of ASES scores with pain severity and emotional distress were moderated by ASES version and subscale content, respectively.
Conclusion
The ASES has significant overall associations with key areas of functioning. Moderator analyses of the measure provide empirically grounded suggestions for optimal use of the ASES within OA and RA patient samples.
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Affiliation(s)
- Todd Jackson
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
- Department of Psychology, University of Macau, Taipa, Macau, S.A.R., China
| | - Ting Xu
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
| | - Xiaojun Jia
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing
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30
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Coutinho C, Santos S, Queirós A, Silva AG. Capacity Measures Explain Only a Small Part of Self-Reported Disability in Institutionalized Ambulatory Older Adults: An Observational Study. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2019. [DOI: 10.1080/02703181.2019.1617379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Cristiana Coutinho
- Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Sara Santos
- Department of Medical Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Alexandra Queirós
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- Institute of Electronics and Telematics Engineering of Aveiro (IEETA), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Anabela G. Silva
- School of Health Sciences, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
- Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
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31
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Siviero P, Limongi F, Gesmundo A, Zambon S, Cooper C, Dennison EM, Edwards MH, Timmermans EJ, van der Pas S, Schaap LA, van Schoor NM, Denkinger MD, Herbolsheimer F, Peter R, Castell MV, Otero Á, Queipo R, Pedersen NL, Deeg DJH, Maggi S. Minimal clinically important decline in physical function over one year: EPOSA study. BMC Musculoskelet Disord 2019; 20:227. [PMID: 31101033 PMCID: PMC6525447 DOI: 10.1186/s12891-019-2593-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 04/26/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The Australian/Canadian hand Osteoarthritis Index (AUSCAN) and the Western Ontario and McMaster Universities knee and hip Osteoarthritis Index (WOMAC) are the most commonly used clinical tools to manage and monitor osteoarthritis (OA). Few studies have as yet reported longitudinal changes in the AUSCAN index regarding the hand. While there are published data regarding WOMAC assessments of the hip and the knee, the two sites have always evaluated separately. The current study therefore sought to determine the minimal clinically important difference (MCID) in decline in the AUSCAN hand and WOMAC hip/knee physical function scores over 1 year using anchor-based and distribution-based methods. METHODS The study analysed data collected by the European Project on Osteoarthritis, a prospective observational study investigating six adult cohorts with and without OA by evaluating changes in the AUSCAN and WOMAC physical function scores at baseline and 12-18 months later. Pain and stiffness scores, the performance-based grip strength and walking speed and health-related quality of life measures were used as the study's anchors. Receiver operating characteristic curves and distribution-based methods were used to estimate the MCID in the AUSCAN and WOMAC physical function scores; only the data of those participants who possessed paired (baseline and follow up-measures) AUSCAN and WOMAC scores were included in the analysis. RESULTS Out of the 1866 participants who were evaluated, 1842 had paired AUSCAN scores and 1845 had paired WOMAC scores. The changes in the AUSCAN physical function score correlated significantly with those in the AUSCAN pain score (r = 0.31). Anchor- and distribution-based approaches converged identifying 4 as the MCID for decline in the AUSCAN hand physical function. Changes in the WOMAC hip/knee physical function score were significantly correlated with changes in both the WOMAC pain score (r = 0.47) and the WOMAC stiffness score (r = 0.35). The different approaches converged identifying two as the MCID for decline in the WOMAC hip/knee physical function. CONCLUSIONS The most reliable MCID estimates of decline over 1 year in the AUSCAN hand and WOMAC hip/knee physical function scores were 4 and 2 points, respectively.
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Affiliation(s)
- Paola Siviero
- National Research Council, Neuroscience Institute - Aging Branch, Via Giustiniani 2, ,35128 Padova, Italy
| | - Federica Limongi
- National Research Council, Neuroscience Institute - Aging Branch, Via Giustiniani 2, ,35128 Padova, Italy
| | - Antonella Gesmundo
- Department of Medicine, University of Padova, Via 8 Febbraio 2, 35122 Padova, Italy
| | - Sabina Zambon
- Department of Medicine, University of Padova, Via 8 Febbraio 2, 35122 Padova, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK
| | - Mark H. Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD UK
- Portsmouth Hospitals NHS Trust, Portsmouth, PO6 3LY UK
| | - Erik J. Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Suzan van der Pas
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Laura A. Schaap
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Michael D. Denkinger
- Bethesda Geriatric Clinic, University of Ulm, Zollernring 26, 89073 Ulm, Germany
| | - Florian Herbolsheimer
- Institute of the History Philosophy and Ethics of Medicine, University of Ulm, Frauensteige 6, 89075 Ulm, Germany
| | - Richard Peter
- Institute of the History Philosophy and Ethics of Medicine, University of Ulm, Frauensteige 6, 89075 Ulm, Germany
| | - Maria Victoria Castell
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Ángel Otero
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Rocio Queipo
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Arzobispo Morcillo 4, 28029 Madrid, Spain
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, P.O.Box 281, Nobels väg 12A, SE-171 77 Stockholm, Sweden
| | - Dorly J. H. Deeg
- Department of Epidemiology and Biostatistics, Amsterdam UMC - location VU University medical center, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Stefania Maggi
- National Research Council, Neuroscience Institute - Aging Branch, Via Giustiniani 2, ,35128 Padova, Italy
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Chopp-Hurley JN, Wiebenga EG, Gatti AA, Maly MR. Investigating the Test-Retest Reliability and Validity of Hand-Held Dynamometry for Measuring Knee Strength in Older Women with Knee Osteoarthritis. Physiother Can 2019; 71:231-238. [PMID: 31719719 PMCID: PMC6830419 DOI: 10.3138/ptc-2018-0051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Purpose: Hand-held dynamometry (HHD) can be used to evaluate strength when gold-standard isokinetic dynamometry (IKD) is not feasible. HHD is useful for measuring lower limb strength in a healthy population; however, its reliability and validity in individuals with knee osteoarthritis (OA) has received little attention. In this research, we examined the test-retest reliability and validity of HHD in older women with knee OA. We also examined the associations between reliability and symptom and disease severity. Method: A total of 28 older women with knee OA completed knee extension and flexion exertions measured using HHD and IKD. Intra-class correlation coefficients (ICC2,3), standard error of measurement, and minimal detectable change were calculated. Correlation coefficients and regressions evaluated the relationships between inter-trial differences and symptom and disease severity. Results: High test-retest reliability was demonstrated for both exertions with each device (ICC2,3 = 0.83-0.96). Variance between trials was not correlated with OA symptoms. Criterion validity was good (ICC2,3 = 0.76), but extension yielded lower agreement than flexion. Regression analysis demonstrated that true strength can be predicted from HHD measurements. Conclusions: HHD is a reliable tool for capturing knee extension and flexion in individuals with OA. Because of lower agreement, HHD might be best suited for evaluating within-subject strength changes rather than true strength scores. However, gold-standard extension strength magnitudes may reasonably be predicted from regression equations (r 2 = 0.82).
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Affiliation(s)
- Jaclyn N. Chopp-Hurley
- School of Rehabilitation Science
- School of Kinesiology and Health Science, York University, Toronto
| | - Emily G. Wiebenga
- School of Rehabilitation Science
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
| | | | - Monica R. Maly
- School of Rehabilitation Science
- Department of Kinesiology, McMaster University, Hamilton
- Department of Kinesiology, University of Waterloo, Waterloo, Ont
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Rao PS, Ramanjaneyulu YS, Prisk VR, Schurgers LJ. A Combination of Tamarindus indica seeds and Curcuma longa Rhizome Extracts Improves Knee Joint Function and Alleviates Pain in Non-Arthritic Adults Following Physical Activity. Int J Med Sci 2019; 16:845-853. [PMID: 31337958 PMCID: PMC6643110 DOI: 10.7150/ijms.32505] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 04/11/2019] [Indexed: 11/05/2022] Open
Abstract
Background: Knee joint pain is the most common reason for physical disability which associates with age. TamaFlexTM (NXT15906F6) is a synergistic anti-inflammatory formulation which contains ethanol/aqueous extracts of Tamarindus indica seeds and ethanol extract of Curcuma longa rhizome. Methods: In a 90-day randomized, double-blind, placebo-controlled study, we evaluated efficacy of NXT15906F6 in relieving pain and improving joint function in non-arthritic adults. Ninety non-arthritic subjects who experienced knee pain and joint discomfort following a six-minute walk test (SMWT) and Stair climb test (SCT) participated in the present trial. Subjects received either 250 mg (n=30) or 400 mg (n=30) of NXT15906F6 or matched placebo (PL: n=30) daily for 90 days. Improvement from baseline six-minute walk distance (SMWD) in NXT15906F6 groups, compared with placebo (PL) was the primary outcome of the study. Results: At post-intervention, subjects in NXT15906F6-250 (p<0.001) and NXT15906F6-400 (p<0.0001) groups showed substantial improvements in mean changes of SMWD from baseline compared to placebo. The 250 mg and 400 mg NXT15906F6 groups also improved average walking speed from baseline by 0.08±0.07 m/s (p=0.0010) and 0.11±0.08 m/s (p<0.0001), respectively. The NXT15906F6 groups experienced significant improvement in SMWT performances as early as 14 days. NXT15906F6-supplemented participants showed a consistent benefit of pain relief and improved musculoskeletal functions, compared to placebo. Conclusion: NXT15906F6 provided substantial relief from knee pain after physical activity and improved joint function in non-arthritic adults. Study participants did not show any major adverse events, and they tolerated well this novel herbal formulation.
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Affiliation(s)
| | | | | | - Leon J Schurgers
- Department of Biochemistry, Maastricht University, Maastricht, The Netherlands
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Harikesavan K, Chakravarty R, Maiya AG. Influence of early mobilization program on pain, self-reported and performance based functional measures following total knee replacement. J Clin Orthop Trauma 2019; 10:340-344. [PMID: 30828205 PMCID: PMC6383169 DOI: 10.1016/j.jcot.2018.04.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 04/24/2018] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Total knee replacement (TKR) is an optimal treatment for persons with severe knee joint pain and disability, who were unsuccessful with conservative management. Early mobilization can be defined as moving out of bed and/or walking quickly after the surgery for reducing the risks allied with bed rest. There is a paucity of studies on effects of early mobilization on a performance-based measure of timed up and go test (TUG), six-minute walk test (SMWT) and a self-reported disease-specific measure of a knee injury and Osteoarthritis outcome score (KOOS) following TKR. METHODS A prospective pre-post-trial was conducted at Manipal Hospital, Bangalore, India. Participants underwent early (POD '0') mobilization on the same postoperative day within 7 h post-TKR surgery. Outcome measures were recorded by an independent blinded observer. The statistical significance level was set at 'p' value < 0.05. The difference between pre-operative and post-operative outcome measure at 1 month and 3 months post-intervention were analyzed using repeated measures of ANOVA. RESULTS The study included a total of 78 participants (59 Females; 19 Males) and the mean age of the included participants was 64.1 ± 7 years. Amongst, 78 participants, 53 underwent unilateral TKR, 25 underwent bilateral TKR. There were three dropouts in the study due to post-operative complications. Significant improvements from pre-operative to one month were observed following POD '0' mobilization on NPRS (7.35 ± 1.2 to 4.3 ± 1.7), SMWT (169 ± 70 to 236.7 ± 80.7). KOOS subscales of pain, symptom, and quality of life showed significant changes at one month and 3 months. TUG, Knee strength, Knee ROM and KOOS ADL subscale shown improvements only at 3 months post-intervention. CONCLUSION Our study findings suggest that POD '0' (early) mobilization can result in reduced pain and an increase in walking speed at 1 month. Significant changes were observed in pain, Knee strength, Knee ROM, TUG, SMWT and KOOS subscales at 3 months following total knee replacement.
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Affiliation(s)
- Karvannan Harikesavan
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Bangalore, India,Correspondence author at: No 98, Old Airport Road, Rustum Bagh, School of Allied Health Sciences, Manipal Academy of Higher Education, Bangalore.
| | - R.D. Chakravarty
- Orthopaedic Joint Replacement Surgeon, Manipal Hospital, Bangalore, India
| | - Arun G. Maiya
- Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, Manipal, India
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Nawito ZO, El-Azkalany GS, El-Sayad M. Nottingham health profile assessment of health-related quality of life in primary knee osteoarthritis patients: Relation to clinical features and radiologic score. THE EGYPTIAN RHEUMATOLOGIST 2018. [DOI: 10.1016/j.ejr.2017.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peter WF, de Vet HCW, Terwee CB. Reliability of the Animated Activity Questionnaire for assessing activity limitations of patients with hip and knee osteoarthritis. Musculoskeletal Care 2018; 16:363-369. [PMID: 29770556 DOI: 10.1002/msc.1349] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 04/05/2018] [Accepted: 04/06/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The aim of the study was to determine the internal consistency, test-retest reliability and measurement error of the Animated Activity Questionnaire (AAQ) for assessing activity limitations in hip and knee osteoarthritis (HKOA) patients. METHODS A total of 1,177 patients, from six countries (the Netherlands, UK, France, Denmark, Italy and Spain), completed the AAQ, a questionnaire consisting of videos displaying 17 activities with 3-5 levels of performance, from which patients choose the video that best matches their own performance. Unidimensionality was assessed by means of confirmatory factor analysis (CFA), using the following fit indices: the Tucker-Lewis index (TFI) >0.95, comparative fit index (CFI) >0.95, and root mean square error of approximation (RMSEA) <0.06. Cronbach's alpha was computed. In 238 patients who completed the AAQ twice, the intra-class correlation coefficient (ICC) was calculated for test-retest reliability. The standard error of measurement (SEM) and the smallest detectable change (SDC) were calculated as parameters of measurement error. RESULTS The fit indices for unidimensionality were CFI 0.957, TLI 0.950, and RMSEA 0.144. Cronbach's alpha was 0.95. ICC for test-retest reliability was 0.93 (95% confidence interval 0.91 to 0.95), ranging from 0.85 to 0.98 across countries. SEM and SDC were 4.9 and 13.6, respectively, on a scale from 0 to 100, and ranging from 2.7 to 6.7, and from 7.5 to 18.4, respectively, across countries. The AAQ appeared to measure slightly more precisely in patients with knee problems and patients without prosthesis. CONCLUSION The AAQ seemed to be unidimensional, and showed good internal consistency and test-retest reliability. The SDC indicated that changes in scores of at least 14% indicate real improvement in activity limitations.
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Affiliation(s)
- W F Peter
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
- Amsterdam Rehabilitation Research Center, Reade, Amsterdam, the Netherlands
| | - H C W de Vet
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
| | - C B Terwee
- Department of Epidemiology and Biostatistics and the Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, the Netherlands
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Kabiri S, Halabchi F, Angoorani H, Yekaninejad S. Comparison of three modes of aerobic exercise combined with resistance training on the pain and function of patients with knee osteoarthritis: A randomized controlled trial. Phys Ther Sport 2018; 32:22-28. [DOI: 10.1016/j.ptsp.2018.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 03/19/2018] [Accepted: 04/03/2018] [Indexed: 12/15/2022]
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Abdelaleem EA, Rizk YM. Health-related quality of life in Egyptian patients with knee osteoarthritis: correlation with performance-related measures. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2018. [DOI: 10.4103/1110-161x.237048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Iijima H, Aoyama T, Fukutani N, Isho T, Yamamoto Y, Hiraoka M, Miyanobu K, Jinnouchi M, Kaneda E, Kuroki H, Matsuda S. Psychological health is associated with knee pain and physical function in patients with knee osteoarthritis: an exploratory cross-sectional study. BMC Psychol 2018; 6:19. [PMID: 29716654 PMCID: PMC5930799 DOI: 10.1186/s40359-018-0234-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Accepted: 04/19/2018] [Indexed: 12/27/2022] Open
Abstract
Background Depressive symptoms are a major comorbidity in older adults with knee osteoarthritis (OA). However, the type of activity-induced knee pain associated with depression has not been examined. Furthermore, there is conflicting evidence regarding the association between depression and performance-based physical function. This study aimed to examine (i) the association between depressive symptoms and knee pain intensity, particularly task-specific knee pain during daily living, and (ii) the association between depressive symptoms and performance-based physical function, while considering other potential risk factors, including bilateral knee pain and ambulatory physical activity. Methods Patients in orthopaedic clinics (n = 95; age, 61–91 years; 67.4% female) who were diagnosed with radiographic knee OA (Kellgren/Lawrence [K/L] grade ≥ 1) underwent evaluation of psychological health using the Geriatric Depression Scale (GDS). Knee pain and physical function were assessed using the Japanese Knee Osteoarthritis Measure (JKOM), 10-m walk, timed up and go (TUG), and five-repetition chair stand tests. Results Ordinal logistic regression analysis showed that depression, defined as a GDS score ≥ 5 points, was significantly associated with a worse score on the JKOM pain-subcategory and a higher level of task-specific knee pain intensity during daily living, after being adjusted for age, sex, body mass index (BMI), K/L grade, and ambulatory physical activity. Furthermore, depression was significantly associated with a slower gait velocity and a longer TUG time, after adjusting for age, sex, BMI, K/L grade, presence of bilateral knee pain, and ambulatory physical activity. Conclusions These findings indicate that depression may be associated with increased knee pain intensity during daily living in a non-task-specific manner and is associated with functional limitation in patients with knee OA, even after controlling for covariates, including bilateral knee pain and ambulatory physical activity. Electronic supplementary material The online version of this article (10.1186/s40359-018-0234-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hirotaka Iijima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan. .,Japan Society for the Promotion of Science, Tokyo, Japan. .,Department of System Design Engineering, Keio University, Yokohama, Japan.
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoto Fukutani
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takuya Isho
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.,Rehabilitation Center, Fujioka General Hospital, Gunma, Japan
| | | | | | | | | | - Eishi Kaneda
- Nozomi Orthopaedic Clinic, Hiroshima, Japan.,Nozomi Orthopaedic Clinic Studium, Hiroshima, Japan.,Nozomi Orthopaedic Clinic Hiroshima, Hiroshima, Japan
| | - Hiroshi Kuroki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Nur H, Sertkaya BS, Tuncer T. Determinants of physical functioning in women with knee osteoarthritis. Aging Clin Exp Res 2018; 30:299-306. [PMID: 28608254 DOI: 10.1007/s40520-017-0784-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/30/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) is an important health problem with its high prevalence and association with pain and functional disability in physical tasks and activities especially in women. AIMS To explore the impacts of widely seen demographic, pathological, psychological, and impairment factors on physical functioning in women with knee OA using the performance-based and self-reported measures. METHODS One hundred and ten women with knee OA participated in this study. Performance-based measures included the 10-m walk test, timed up and go (TUG) test, and a stair test. Self-reported physical functioning was measured using the Western Ontario and McMasters Universities OA Index. Knee muscle strength, pain intensity, flexion range of motion (ROM), body mass index (BMI), radiographic severity, and anxious and depressive symptoms were measured. Age, disease duration, and comorbidities were recorded. Correlation and linear regression analyses were used to assess the associations. RESULTS In the linear regression models, knee muscle weakness, limited knee flexion ROM, pain intensity, and older age contributed to 65% of variance in physical performance measures mostly explained by knee muscle weakness. Knee pain intensity, BMI, anxiety, and knee muscle weakness contributed to 60% of variance in WOMAC physical function score mostly explained by pain. Radiologic severity, depression, comorbidities, and disease duration did not have a significant association (P < 0.05). Performance-based measures had significant but moderate correlations with WOMAC physical function score (r range 0.51-0.57, P < 0.05). CONCLUSION In women with knee OA, knee muscle strength was the main determinant of performance-based physical functioning together with knee flexion ROM, knee pain, and age. Knee pain was the main determinant of self-reported physical functioning. BMI, anxiety, and knee muscle strength had some contributions as well. Performance-based and self-reported measures had moderate relations and evaluate different aspects of physical functioning. In the management of women with knee OA strengthening of weak knee muscles, improving limited flexion ROM, pain management, weight loss, and improving anxiety should be considered as a priority and performance-based and self-reported measures should be used together for a comprehensive evaluation of physical functioning.
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Affiliation(s)
- Hakan Nur
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, 07059, Antalya, Turkey.
| | - Bilge Saruhan Sertkaya
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, 07059, Antalya, Turkey
| | - Tiraje Tuncer
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Akdeniz University, 07059, Antalya, Turkey
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Randomized Controlled Trial Investigating the Role of Exercise in the Workplace to Improve Work Ability, Performance, and Patient-Reported Symptoms Among Older Workers With Osteoarthritis. J Occup Environ Med 2018; 59:550-556. [PMID: 28379878 DOI: 10.1097/jom.0000000000001020] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effectiveness of a 12-week workplace exercise program on work ability, performance, and patient-reported symptoms in older university employees with knee and/or hip osteoarthritis. METHODS Twenty-four participants with clinical hip and/or knee osteoarthritis were randomized to exercise or no exercise. At baseline and follow-up, several work (work ability, resilience), patient-reported (pain, physical function, depressive symptoms, self-efficacy), and performance outcomes (hip and knee strength, mobility performance) were measured. RESULTS Significant improvements in work ability (P < 0.049) and patient-reported outcomes (pain, function, depressive symptoms) existed in the exercise group. No improvements were demonstrated in the no exercise group. CONCLUSIONS Exercise in the workplace improved work ability and patient-reported symptoms in older workers with osteoarthritis. The benefits of workplace exercise programs should be studied in a larger sample in which attention is given to improving exercise adherence.
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Disantis AY, Piva SR, Irrgang JJ. Standardized Patient Reported Outcomes Do Not Capture Functional Deficits of Patients Following Contemporary Total Knee Replacement: Descriptive Study. JOURNAL OF EXERCISE, SPORTS & ORTHOPEDICS 2018; 5:10.15226/2374-6904/5/1/00167. [PMID: 30370333 PMCID: PMC6203347 DOI: 10.15226/2374-6904/5/1/00167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The physical function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC-PF) is widely used and endorsed by professional organizations for patients with knee osteoarthritis. Its use post total knee replacement (TKR) has been challenged as it may not represent the high level of functional performance that is expected by patients who undergo contemporary TKR with more advanced techniques and care pathways. OBJECTIVE To assess whether the items of the WOMAC-PF reflect the activity limitations identified by patients following TKR. DESIGN Data for this descriptive study were obtained from baseline assessments of a randomized clinical trial comparing exercise interventions following TKR. METHODS Participants completed the WOMAC-PF and identified activity limitations in the Canadian Occupational Performance Measure (COPM) in the same day. The responses to both questionnaires were compared. RESULTS This investigation included 50 participants (36 women, mean age 63.8±6.7). The WOMAC-PF failed to capture 50% of the activity limitations identified by participants in the COPM. These activities included kneeling, squatting, carrying/lifting items, strength/endurance exercise, floor transfer, lower extremity exercise, walking up/down hills, yard work, climbing a ladder, driving, managing the environment, carrying objects up/down stairs, gait initiation, balance, and going up/down curbs. Only one activity on the WOMAC-PF (going shopping) was not identified by participant responses on the COPM. LIMITATIONS Participants were included if they had TKR between 3 and 6 months prior, which may limit generalizability to those immediately after TKR, and the study sample was relatively small. CONCLUSIONS In individuals following TKR, the WOMAC-PF failed to represent a subset of higher level, more physically demanding activities that were identified as important by patients following TKR.
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Hsu WH, Hsu WB, Shen WJ, Lin ZR, Chang SH, Hsu RWW. Circuit training enhances function in patients undergoing total knee arthroplasty: a retrospective cohort study. J Orthop Surg Res 2017; 12:156. [PMID: 29052519 PMCID: PMC5649052 DOI: 10.1186/s13018-017-0654-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 10/08/2017] [Indexed: 11/13/2022] Open
Abstract
Background The number of patients receiving total knee arthroplasty (TKA) has been rising every year due to the aging population and the obesity epidemic. Post-operative rehabilitation is important for the outcome of TKA. Methods A series of 34 patients who underwent primary unilateral TKA was retrospectively collected and divided into either exercise group (n = 16) and control group (n = 18). The exercise group underwent a 24-week course of circuit training beginning 3 months after total knee arthroplasty (TKA). The effect of circuit training on TKA patients in terms of motion analysis, muscle strength testing, Knee injury and Osteoarthritis Outcomes Score (KOOS) questionnaire and patient-reported outcome measurement Short-Form Health Survey (SF-36) at the pre-operation, pre-exercise, mid-exercise, and post-exercise. Results Motion analysis revealed the stride length, step velocity, and excursion of active knee range of motion significantly improved in the exercise group when compared to those in the control group. KOOS questionnaire showed a greater improvement in pain, ADL, and total scores in the exercise group. The SF-36 questionnaire revealed a significant improvement in general health, bodily pain, social function, and physical components score in the exercise group. Conclusions The post-operative circuit training intervention can facilitate recovery of knee function and decrease the degree of pain in the TKA and might be considered a useful adjunct rehabilitative modality. The ultimate influence of circuit training on TKA needs further a prospective randomized clinical trial study and long-term investigation. Trial registration NCT02928562
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Affiliation(s)
- Wei-Hsiu Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China.,Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China
| | - Wei-Bin Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China
| | - Wun-Jer Shen
- PO CHENG Orthopedic Institute, No. 100, Bo-ai 2nd Road, Kaohsiung, 81357, Zuoying District, Taiwan, Republic of China
| | - Zin-Rong Lin
- Department of Athletic Sports, National Chung Cheng University, No.168, University Road, Minhsiung Township, 62102, Chiayi Country, Taiwan, Republic of China
| | - Shr-Hsin Chang
- Sports Medicine Center, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China
| | - Robert Wen-Wei Hsu
- Sports Medicine Center, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China. .,Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, No. 6, West Section, Chia-Pu Road, Putz City, 61363, Chiayi Country, Taiwan, Republic of China.
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Imada A, Nelms N, Halsey D, Blankstein M. Physical therapists collect different outcome measures after total joint arthroplasty as compared to most orthopaedic surgeons: a New England study. Arthroplast Today 2017; 4:113-117. [PMID: 29560405 PMCID: PMC5859202 DOI: 10.1016/j.artd.2017.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/10/2017] [Accepted: 08/13/2017] [Indexed: 11/18/2022] Open
Abstract
Background Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists. Methods An online survey was conducted in July and August of 2015 asking physical therapists in New England to rate their current and anticipated future use of PROMs and PBOMs in terms of clinical decision making associated with the treatment and care of patients after total hip and knee replacement. Results There were 122 responses. The most often used and recommended PROMS were the Numeric Pain Rating Scale (99.2% and 97.5%, respectively) and Lower Extremity Function Scale (76.2% and 77.0%). There was significant variability in the use of different PBOMs, but the most often used and recommended were the Timed Up and Go (93.4% and 85.2%) and the Single Leg Balance Test (90.2% and 87.7%). Conclusions This study suggests that orthopaedic surgeons and physical therapists use different PROMs and PBOMs for postoperative assessment of total joint patients and highlights the need for more collaboration and consistency between these disciplines.
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Affiliation(s)
- Allicia Imada
- Department of Orthopedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT, USA
| | - Nathaniel Nelms
- Department of Orthopedics and Rehabilitation, University of Vermont Medical Center, South Burlington, VT, USA
| | - David Halsey
- Department of Orthopedics and Rehabilitation, University of Vermont Medical Center, South Burlington, VT, USA
| | - Michael Blankstein
- Department of Orthopedics and Rehabilitation, University of Vermont Medical Center, South Burlington, VT, USA
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Functioning Without Cartilage: Older People With Radiographic Knee Osteoarthritis Who Self-Report No Functional Limitations Do Score Lower on a Performance Battery. J Aging Phys Act 2017; 25:570-575. [PMID: 28181834 DOI: 10.1123/japa.2016-0112] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The majority of the older population shows signs of radiographic knee osteoarthritis. However, many remain without functional complaints for a long period. This study aims to find early functional changes associated with stages of radiographic knee osteoarthritis. A group of older people without self-reported complaints was divided in two groups: knee osteoarthritis (K&L = 2-4, N = 29) and control (K&L = 0-1, N = 31). Muscle function was assessed with voluntary and electrically-stimulated isometric knee contractions, including a fatigue test. Physical functioning was assessed with a 6-min walk test (6MWT), a stair climb test (SCT), and a short performance battery. There were no differences in muscle function parameters, 6MWT, and SCT between groups. A clinically relevant lower score on the performance battery was found in participants with knee osteoarthritis. In conclusion, even when older people indicate to have no functional limitations, a decline in functional outcome can be measured with a physical performance battery.
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Peter WF, Dagfinrud HS, Østerås N, Terwee CB. Animated Activity Questionnaire (AAQ), a new method of self-reporting activity limitations in patients with hip and knee osteoarthritis: Comparisons with observation by spouses for construct validity. Musculoskeletal Care 2017; 15:263-271. [PMID: 27925376 DOI: 10.1002/msc.1172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE The aim of the present study was to evaluate the construct validity of the Animated Activity Questionnaire (AAQ) for measuring activity limitations of patients with hip and knee osteoarthritis (HKOA). DESIGN In a psychometric design, data from HKOA patients and their spouses in Norway and the Netherlands were collected independently of each other, using the AAQ, the Function of Daily Living (FDL) subscale from the Hip disability or Knee injury Osteoarthritis Outcome Scale (H/KOOS) and the Numerical Rating Scale for pain (NRS-pain). By showing standardized animations on a computer, the AAQ minimizes the influence of the patient's own frame of reference. Therefore, we expected a strong correlation (≥ 0.6) for the AAQ, between patients and spouses. By contrast, we expected a moderate correlation (0.3-0.6) between patients and spouses on the H/KOOS and the NRS-pain. Analyses were carried out by partial correlations. RESULTS In total, 29 Norwegian and 30 Dutch patients with HKOA and their spouses participated. A high correlation between patient and spouse scores on the AAQ (r = 0.61) was confirmed, but the correlations between patient and spouses scores on the H/KOOS FDL subscale (0.55) and NRS-pain (0.64) were higher than expected, indicating that spouses may have insight not only into the observed activity limitations of the patient (as measured by the AAQ), but also into patients' subjectively perceived activity limitations (as measured by written questionnaires). CONCLUSIONS The construct validity of the AAQ was supported by a high correlation between patients' and spouses' scores. Our hypothesis that spouses are less influenced by patients' subjective frame of reference in responding to self-report questionnaires may not be correct.
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Affiliation(s)
- W F Peter
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands
| | - H S Dagfinrud
- University of Oslo, Oslo, Norway
- National Advisory Unit for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - N Østerås
- National Advisory Unit for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - C B Terwee
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care research, VU University Medical Center, Amsterdam, The Netherlands
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Peter WF, de Vet HCW, Boers M, Harlaar J, Roorda LD, Poolman RW, Scholtes VAB, Steultjens M, Hendry GJ, Roos EM, Guillemin F, Benedetti MG, Cavazzuti L, Escobar A, Dagfinrud H, Terwee CB. Cross-Cultural and Construct Validity of the Animated Activity Questionnaire. Arthritis Care Res (Hoboken) 2017; 69:1349-1359. [DOI: 10.1002/acr.23127] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/06/2016] [Accepted: 10/11/2016] [Indexed: 11/08/2022]
Affiliation(s)
- Wilfred F. Peter
- EMGO Institute for Health and Care Research, VU University Medical Center, and the Amsterdam Rehabilitation Research Center
- Reade; Amsterdam The Netherlands
| | - Henrika C. W. de Vet
- EMGO Institute for Health and Care Research, VU University Medical Center; Amsterdam The Netherlands
| | - Maarten Boers
- Amsterdam Rheumatology and Immunology Center, VU University Medical Center; Amsterdam The Netherlands
| | - Jaap Harlaar
- MOVE Research Institute Amsterdam, VU University Medical Center; Amsterdam The Netherlands
| | - Leo D. Roorda
- Amsterdam Rehabilitation Research Center
- Reade; Amsterdam The Netherlands
| | - Rudolf W. Poolman
- Joint Research, Onze Lieve Vrouwe Gasthuis; Amsterdam The Netherlands
| | | | - Martijn Steultjens
- Glasgow Caledonian University, School of Health and Life Sciences; Glasgow UK
| | - Gordon J. Hendry
- Glasgow Caledonian University, School of Health and Life Sciences; Glasgow UK
| | - Ewa M. Roos
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark; Odense Denmark
| | - Francis Guillemin
- University of Lorraine, EA 4360 APEMAC, Inserm CIC-EC 1433, University Hospital; Nancy France
| | | | | | | | | | - Caroline B. Terwee
- EMGO Institute for Health and Care Research, VU University Medical Center; Amsterdam The Netherlands
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Manoy P, Yuktanandana P, Tanavalee A, Anomasiri W, Ngarmukos S, Tanpowpong T, Honsawek S. Vitamin D Supplementation Improves Quality of Life and Physical Performance in Osteoarthritis Patients. Nutrients 2017; 9:nu9080799. [PMID: 28933742 PMCID: PMC5579593 DOI: 10.3390/nu9080799] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 07/06/2017] [Accepted: 07/22/2017] [Indexed: 12/17/2022] Open
Abstract
(1) Background: Lower levels of serum 25-hydroxyvitamin D (25(OH)D) are common in osteoarthritis (OA) patients. However, the effect of vitamin D supplementation on muscle strength and physical performance remains unclear. This study will investigate the effects of vitamin D₂ supplementation on muscle strength and physical performance in knee OA patients; (2) Methods: One hundred and seventy-five primary knee OA patients with low levels of serum 25(OH)D (<30 ng/mL) received 40,000 IU vitamin D₂ (ergocalciferol) per week for six months. Body composition, muscle strength, physical performance, serum 25(OH)D level, leptin, interlukin-6 (IL-6), parathyroid hormone (PTH), protein carbonyl, and metabolic profile were analyzed; (3) Results: Baseline mean serum 25(OH)D levels in knee OA patients was 20.73 ng/mL. Regarding baseline vitamin D status, 58.90% of patients had vitamin D insufficiency, and 41.10% had vitamin D deficiency. After vitamin D₂ supplementation for six months, mean serum 25(OH)D level was 32.14 ng/mL. For post-supplementation vitamin D status, 57.10% of patients had vitamin D sufficiency and 42.90% had vitamin D insufficiency. From baseline to six months, there was a significant increase in mean serum 25(OH)D level (p < 0.001), while mean LDL cholesterol (p = 0.001), protein carbonyl (p = 0.04), and PTH (p = 0.005) all significantly decreased. Patient quality of life (SF-12) and pain (visual analog scale, VAS) both improved significantly from baseline to the six-month time point (p = 0.005 and p = 0.002, respectively). Knee OA patients demonstrated significant improvement grip strength and physical performance measurements after vitamin D₂ supplementation (p < 0.05); (4) Conclusions: Vitamin D₂ supplementation for six months reduced oxidative protein damage, decreased pain (VAS), improved quality of life, and improved grip strength and physical performance in osteoarthritis patients.
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Affiliation(s)
- Pacharee Manoy
- Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Pongsak Yuktanandana
- Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Aree Tanavalee
- Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Wilai Anomasiri
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Srihatach Ngarmukos
- Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Thanathep Tanpowpong
- Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
| | - Sittisak Honsawek
- Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
- Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand.
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49
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Bream E, Black N. What is the Relationship Between Patients’ And Clinicians’ Reports of the Outcomes of Elective Surgery? J Health Serv Res Policy 2017; 14:174-82. [DOI: 10.1258/jhsrp.2009.008115] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objectives To identify studies in which patients’ and clinicians’ reports of health status and complications of one of four elective operations - hip and knee replacement, varicose vein surgery and groin hernia repair - are reported, and to describe the associations that have been reported between clinicians’ and patients’ reports. Methods Systematic search of several bibliographic databases and review of citations of articles meeting inclusion criteria. A narrative summary of the findings was conducted. Results Most of the 62 studies of health status identified were for hip (23) or knee (33) disease. The literature on complications was even more limited with 12 studies of surgical site infection, one for urinary tract infection and none for lower respiratory tract infections. Procedure-specific complications were restricted to one for arthroplasties and three for hernia repair. Despite considerable variation in the findings of studies, some clear patterns emerge, albeit they are largely based on arthroplasty. Patients’ and clinicians’ views of health status generally correlate moderately (0.5-0.6) when both are reporting on the same dimension of health status. Inevitably this is confined to disability, though patients’ and clinicians’ reports of symptoms are also moderately correlated. In contrast, comparisons of different dimensions, such as patients’ reports of disability and clinicians’ reports of impairment, result in poor correlation (0.3). There is huge variation in the way postoperative complications are measured which limits the extent to which an overview can be undertaken. Despite that, moderate to strong correlations have been reported between patients’ and clinicians’ views of complications. Conclusions Patients’ views of their level of disability reflect clinicians’ views and can be relied upon to assess this dimension of health status. In addition, patients are the ‘gold standard’ judges of symptoms and quality of life. Given these findings, clinicians, provider managers, commissioners and politicians can be confident that patients’ reports provide an accurate indication of the outcome of elective surgery.
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Affiliation(s)
| | - Nick Black
- Health Services Research Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Siviero P, Zambon S, Limongi F, Castell MV, Cooper C, Deeg DJH, Denkinger MD, Dennison EM, Edwards MH, Gesmundo A, Otero Á, Pedersen NL, Peter R, Queipo R, Timmermans EJ, van Schoor NM, Maggi S. How Hand Osteoarthritis, Comorbidity, and Pain Interact to Determine Functional Limitation in Older People: Observations From the European Project on OSteoArthritis Study. Arthritis Rheumatol 2017; 68:2662-2670. [PMID: 27214708 DOI: 10.1002/art.39757] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 05/12/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To examine the role of comorbidity and pain in the associations of hand osteoarthritis (OA) with self-reported and performance-based physical function in a general population of elderly persons. METHODS We studied data from 2,942 participants ages 65-85 years in the European Project on OSteoArthritis, a collaborative observational study of 6 European cohorts (from Germany, Italy, The Netherlands, Spain, Sweden, and the UK). Outcome measures included self-reported physical function of the hands measured by the AUStralian/CANadian Osteoarthritis Hand Index (AUSCAN) for hand OA physical function subscale and performance-based grip strength measured using a strain gauge dynamometer. RESULTS Comorbidity was not a confounder in the association of hand OA with self-reported and performance-based functional limitations, while the role of pain as a mediator was confirmed. Anxiety, depression, stroke, and osteoporosis were associated with AUSCAN scores reflecting more impairment. Depression and osteoporosis were associated with less grip strength. CONCLUSION Although comorbidity was decidedly and independently associated with hand functional limitation, it had no effect on the relationship of hand OA with physical function. Hand OA was found to be associated with both self-reported and performance-based physical function impairment; the association was found to be partially mediated by pain, which reduced its impact.
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Affiliation(s)
- Paola Siviero
- National Research Council, Neuroscience Institute, Padua, Italy.
| | - Sabina Zambon
- National Research Council, Neuroscience Institute, and University of Padova, Padua, Italy
| | | | | | - Cyrus Cooper
- University of Southampton, Southampton General Hospital, Southampton, UK
| | - Dorly J H Deeg
- VU University Medical Center, Amsterdam, The Netherlands
| | | | - Elaine M Dennison
- University of Southampton, Southampton General Hospital, Southampton, UK
| | - Mark H Edwards
- University of Southampton, Southampton General Hospital, Southampton, UK
| | | | - Ángel Otero
- Universidad Autonoma de Madrid, Madrid, Spain
| | | | | | - Rocio Queipo
- University of Southampton, Southampton General Hospital, Southampton, UK
| | | | | | - Stefania Maggi
- National Research Council, Neuroscience Institute, Padua, Italy
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