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Nagamoto H, Okunuki T, Takahashi S, Wakamiya K, Liu Z, Maemichi T, Katsutani H, Yamada Y, Takahashi H, Tanaka H, Aizawa T, Kumai T. Are floating toes associated with lifestyle in children? A cross-sectional study. J Foot Ankle Res 2023; 16:90. [PMID: 38087348 PMCID: PMC10717254 DOI: 10.1186/s13047-023-00685-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Floating toes are a condition and deformity in which some of the toes are afloat. Many functional impairments in floating toes have been previously studied lately and several factors related to floating toes have also been reported. However, no reports have considered the relationship between lifestyle and floating toes among children. The purpose of this study was to reveal the prevalence of floating toes among school children and reveal its relationship with lifestyle. METHODS In total, 138 young male baseball players were recruited. Lifestyle was evaluated by using a questionnaire and chosen whether the main lifestyle was Japanese or Western, if the bedding was futons or beds, and if the toilet was Japanese style (a squat toilet) or Western style. Floating toes were defined as toes that were not in contact with the mat. Ankle dorsiflexion in the knee-flexed and knee-extended positions was measured in a weight-bearing position. The relationship between the floating toes and lifestyles, and the comparison of ankle dorsiflexion range of motion between the lifestyles were statistically analyzed. RESULTS Players living in a Western style showed a significantly higher prevalence of floating toes on both feet compared with the players living in a Japanese style (throwing side; 39% vs. 19%, p = 0.04, and non-throwing side; 43% vs. 19%, p = 0.01). Players living in a Western style with beds showed a significantly smaller range of motion on both sides of ankle dorsiflexion in the knee-flexed position compared with those who were not (throwing side; 37.2 ± 5.7° vs. 39.0 ± 6.6°, p = 0.04, and non-throwing side; 36.8 ± 5.8° vs. 38.6 ± 6.1°, p = 0.04). CONCLUSION Children mainly living in a Western lifestyle showed a significantly higher prevalence of floating toes on both feet compared to those mainly living in a Japanese lifestyle. The prevalence of floating toes may be related to lifestyles among children. TRIAL REGISTRATION The study was approved by the institutional review board of the Waseda University Graduate School of Sport Sciences (IRB number 2021-185).
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Affiliation(s)
- Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan.
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Miyagi, Japan.
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan.
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan.
| | - Takumi Okunuki
- Japan Society for the Promotion of Sciences, Tokyo, Japan
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
| | - Shimpei Takahashi
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School, Sendai, Miyagi, Japan
| | - Kazuki Wakamiya
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Zijian Liu
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Toshihiro Maemichi
- Institute of Life Innovation Studies, Toyo University, Tokyo, Japan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
| | - Hirofumi Katsutani
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Yoshiyasu Yamada
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Miyagi, Japan
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
| | - Hiroyuki Takahashi
- Specified Non-Profit Organization, Network for Sports Medicine and Science, Sendai, Miyagi, Japan
- Department of Orthopaedic Surgery, Kesen-Numa City Hospital, Kesen-Numa, Miyagi, Japan
| | - Hirofumi Tanaka
- Graduate School of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa, Saitama, 359-1192, Japan
| | - Toshimi Aizawa
- Department of Orthopaedic Surgery, Tohoku University, Sendai, Miyagi, Japan
| | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Saitama, Japan
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Nawatthakul A, Hongnaparak T, Iamthanaporn K, Yuenyongviwat V. The ability and factors related with floor sitting after total hip arthroplasty with a posterolateral approach. Orthop Rev (Pavia) 2022; 14:37072. [PMID: 35910547 DOI: 10.52965/001c.37072] [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] [Received: 01/28/2022] [Accepted: 05/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Prosthesis dislocation following total hip arthroplasty (THA) is one complication that affects treatment outcome and increases the cost of treatment. Currently, many surgeons prohibit patients from performing floor-based activities; however, these prohibitions might affect the lifestyle of a number of patients. Objective This study aimed to evaluate the ability of floor sitting after THA, and factors associated with this ability. Methods This study was a retrospective cohort study, evaluating 240 patients who underwent THA with a posterolateral approach, in a single tertiary hospital. Patient demographic data, preoperative clinical data, prostheses type, and postoperative radiographic were extracted from the electronic medical records. Postoperative ability to perform floor sitting was evaluated at 6 months postoperatively. Results There were 52 patients (21.66%) who were able to sit on the floor postoperatively. Multivariate logistic regression analysis showed independent association between three factors with ability to sit on the floor after surgery: pre-operative external rotation range of motion (OR 1.03; 95% CI, 1.01-1.06; P = 0.01), pre-operative Harris Hip Scores (OR 1.05; 95% CI, 1.01-1.10; P = < 0.01), pre-operative ability to sit on the floor (OR 10.2; 95% CI, 3.65-28.5; P = < 0.01). Conclusion There were a number of patients who could sit on the floor after THA. However, there were factors which were associated with this ability. Hence, these results could be useful for adjusted patient preoperative expectations, and did not preclude all patients to perform floor activities.
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Hasebe Y, Akasaka K, Otsudo T, Hall T, Yamamoto M. Effects of incorporating elliptical trainer exercise during rehabilitation on physical function and self-reported outcomes after total hip arthroplasty: a randomized controlled trial. J Phys Ther Sci 2022; 34:230-235. [PMID: 35291467 PMCID: PMC8918105 DOI: 10.1589/jpts.34.230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To investigate the effects of incorporating elliptical trainer exercise in
early rehabilitation after total hip arthroplasty on physical function and self-reported
outcomes. [Participants and Methods] Participants with independent gait prior to total hip
arthroplasty underwent conventional postoperative physiotherapy and were divided into two
groups. The intervention group additionally underwent elliptical trainer exercise, while
the control group underwent a walking program. The main outcomes were low back and hip
region pain, lower limb muscle strength, single-leg stance time, Timed Up & Go Test
results, 10 m walking test results, hip disability and osteoarthritis outcome score, and
modified fall efficacy scale score. These outcomes were evaluated preoperatively, at
discharge, and at 1 and 3 months postoperatively. [Results] Fifty participants (including
40 females; age, 68.3 ± 10.8 years) participated in this study. Physical function
evaluations showed a significant improvement in hip region pain during walking at
discharge. Knee extensor strength, single-leg stance time, stride length, and walking
speed were significantly greater in the intervention group at discharge and at 1 and 3
months postoperatively. The modified fall efficacy scale score significantly improved in
the intervention group 1 month postoperatively. [Conclusion] Elliptical trainer exercise
and conventional physiotherapy in the early postoperative period contribute to improved
physical function and walking ability and improvement in the fear of falling.
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Affiliation(s)
- Yuki Hasebe
- Department of Rehabilitation, Saitama Medical University Saitama Medical Center: 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
| | - Kiyokazu Akasaka
- Department of Physical Therapy, Saitama Medical University Graduate School of Medicine: 981 Kawakado, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | - Takahiro Otsudo
- Department of Physical Therapy, Saitama Medical University Graduate School of Medicine: 981 Kawakado, Moroyama, Iruma-gun, Saitama 350-0495, Japan
| | | | - Mitsuru Yamamoto
- Department of Rehabilitation, Saitama Medical University Saitama Medical Center: 1981 Kamoda, Kawagoe, Saitama 350-8550, Japan
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Gates M, Tang AR, Godil SS, Devin CJ, McGirt MJ, Zuckerman SL. Defining the relative utility of lumbar spine surgery: A systematic literature review of common surgical procedures and their impact on health states. J Clin Neurosci 2021; 93:160-167. [PMID: 34656241 DOI: 10.1016/j.jocn.2021.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/18/2021] [Accepted: 09/02/2021] [Indexed: 10/20/2022]
Abstract
Degenerative lumbar spondylosis is a common indication for patients undergoing spine surgery. As healthcare costs rise, measuring quality of life (QOL) gains after surgical procedures is critical in assessing value. We set out to: 1) compare baseline and postoperative EuroQol-5D (EQ-5D) scores for lumbar spine surgery and common surgical procedures to obtain post-operative quality-adjusted life year (QALY) gain, and 2) establish the relative utility of lumbar spine surgery as compared to other commonly performed surgical procedures. A systematic literature review was conducted to identify all studies reporting preoperative/baseline and postoperative EQ-5D scores for common surgical procedures. For each study, the number of patients included and baseline/preoperative and follow-up mean EQ-5D scores were recorded, and mean QALY gained for each intervention was calculated. A total of 67 studies comprising 95,014 patients were identified. Patients with lumbar spondylosis had the worst reported QOL at baseline compared to other surgical cohorts. The greatest QALY gain was seen in patients undergoing hip arthroplasty (0.38), knee arthroplasty (0.35) and lumbar spine surgery (0.32), nearly 2.5-fold greater QALY gained than for all other procedures. The low preoperative QOL, coupled with the improvements offered with surgery, highlight the utility and value of lumbar spine surgery compared to other common surgical procedures.
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Affiliation(s)
- Marcus Gates
- Department of Neurological Surgery, Wellstar Health System, Austell, GA, United States
| | - Alan R Tang
- Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Saniya S Godil
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Clint J Devin
- Steamboat Orthopaedic and Spine Institute, Steamboat Springs, CO, United States
| | - Matthew J McGirt
- Carolina Neurosurgery and Spine Associates, Charlotte, NC, United States
| | - Scott L Zuckerman
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, United States.
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Nakashima F, Kukihara H. Daily step counts and health-related quality of life before and after bilateral and unilateral total hip arthroplasty. J Rural Med 2020; 15:146-154. [PMID: 33033534 PMCID: PMC7530593 DOI: 10.2185/jrm.2020-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 04/28/2020] [Indexed: 11/27/2022] Open
Abstract
Purpose: We examined and compared the daily step counts and health-related
quality of life of patients before undergoing either bilateral or unilateral (with or
without arthritis in the opposite joint) total hip arthroplasty (THA), and for 6 months
afterwards. Participants and Methods: Participants were patients who were living at home
and were requested to wear accelerometers and log their daily step count preoperatively
and again 6 months postoperatively. Additionally, they completed the Oxford Hip Score and
EuroQol 5-Dimension questionnaires at both time points. Results: Data from 40 patients were analyzed. Patients underwent bilateral
total hip arthroplasty (n=13), unilateral total hip arthroplasty with arthritis in the
opposite joint (n=13), and unilateral total hip arthroplasty without arthritis in the
opposite joint (n=14). The Oxford Hip Score and EuroQol 5-Dimension score showed that the
daily step counts of patients who underwent bilateral or unilateral total hip arthroplasty
without arthritis in the opposite joint significantly increased postoperatively, but that
of patients who received unilateral THA with arthritis in the opposite joint did not
change significantly. The Oxford Hip Score indicated an improvement in hip joint function
after surgery, but the EuroQol 5-Dimension score did not show a significant change
postoperatively in patients who received bilateral total hip arthroplasty. Conclusion: The pre- and postoperative comparisons of the participant’s
daily step count after bilateral and unilateral operations without arthritis on the other
side showed improvements in their amount of daily life activities. In all surgeries,
Oxford Hip Score improvements were confirmed. The EuroQol 5-Dimension score of bilateral
operations did not change. Bilateral operations and an understanding of unilateral
postoperative qualitative support will be necessary in the future.
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Affiliation(s)
| | - Hiroko Kukihara
- School of Nursing, Faculty of Medicine, Fukuoka University, Japan
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Makimoto K, Fujita K, Konno R. Review and synthesis of the experience of patients following total hip or knee arthroplasty in the era of rapidly decreasing hospital length of stay. Jpn J Nurs Sci 2020; 17:e12361. [PMID: 32830912 DOI: 10.1111/jjns.12361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 05/12/2020] [Accepted: 06/14/2020] [Indexed: 11/27/2022]
Abstract
AIM The hospital length of stay for orthopedic surgery has been decreasing during the last couple of decades. Therefore, this study was performed to explore the postoperative experiences of adult/older patients (age ≥20 years) with osteoarthritis who underwent total hip or knee arthroplasty, focusing on the first 6 weeks following discharge. METHODS A systematic literature search on qualitative studies was conducted using six databases, such as Medline, CINAHL and Mednar. Verbatim interview data and themes or subthemes related to the patients' experience after discharge were extracted. Content analysis was used to code interview data. Codes similar in meaning were grouped, and subcategories were formed. These subcategories were then grouped into categories. RESULTS Sixteen qualitative studies with 253 participants were analyzed. In total, 136 codes were generated and formed 29 subcategories. Six categories were generated: (a) postoperative pain and medication; (b) difficulty in performing activities of daily living; (c) appreciation for support and difficulties associated with receiving support; (d) variability in recovery process and information-seeking; (e) lack of patient-centered care; and (f) transportation problems and social isolation. CONCLUSION Our review suggests that prospective patients and their caregivers need individually tailored presurgical education and advanced planning for postsurgical reduced mobility.
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Affiliation(s)
- Kiyoko Makimoto
- School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, Fukuoka, Japan
| | - Rie Konno
- School of Nursing, Hyogo Medical University, Nishinomiya, Japan
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Taniguchi Y, Yoshioka T, Kanamori A, Aoto K, Sugaya H, Yamazaki M. Intra-articular platelet-rich plasma (PRP) injections for treating knee pain associated with osteoarthritis of the knee in the Japanese population: a phase I and IIa clinical trial. NAGOYA JOURNAL OF MEDICAL SCIENCE 2018; 80:39-51. [PMID: 29581613 PMCID: PMC5857500 DOI: 10.18999/nagjms.80.1.39] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Intra-articular platelet-rich plasma (PRP) injection has been found to be effective for treating osteoarthritis in patients from Western countries; however, the safety and efficacy of PRP have not been sufficiently investigated in Japanese patients. The present study aimed to evaluate the safety and feasibility of intra-articular PRP injection in Japanese patients with knee osteoarthritis. PRP without white blood cells was prepared using a single-spin centrifuge (PRGF-Endoret; BTI Biotechnology Institute, Vitoria, Spain). A 6-mL PRP volume was injected in the knee joint three times at 1 week intervals. All patients were prospectively evaluated before intervention and at 1, 3, and 6 months after the treatment. Adverse events, the Visual Analog Scale (VAS) pain score, Japanese Knee Osteoarthritis Measure (JKOM) score and Japanese Orthopedic Association score were evaluated. Ten patients (all women; average age, 60.6 years) were treated. Only minor adverse events after injection were noted, and symptoms resolved within 48 hours after the injection. The average VAS pain scores were 71.6 mm and 18.4 mm at baseline and the 6-month follow-up, respectively (P < 0.05). At the 6-month follow-up, 80% of patients had a decrease in the VAS pain score of 50% or more. The average JKOM scores were 35.2 and 14.3 at baseline and at the 1-month follow-up, respectively (P < 0.05). Intra-articular PRP injection likely represents a safe treatment option for Japanese patients with mild-to-moderate knee osteoarthritis, and has the potential to relieve pain for up to 6 months, but further study is needed to verify the efficacy.
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Affiliation(s)
- Yu Taniguchi
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomokazu Yoshioka
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Akihiro Kanamori
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Katsuya Aoto
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hisashi Sugaya
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan.,Division of Regenerative Medicine for Musculoskeletal System, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masashi Yamazaki
- Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Miao NF, Lin PC. A prospective study of joint function and the quality of life of patients undergoing total joint replacement. Int J Nurs Pract 2018; 24:e12675. [PMID: 30009508 DOI: 10.1111/ijn.12675] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/01/2018] [Accepted: 06/12/2018] [Indexed: 11/27/2022]
Abstract
AIMS To investigate joint functioning and the quality of life (QOL) before and after total knee and total hip replacement and the factors that influence the QOL. METHODS A longitudinal study was conducted between August 2015 and January 2017. A questionnaire composed of the EQ-5D, Oxford Hip Score, and Oxford Knee Score was used to collect data before surgery and 6 weeks, 3 months, and 6 months after surgery. RESULTS A repeated-measures analysis of variance revealed significant differences in the EQ-5D utility index between the preoperative and all 3 postoperative periods (F = 124.195, P < .05). There were significant differences in knee functioning (F = 133.859, P < .05) and hip functioning (F = 34.717, P < .05) between the preoperative and all 3 postoperative periods. The EQ-5D utility index was significantly higher among patients undergoing total knee replacement than those undergoing total hip replacement (F = 15.490, P < .05) and higher among female than male patients (F = 7.613, P < .05). A positive correlation between the QOL and the perceived convenience of living at home was observed (P < .05). CONCLUSIONS The findings are expected to inform patient education for patients undergoing arthroplasty surgery.
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Affiliation(s)
- Nae-Fang Miao
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Pi-Chu Lin
- Master Program in Long-term Care, College of Nursing, Taipei Medical University, Taipei, Taiwan
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Fujita K, Kang HS, Mawatari M, Makimoto K, Lee M, Hwang J. Quality of life, effects on Asian Lifestyle, and perceived satisfaction after total hip arthroplasty in Japan and Korea. Int J Orthop Trauma Nurs 2018; 31:20-25. [PMID: 30049583 DOI: 10.1016/j.ijotn.2018.07.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/08/2018] [Accepted: 07/08/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The Asian lifestyle requires deep hip flexion, which increases the risk of dislocation. Hence, Asian total hip arthroplasty (THA) patients may have problems postoperatively. This study aimed to 1) document quality of life (QoL), Asian lifestyle-related items (five postures that require deep hip flexion), and perceived satisfaction in patients who underwent THA in Japan versus Korea, 2) assess the differences in QoL and Asian lifestyle-related items by patient lifestyle, and 3) identify the factors predicting QoL. METHODS This cross-sectional study included 222 THA patients. Korean patients completed the questionnaires. Japanese patients were then matched with Korean patients by age, sex, and post-THA period. Assessed parameters included QoL measured by the EuroQoL, Oxford hip score (OHS), Asian lifestyle (measured by the Asian lifestyle-related items), and perceived satisfaction (measured by the five items of postoperative satisfaction). Multiple regression analysis was used to determine the predictors of QoL. RESULTS Compared with Korean patients, Japanese patients had better QoL, but more difficulty performing postures requiring deep hip flexion. Greater QoL was associated with greater satisfaction. The predictors of decreased QoL after THA were lower OHS in both countries, worse squatting ability in Japan, and worse leg-crossing ability in Korea. CONCLUSIONS In Japan and Korea, the OHS is an important predictor of QoL after THA.
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Affiliation(s)
- Kimie Fujita
- Division of Health Sciences, Graduate School of Medicine, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, Japan.
| | - Hee Sun Kang
- Red Cross College of Nursing, Chung-Ang University, 84Heukseok-Rd, Dongjak-Gu, Seoul, 156-756, South Korea.
| | - Masaaki Mawatari
- Orthopaedic Surgery, Saga University, 5-1-1, Nabeshima Saga-city, Saga, Japan.
| | - Kiyoko Makimoto
- Konan Women's University, School of Nursing and Rehabilitation, 6-2-23, Morikita-machi, Higashinada-ku, Kobe, Hyogo, Japan.
| | - Mihee Lee
- Unit Manager, Department of Nursing, Hallym University Medical Center Kangnam Sacred Heart Hospital, 1 Singil Ro, Youngdeungpo Gu, Seoul, 07441, South Korea.
| | - Jihyo Hwang
- Orthopaedic Surgery, Hallym University Medical Center Kangnam Sacred Heart Hospital, 1 Singil Ro, Youngdeungpo Gu, Seoul, 07441, South Korea.
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Nagai K, Ikutomo H, Tagomori K, Miura N, Tsuboyama T, Masuhara K. Fear of Falling Restricts Activities of Daily Living after Total Hip Arthroplasty: A One-Year Longitudinal Study. Clin Gerontol 2018; 41:308-314. [PMID: 28990881 DOI: 10.1080/07317115.2017.1364682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES To determine the prevalence and time course in changes regarding the fear of falling and whether there are consequent restrictions in activities of daily living (ADL) after total hip arthroplasty (THA). METHODS This is 1-year longitudinal observational study. We recruited ninety-eight patients before and after THA. Fear of falling was assessed for 12 ADLs preoperatively and postoperatively at 3, 6, and 12 months following THA. In addition, we asked patients to answer whether they had refrained from performing each ADL because of fear of falling. RESULTS Fifty-two patients were enrolled for the analysis. The total fear of falling score during ADLs decreased with time after THA. The ADLs in which many patients (over 20%) felt fear even at 12 months were using the stairs (25%), sitting and standing from the floor (23%), and walking around the neighborhood (21%). Approximately 10% of patients were restricted in performing ADLs, such as sitting and standing from the floor, because of fear. CONCLUSIONS Patients undergoing THA frequently experience fear of falling during some ADLs even at 1 year after the operation, which could cause ADL restrictions. CLINICAL IMPLICATIONS Clinicians should evaluate fear of falling and institute rehabilitation programs individually to decrease excessive fear that might lead to ADL restrictions.
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Affiliation(s)
- Koutatsu Nagai
- a Department of Physical Therapy , School of Rehabilitation, Hyogo University of Health Sciences , Kobe , Japan
| | | | | | | | - Tadao Tsuboyama
- c Human Health Sciences, Graduate School of Medicine, Kyoto University , Kyoto , Japan
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Cultural Factors Influencing Osteoarthritis Care in Asian Communities: A Review of the Evidence. J Community Health 2018; 43:816-826. [PMID: 29468518 DOI: 10.1007/s10900-018-0470-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
With the prevalence of osteoarthritis (OA) increasing internationally, there is a need to study the impact of this disease on culturally diverse populations. Individuals of Asian descent make up more than 60% of the world population, yet comprehensive information on the cultural factors that impact OA care is not available. Scoping review methodology using directed content analysis was employed to identify and analyze existing research on OA care for Asians. A categorization matrix was developed using the six care areas from the OA clinical practice guidelines along with an additional three non-clinical areas (cross-cultural adaptation of clinical tools; psychological well-being; family systems and informal care) identified in an initial scan resulting in a total of nine OA care areas to guide initial coding. A full scoping review was conducted across five databases resulting in 656 abstracts screened. All text was coded using the categorization matrix and resulting subthemes were identified. A total of 74 articles were analyzed with 23 subthemes identified across the nine categories. Four new perspectives emerged to support OA care for Asian populations: (1) the importance of family and peer assistance, (2) the importance of culturally specific activities, (3) distrust in western medicine, and (4) impact of positive coping mechanisms on health appraisals. While Asians are more susceptible to knee and hand OA because of their cultural lifestyle factors (e.g. squatting for chores, hygiene and religious activities), and traditional beliefs on OA management (e.g. traditional diet, topical oils, physical therapy), many do not present themselves for conventional treatments (e.g. surgery) until all traditional treatments are exhausted. The results suggest that cultural factors influence the uptake of OA management practices among Asians. Greater awareness of these cultural factors may improve diagnosis, treatment, and management of OA among Asian patients.
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Maeda Y, Nakamura N, Sugano N. Improvement of activities of daily living after total hip arthroplasty using a computed tomography-based navigation system. J Artif Organs 2017; 20:152-157. [DOI: 10.1007/s10047-017-0950-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/22/2017] [Indexed: 11/24/2022]
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Fujita K, Makimoto K, Mawatari M. Three-year follow-up study of health related QOL and lifestyle indicators for Japanese patients after total hip arthroplasty. J Orthop Sci 2016; 21:191-8. [PMID: 26740433 DOI: 10.1016/j.jos.2015.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 11/13/2015] [Accepted: 11/16/2015] [Indexed: 02/09/2023]
Abstract
BACKGROUND In non-Western countries including Japan, activities requiring deep flexion of the hip joint, such as seiza (kneeling with calves tucked under the thighs and buttocks resting on the heels) and using squat toilets are commonly practiced. The purpose of this study was to assess longitudinal changes in traditional health-related quality of life measures and measures of physical functions associated with lifestyle for Japanese patients pre-surgery and after total hip arthroplasty. METHODS Consecutive primary total hip arthroplasty patients between July 2003 and November 2006 were eligible. Patients were measured preoperatively and at 6 weeks, 1 year and 3 years postoperatively. Patients completed the EuroQol 5D, the Western Ontario and McMaster Universities Osteoarthritis Index and items related to Japanese lifestyle activities such as squatting. Changes in these scale scores across the four time points were tested, and we examined predictive factors of EuroQol 5D score at 3-year follow-up using multiple linear regression. RESULTS Of 1103 eligible patients, 576 completed questionnaires at all four time points. By 6 weeks post-surgery, reductions in pain and improvements in physical function and stiffness became highly significant, and improvements continued to 3 years postoperative. In contrast, improvements were far more limited for items related to Japanese lifestyle functions such as seiza and use of a Japanese squat toilet, even 3 years after surgery. Predictive factors of EQ5D at 3-year post THA were WOMAC pain and physical function, seiza, age and comorbidity measured at 3-year post THA. CONCLUSION The rate of improvement in QOL requiring deep flexion of the hip joint was much slower than that in QOL related to Western lifestyle. Our study suggests a need for lifestyle modification for THA patients in the other countries where kneeling and squatting are commonly performed.
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Affiliation(s)
- Kimie Fujita
- Department of Health Sciences, Graduate School of Medicine, Kyushu University, Japan.
| | - Kiyoko Makimoto
- Department of Health Sciences, Graduate School of Medicine, Osaka University, Japan.
| | - Masaaki Mawatari
- Department of Orthopedic Surgery, Faculty of Medicine, Saga University, Japan.
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Clarke A, Pulikottil-Jacob R, Grove A, Freeman K, Mistry H, Tsertsvadze A, Connock M, Court R, Kandala NB, Costa M, Suri G, Metcalfe D, Crowther M, Morrow S, Johnson S, Sutcliffe P. Total hip replacement and surface replacement for the treatment of pain and disability resulting from end-stage arthritis of the hip (review of technology appraisal guidance 2 and 44): systematic review and economic evaluation. Health Technol Assess 2015; 19:1-668, vii-viii. [PMID: 25634033 DOI: 10.3310/hta19100] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Total hip replacement (THR) involves the replacement of a damaged hip joint with an artificial hip prosthesis. Resurfacing arthroplasty (RS) involves replacement of the joint surface of the femoral head with a metal surface covering. OBJECTIVES To undertake clinical effectiveness and cost-effectiveness analysis of different types of THR and RS for the treatment of pain and disability in people with end-stage arthritis of the hip, in particular to compare the clinical effectiveness and cost-effectiveness of (1) different types of primary THR and RS for people in whom both procedures are suitable and (2) different types of primary THR for people who are not suitable for hip RS. DATA SOURCES Electronic databases including MEDLINE, EMBASE, The Cochrane Library, Current Controlled Trials and UK Clinical Research Network (UKCRN) Portfolio Database were searched in December 2012, with searches limited to publications from 2008 and sample sizes of ≥ 100 participants. Reference lists and websites of manufacturers and professional organisations were also screened. REVIEW METHODS Systematic reviews of the literature were undertaken to appraise the clinical effectiveness and cost-effectiveness of different types of THR and RS for people with end-stage arthritis of the hip. Included randomised controlled trials (RCTs) and systematic reviews were data extracted and risk of bias and methodological quality were independently assessed by two reviewers using the Cochrane Collaboration risk of bias tool and the Assessment of Multiple Systematic Reviews (AMSTAR) tool. A Markov multistate model was developed for the economic evaluation of the technologies. Sensitivity analyses stratified by sex and controlled for age were carried out to assess the robustness of the results. RESULTS A total of 2469 records were screened of which 37 were included, representing 16 RCTs and eight systematic reviews. The mean post-THR Harris Hip Score measured at different follow-up times (from 6 months to 10 years) did not differ between THR groups, including between cross-linked polyethylene and traditional polyethylene cup liners (pooled mean difference 2.29, 95% confidence interval -0.88 to 5.45). Five systematic reviews reported evidence on different types of THR (cemented vs. cementless cup fixation and implant articulation materials) but these reviews were inconclusive. Eleven cost-effectiveness studies were included; four provided relevant cost and utility data for the model. Thirty registry studies were included, with no studies reporting better implant survival for RS than for all types of THR. For all analyses, mean costs for RS were higher than those for THR and mean quality-adjusted life-years (QALYs) were lower. The incremental cost-effectiveness ratio for RS was dominated by THR, that is, THR was cheaper and more effective than RS (for a lifetime horizon in the base-case analysis, the incremental cost of RS was £11,284 and the incremental QALYs were -0.0879). For all age and sex groups RS remained clearly dominated by THR. Cost-effectiveness acceptability curves showed that, for all patients, THR was almost 100% cost-effective at any willingness-to-pay level. There were age and sex differences in the populations with different types of THR and variations in revision rates (from 1.6% to 3.5% at 9 years). For the base-case analysis, for all age and sex groups and a lifetime horizon, mean costs for category E (cemented components with a polyethylene-on-ceramic articulation) were slightly lower and mean QALYs for category E were slightly higher than those for all other THR categories in both deterministic and probabilistic analyses. Hence, category E dominated the other four categories. Sensitivity analysis using an age- and sex-adjusted log-normal model demonstrated that, over a lifetime horizon and at a willingness-to-pay threshold of £20,000 per QALY, categories A and E were equally likely (50%) to be cost-effective. LIMITATIONS A large proportion of the included studies were inconclusive because of poor reporting, missing data, inconsistent results and/or great uncertainty in the treatment effect estimates. This warrants cautious interpretation of the findings. The evidence on complications was scarce, which may be because of the absence or rarity of these events or because of under-reporting. The poor reporting meant that it was not possible to explore contextual factors that might have influenced study results and also reduced the applicability of the findings to routine clinical practice in the UK. The scope of the review was limited to evidence published in English in 2008 or later, which could be interpreted as a weakness; however, systematic reviews would provide summary evidence for studies published before 2008. CONCLUSIONS Compared with THR, revision rates for RS were higher, mean costs for RS were higher and mean QALYs gained were lower; RS was dominated by THR. Similar results were obtained in the deterministic and probabilistic analyses and for all age and sex groups THR was almost 100% cost-effective at any willingness-to-pay level. Revision rates for all types of THR were low. Category A THR (cemented components with a polyethylene-on-metal articulation) was more cost-effective for older age groups. However, across all age-sex groups combined, the mean cost for category E THR (cemented components with a polyethylene-on-ceramic articulation) was slightly lower and the mean QALYs gained were slightly higher. Category E therefore dominated the other four categories. Certain types of THR appeared to confer some benefit, including larger femoral head sizes, use of a cemented cup, use of a cross-linked polyethylene cup liner and a ceramic-on-ceramic as opposed to a metal-on-polyethylene articulation. Further RCTs with long-term follow-up are needed. STUDY REGISTRATION This study is registered as PROSPERO CRD42013003924. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Aileen Clarke
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Amy Grove
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - Karoline Freeman
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - Hema Mistry
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Martin Connock
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rachel Court
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | | | - Matthew Costa
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - Gaurav Suri
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - David Metcalfe
- Warwick Orthopaedics, University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Michael Crowther
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Sarah Morrow
- Oxford Medical School, University of Oxford, Oxford, UK
| | - Samantha Johnson
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
| | - Paul Sutcliffe
- Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UK
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Gandek B. Measurement properties of the Western Ontario and McMaster Universities Osteoarthritis Index: a systematic review. Arthritis Care Res (Hoboken) 2015; 67:216-29. [PMID: 25048451 DOI: 10.1002/acr.22415] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 07/15/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To conduct a systematic review of the measurement properties of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and to evaluate the quality of WOMAC measurement studies using COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) criteria. METHODS A search was conducted in the MEDLINE, CINAHL, Embase, PsycINFO, Scopus, and SPORTDiscus databases through September 2013. Data that assessed the WOMAC measurement model, reliability, validity, respondent burden, and equivalence across methods of administration were extracted. Overall study quality was rated following COSMIN criteria. RESULTS A total of 76 articles from 22 countries were included. Internal consistency reliability was consistently high (≥0.90) for the function scale and acceptable (≥0.70) for the pain and stiffness scales. Test-retest reliability was acceptable. Score equivalence was demonstrated across paper and electronic methods of data collection. Floor and ceiling effects were low except for notable (24-38%) proportions of patients achieving the best possible scores on the pain and stiffness scales 1-23 years after arthroplasty. Five exploratory factor analyses did not support a measurement model in which the pain and function items were distinct. Correlations between the WOMAC pain and function scales were high (median 0.79). The WOMAC pain and function scales had similar correlations with other pain measures, and therefore the WOMAC pain scale did not show divergent validity. COSMIN criteria were not fully met in most studies. CONCLUSION The WOMAC scales were reliable, but its pain scale was highly related to physical function. Further research into joint-specific pain measures that have broader content validity is needed.
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16
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Konan S, Hossain F, Patel S, Haddad FS. Measuring function after hip and knee surgery: the evidence to support performance-based functional outcome tasks. Bone Joint J 2015; 96-B:1431-5. [PMID: 25371452 DOI: 10.1302/0301-620x.96b11.33773] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Accurate, reproducible outcome measures are essential for the evaluation of any orthopaedic procedure, in both clinical practice and research. Commonly used patient-reported outcome measures (PROMs) have drawbacks such as 'floor' and 'ceiling' effects, limitations of worldwide adaptability and an inability to distinguish pain from function. They are also unable to measure the true outcome of an intervention rather than a patient's perception of that outcome. Performance-based functional outcome tools may address these problems. It is important that both clinicians and researchers are aware of these measures when dealing with high-demand patients, using a new intervention or implant, or testing a new rehabilitation protocol. This article provides an overview of some of the clinically-validated performance-based functional outcome tools used in the assessment of patients undergoing hip and knee surgery.
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Affiliation(s)
- S Konan
- NE (UCH) London Orthopaedic Training Rotation, 235 Euston Road, London, NW1 2BU, UK
| | - F Hossain
- Leeds General Infirmary, Great George St, Leeds LS1 3EX, UK
| | - S Patel
- NE (UCH) London Orthopaedic Training Rotation, 235 Euston Road, London, NW1 2BU, UK
| | - F S Haddad
- University College London Hospitals, 235 Euston Road, London, NW1 2BU, UK
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17
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Fujita K, Xia Z, Liu X, Mawatari M, Makimoto K. Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties. Nurs Health Sci 2014; 16:365-72. [PMID: 24845456 DOI: 10.1111/nhs.12114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Revised: 09/24/2013] [Accepted: 11/01/2013] [Indexed: 11/27/2022]
Affiliation(s)
- Kimie Fujita
- Department of Nursing; Saga University; Saga Japan
| | - Zhenlan Xia
- Department of Nursing; Zhujiang Hospital, Southern Medical University; Guangzhou China
| | - Xueqin Liu
- Department of Nursing; Zhujiang Hospital, Southern Medical University; Guangzhou China
| | - Masaaki Mawatari
- Department of Orthopedic Surgery; Saga University Hospital; Saga
| | - Kiyoko Makimoto
- Department of Nursing; Graduate School of Medicine; Osaka University; Suita Japan
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18
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Nagai K, Ikutomo H, Yamada M, Tsuboyama T, Masuhara K. Fear of falling during activities of daily living after total hip arthroplasty in Japanese women: a cross-sectional study. Physiotherapy 2014; 100:325-30. [PMID: 24602831 DOI: 10.1016/j.physio.2013.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 10/07/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate the prevalence of fear of falling, and identify factors associated with fear of falling during activities of daily living after total hip arthroplasty (THA). DESIGN Cross-sectional study. SETTING Community. PARTICIPANTS Two hundred and fourteen women who had undergone THA. MAIN OUTCOME MEASURES Fear of falling after THA was assessed for 12 activities of daily living using a fear of falling score. The number of falls in the past year, total Oxford Hip Score (OHS), total Penn State Worry Questionnaire (PSWQ) score and walking capacity were recorded as descriptive statistics. Multiple linear regression analysis was performed, with total fear of falling score as the dependent variable and age, body mass index, time since THA, bilateral THA, total OHS, history of falling, walking capacity and total PSWQ score as the independent variables. RESULTS A number of participants (mean age = 64.2) experienced fear of falling while ascending and descending stairs: 45% (97/214), taking a bath: 26% (56/214), bending to pick something up off the floor: 26% (55/214), and getting up from lying on the floor: 25% (54/214). Fear of falling during activities of daily living after THA was significantly correlated with total OHS, history of falling, walking capacity, total PSWQ score and age (P<0.05). CONCLUSIONS Fear of falling develops in certain activities of daily living after THA. It is associated with poorer functional outcome, history of falling, lower walking capacity, higher anxiety level and older age.
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Affiliation(s)
- K Nagai
- Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, Kyoto, Japan.
| | | | - M Yamada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - T Tsuboyama
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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19
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Fujita K, Makimoto K, Tanaka R, Mawatari M, Hotokebuchi T. Prospective study of physical activity and quality of life in Japanese women undergoing total hip arthroplasty. J Orthop Sci 2013; 18:45-53. [PMID: 23096948 DOI: 10.1007/s00776-012-0318-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 09/13/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Improvement in quality of life (QoL) in patients who went through total hip arthroplasty (THA) is well studied, while the number of studies on improvement in actual daily activity in THA patients is limited. The purpose of the study was (1) to describe the pre- to postoperative changes in physical activity (PA) levels, (2) compare PA levels with healthy controls, and (3) examine the association between PA levels and QoL in Japanese women undergoing THA. METHODS PA was measured by pedometers, and QoL was assessed by the Short-Form 8 and the Oxford Hip Scale questionnaires. Consecutive patients undergoing primary THA at Saga University Hospital, Japan, in 2008 were eligible for the study. QoL and pedometers with accelerometers were mailed to THA patients 1 month pre-THA and 6 and 12 months post-THA. The control group completed a single assessment of questionnaires and pedometers. RESULTS Thirty-eight THA patients completed the study. Preoperatively, the patient group had significantly lower QoL scores than the comparison group. However, these differences disappeared by 12 months post-THA. When improvement of PA function in THA patients was compared with healthy controls, light PA was already 78 % of the healthy controls at the pre-THA period and improved to 90 % at 12 months. In contrast, moderate PA was 27 % of the controls and rose to 77 % by 12 months, and vigorous PA remained low throughout the study period. PA was correlated with QoL scores. CONCLUSION The study shows the relative recovery process of PA indicators in THA patients and the contribution of PA to the improvement of QoL.
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Affiliation(s)
- Kimie Fujita
- Department of Nursing, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan.
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20
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Jones CA, Pohar S. Health-related quality of life after total joint arthroplasty: a scoping review. Clin Geriatr Med 2012; 28:395-429. [PMID: 22840305 DOI: 10.1016/j.cger.2012.06.001] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
A scoping review was completed to summarize the change in health status after THA and TKA. Although a recent study has performed a systematic review of functional recovery after THA,(61) we reviewed a broad topic of HRQL changes after total joint arthroplasty. This scoping review was not restricted by study design; however, the majority of studies were prospective single group, observational studies so that change over time could be reported. A variety of HRQL measures were used, including disease-specific, generic, and utility measures. We reported on 33 studies that met our inclusion criteria. Most studies’ primary outcomes were disease-specific measures. Not surprisingly, MCIDs were reported with recovery both short term and long term. These clinically relevant changes were accompanied with large effect sizes for pain and function using disease-specific measures such as the WOMAC. In general, smaller changes were reported with joint stiffness; however, this may also be related to inherent measurement properties of the WOMAC in that it uses two questions to evaluate stiffness. Overall, large effect sizes, in excess of 1.0, were seen not only short term but also long term, that is, more than a year after surgery. The changes may also be reflected in the low rate of complications reported with total joint arthroplasty.(62) The generic health measures showed a smaller magnitude of change, which is to be expected given the construct of these measures evaluate overall health and includes the effect of other health conditions. That being said, the largest changes were seen in those domains that were primary to total joint arthroplasty, pain and physical function. A challenge of evaluating change of health status after total joint arthroplasty is that each measure has individual strengths and limitations. This review introduced the measures and the MCIDs when available to evaluate clinical change. The derived MCIDs should be considered carefully because these values are dependent on a number of features such as the study setting, methodology used to derive the values, baseline scores, and severity of the disease.(63) Change over time was also presented by the effect sizes. The effect size provided another perspective to measuring recovery after total joint arthroplasty in which comparison across measures can be made. Regardless of the type of outcome measure, large effect sizes are seen with total joint arthroplasty both over short-term and long-term outcomes. Because a number of HRQL measures are used to evaluate the outcomes after total joint arthroplasties, comparisons can be challenging. This review summarized published findings to help place the magnitude of change seen with total joint arthroplasty in perspective. Changes seen with HRQL are one aspect of evaluating outcomes from a patient perspective; however, recovery is a complex concept(64) that needs many clinical and research-oriented measures to evaluate the full spectrum of recovery.
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Affiliation(s)
- C Allyson Jones
- Department of Physical Therapy, University of Alberta, Corbett Hall, Edmonton, Canada.
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21
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Alazzawi S, Bardakos NV, Hadfield SG, Butt U, Beer ZH, Field RE. Patient-reported complications after elective joint replacement surgery: are they correct? ACTA ACUST UNITED AC 2012; 94:1120-5. [PMID: 22844056 DOI: 10.1302/0301-620x.94b8.29040] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Using general practitioner records and hospital notes and through direct telephone conversation with patients, we investigated the accuracy of nine patient-reported complications gathered from a self-completed questionnaire after elective joint replacement surgery of the hip and knee. A total of 402 post-discharge complications were reported after 8546 elective operations that were undertaken within a three-year period. These were reported by 136 men and 240 women with a mean age of 71.8 years (34 to 93). A total of 319 reported complications (79.4%; 95% confidence interval 75.4 to 83.3) were confirmed to be correct. High rates of correct reporting were demonstrated for infection (94.5%) and the need for further surgery (100%), whereas the rates of reporting deep-vein thrombosis (DVT), pulmonary embolism, myocardial infarction and stroke were lower (75% to 84.2%). Dislocation, peri-prosthetic fractures and nerve palsy had modest rates of correct reporting (36% to 57.1%). More patients who had knee surgery delivered incorrect reports of dislocation (p = 0.001) and DVT (p = 0.013). Despite these variations, it appears that post-operative complications may form part of a larger patient-reported outcome programme after elective joint replacement surgery.
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Affiliation(s)
- S Alazzawi
- University College Hospital, 235 Euston Road, London NW1 2BU, UK
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22
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Matsumoto T, Kaneuji A, Hiejima Y, Sugiyama H, Akiyama H, Atsumi T, Ishii M, Izumi K, Ichiseki T, Ito H, Okawa T, Ohzono K, Otsuka H, Kishida S, Kobayashi S, Sawaguchi T, Sugano N, Nakajima I, Nakamura S, Hasegawa Y, Fukuda K, Fujii G, Mawatari T, Mori S, Yasunaga Y, Yamaguchi M. Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ): a patient-based evaluation tool for hip-joint disease. The Subcommittee on Hip Disease Evaluation of the Clinical Outcome Committee of the Japanese Orthopaedic Association. J Orthop Sci 2012; 17:25-38. [PMID: 22045450 PMCID: PMC3265722 DOI: 10.1007/s00776-011-0166-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 09/28/2011] [Indexed: 11/05/2022]
Abstract
BACKGROUND The Japanese Orthopaedic Association Hip Score is widely used in Japan, but this tool is designed to reflect the viewpoint of health-care providers rather than that of patients. In gauging the effect of medical therapies in addition to clinical results, it is necessary to assess quality of life (QOL) from the viewpoint of patients. However, there is no tool evaluating QOL for Japanese patients with hip-joint disease. METHODS With the aim of more accurately classifying QOL for Japanese patients with hip-joint disease, we prepared a questionnaire with 58 items for the survey derived from 464 opinions obtained from approximately 100 Japanese patients with hip-joint disease and previously devised evaluation criteria. In the survey, we collected information on 501 cases, and 402 were subjected to factor analysis. From this, we formulated three categories-movement, mental, and pain-each comprising 7 items, for a total of 21 items to be used as evaluation criteria for hip-joint function. RESULTS The Cronbach's α coefficients for the three categories were 0.93, 0.93, and 0.95, respectively, indicating the high reliability of the evaluation criteria. The 21 items included some related to the Asian lifestyle, such as use of a Japanese-style toilet and rising from the floor, which are not included in other evaluation tools. CONCLUSIONS This self-administered questionnaire may become a useful tool in the evaluation of not only Japanese patients, but also of members of other ethnic groups who engage in deep flexion of the hip joint during daily activities.
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Affiliation(s)
- Tadami Matsumoto
- Department of Orthopaedic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293 Japan
| | - Ayumi Kaneuji
- Department of Orthopaedic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293 Japan
| | | | - Hajime Sugiyama
- Department of Orthopaedic Surgery, Kanagawa Rehabilitation Hospital, Atsugi, Kanagawa Japan
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, Faculty of Medicine, Kyoto University, Kyoto, Kyoto Japan
| | - Takashi Atsumi
- Department of Orthopaedic Surgery, Fujigaoka Hospital, Showa University School of Medicine, Yokohama, Kanagawa Japan
| | - Masaji Ishii
- Department of Orthopaedic Surgery, Yamagata Saisei Hospital, Yamagata, Yamagata Japan
| | - Kiyoko Izumi
- Department of Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, Kanazawa, Ishikawa Japan
| | - Toru Ichiseki
- Department of Orthopaedic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293 Japan
| | - Hiroshi Ito
- Department of Orthopaedic Surgery, Asahikawa Medical College, Asahikawa, Hokkaido Japan
| | - Takahiro Okawa
- Department of Orthopaedic Surgery and Center for Joint Surgery, Kurume University Medical Center, Kurume, Fukuoka Japan
| | - Kenji Ohzono
- Department of Orthopaedic Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo Japan
| | - Hiromi Otsuka
- Department of Orthopaedic Surgery, Aichi Medical University, School of Medicine, Aichi-gun, Aichi Japan
| | - Shunji Kishida
- Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Chiba Japan
| | - Seneki Kobayashi
- Department of Orthopaedic Surgery, Suwa Red Cross Hospital, Suwa, Nagano Japan
| | - Takeshi Sawaguchi
- Department of Joint Reconstructive Surgery, Toyama Municipal Hospital, Toyama, Toyama Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Osaka University Graduate School of Medicine, Suita, Osaka Japan
| | - Ikumasa Nakajima
- Social Insurance Kajikazawa Hospital, Minamikoma-gun, Yamanashi Japan
| | - Shigeru Nakamura
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yukiharu Hasegawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi Japan
| | - Kanji Fukuda
- Department of Orthopaedic Surgery, Kinki University School of Medicine, Osakasayama, Osaka Japan
| | - Genji Fujii
- Northeastern Hip-Joint Disease Center, Matsuda Hospital, Sendai, Miyagi Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Fukuoka Japan
| | - Satoshi Mori
- Department of Bone and Joint Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka Japan
| | - Yuji Yasunaga
- Department of Artificial Joints and Biomaterials, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Hiroshima Japan
| | - Masao Yamaguchi
- Department of Rehabilitation, Kanazawa Neurosurgical Hospital, Ishikawa-gun, Ishikawa Japan
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Koyanagi J, Sakai T, Yamazaki T, Watanabe T, Akiyama K, Sugano N, Yoshikawa H, Sugamoto K. In vivo kinematic analysis of squatting after total hip arthroplasty. Clin Biomech (Bristol, Avon) 2011; 26:477-83. [PMID: 21131111 DOI: 10.1016/j.clinbiomech.2010.11.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 11/09/2010] [Accepted: 11/10/2010] [Indexed: 02/07/2023]
Abstract
BACKGROUND The in vivo kinematics of squatting after total hip arthroplasty is unclear. The purpose of the present study was to determine the range of motion of the hip joint during squatting after total hip arthroplasty. METHODS Using fluoroscopy, we investigated 15 primary cementless total hip arthroplasties performed using a computed tomography-based navigation system. An acetabular component with concavities around the rim and a femoral component with reduced neck geometry were used. The motion of the acetabular and femoral components based on the neutral standing position was analyzed using a two-dimensional to three-dimensional registration technique. FINDINGS No prosthetic impingement occurred in any hips. The mean maximum hip flexion range of motion was 86.2° (range, 55.1°-117.4°) and was not always consistent with maximum squatting. The mean maximum pelvic posterior tilting angle was 25.7° (range, 5.5°-43.5°). The pelvis began to tilt posteriorly at 50°-70° of the hip flexion range of motion. At maximum squatting, the mean ratio of the pelvic posterior tilting angle to the femoral flexion angle was 23.2% (range, 3.8%-45.7%). The mean minimum angle up to the theoretical prosthetic impingement was 26.2° (range, 11.8°-39.8°). INTERPRETATION Although this is a preliminary study, three-dimensional assessment of dynamic squatting motion after total hip arthroplasty using the two-dimensional to three-dimensional registration technique appears to enable elucidation of the range of motion of the hip joint, the contribution of pelvic posterior tilting, and the minimum angle up to theoretical prosthetic impingement during squatting.
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Affiliation(s)
- Junichiro Koyanagi
- Department of Orthopaedic Biomaterial Science, Osaka University Graduate School of Medicine, Suita, Japan
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