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Shah N, Borrelli B, Kumar D. Perceptions about smartphone-based interventions to promote physical activity in inactive adults with knee pain - A qualitative study. Disabil Rehabil Assist Technol 2023:1-8. [PMID: 37873670 PMCID: PMC11039564 DOI: 10.1080/17483107.2023.2272854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 10/13/2023] [Indexed: 10/25/2023]
Abstract
PURPOSE Smartphone-based interventions offer a promising approach to address inactivity in people with knee osteoarthritis (OA). We explored perceptions towards smartphone-based interventions to improve physical activity, pain, and depressed mood in inactive people with knee pain. METHODS This qualitative study included six focus groups at Boston University with inactive people with knee pain (n = 35). A smartphone app, developed by our team, using constructs of Social Cognitive Theory, was used to obtain participant feedback. RESULTS Participants discussed wanting to use smartphone-based interventions for personalized exercise advice, for motivation (e.g., customized voice messages, virtual incentives), and to make exercise "less boring" (e.g., music, virtual gaming). Preferred app features included video tutorials on how to use the app, the ability to select information that can be viewed on the home screen, and the ability to interact with clinicians. Features that received mixed responses included daily pain tracking, daily exercise reminders, peer-interaction for accountability, and peer-competition for motivation. All participants discussed privacy and health data security concerns while using the app. CONCLUSIONS Using a co-design approach, we report preferences and concerns related to using smartphone-based physical activity interventions in inactive people with knee pain. This information may help improve acceptability of such interventions in this population.
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Affiliation(s)
- Nirali Shah
- Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, 02215, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Henry M. Goldman School of Dental Medicine, Boston University, 560 Harrison Ave, Boston, MA, 02118, USA
| | - Deepak Kumar
- Department of Physical Therapy, College of Health and Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, 02215, USA
- Section of Rheumatology, Department of Medicine, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
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Hidaka R, Tanaka T, Hashikura K, Oka H, Matsudaira K, Moro T, Matsuda K, Kawano H, Tanaka S. Association of high kinesiophobia and pain catastrophizing with quality of life in severe hip osteoarthritis: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:388. [PMID: 37194069 DOI: 10.1186/s12891-023-06496-6] [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: 11/19/2022] [Accepted: 05/04/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND While fear of movement is an important predictor of pain and disability in osteoarthritis (OA), its impact on patients with hip OA remains uncertain. This study aimed to determine whether fear of movement, evaluated by the Tampa Scale for Kinesiophobia (TSK)-11, and pain catastrophizing, evaluated by the Pain Catastrophizing Scale (PCS), were associated with quality of life (QOL) in patients with hip OA. METHODS This cross-sectional study was conducted between November 2017 and December 2018. Ninety-one consecutively enrolled patients with severe hip OA were scheduled for primary unilateral total hip arthroplasty. The EuroQOL-5 Dimensions questionnaire was used to measure general QOL. The Japanese Orthopedic Association Hip Disease Evaluation Questionnaire was used to assess disease-specific QOL. The covariates included age, sex, body mass index (BMI), pain intensity, high pain catastrophizing (PCS ≥ 30), and high kinesiophobia (TSK-11 ≥ 25). Variables were subjected to multivariate analysis using each QOL scale. RESULTS In multiple regression analysis, pain intensity, high pain catastrophizing, and BMI were independently correlated with the disease-specific QOL scale. High pain catastrophizing, pain intensity, and high kinesiophobia were independently correlated with the general QOL scale. CONCLUSIONS High pain catastrophizing (PCS ≥ 30) was independently associated with disease and general QOL scales. High kinesiophobia (TSK-11 ≥ 25) was independently associated with the general QOL scale in preoperative patients with severe hip OA.
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Affiliation(s)
- Ryo Hidaka
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itahashi-ku, Tokyo, 173-8606, Japan.
- Department of Orthopaedic Surgery, Faculty of Medicine, , The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
| | - Takeyuki Tanaka
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kazuaki Hashikura
- Department of Orthopaedic Surgery, Faculty of Medicine, , The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Hiroyuki Oka
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Toru Moro
- Division of Science for Joint Reconstruction, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Kenta Matsuda
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itahashi-ku, Tokyo, 173-8606, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itahashi-ku, Tokyo, 173-8606, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, Faculty of Medicine, , The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
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Fujita R, Ota S, Yamamoto Y, Kataoka A, Warashina H, Inoue T, Ozeki S, Sugiura H. Effect of diabetes mellitus on physical activity in patients with knee osteoarthritis: A cross-sectional study. J Orthop Surg (Hong Kong) 2023; 31:10225536231197726. [PMID: 37621081 DOI: 10.1177/10225536231197726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
PURPOSE Knee osteoarthritis (OA) may be comorbid with diabetes mellitus (DM), and physical activity is a recommended lifestyle strategy for both diseases. The present study investigated the physical activity differences by intensity between knee OA patients with or without DM, and evaluated if physical activity was associated with the presence of DM in knee OA patients. METHODS A total of 183 patients (mean age 74.9 ± 6.4 years) with moderate-to-severe knee OA underwent evaluation of knee function (i.e., knee flexion/extension range-of-motion, knee-extension muscle strength, and knee pain), the timed up-and-go (TUG) test, and physical activity measurement using an accelerometer. Physical activity by intensity was compared between knee OA patients with and without DM. The association between physical activity, including knee function and the TUG test time, and DM was assessed. RESULTS The 2 groups (with or without DM) did not differ significantly in knee OA severity or age. Compared to knee OA patients without DM, knee OA patients with DM had a significantly lower average daily step count (p < 0.001), and significantly shorter times spent performing light-intensity physical activity (LPA; p < 0.001) and moderate-to-vigorous-intensity physical activity (MVPA; p = 0.006). After adjusting for age, sex, and body mass index, we found that a lower average daily step count and shorter LPA time significantly correlated with DM (β = -0.200, p = 0.006; β = -0.216, p = 0.004, respectively) and a longer TUG test time (β = -0.196, p = 0.014; β = -0.208, p = 0.011, respectively). A shorter MVPA time significantly correlated with lower contralateral knee-extension muscle strength (β = 0.187, p = 0.032). CONCLUSION Knee OA patients with DM had significantly lower physical activity levels than those without DM. Furthermore, the presence of DM correlated with a lower step count and a shorter LPA time in knee OA patients.
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Affiliation(s)
- Remi Fujita
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Department of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Susumu Ota
- Department of Rehabilitation and Care, Seijoh University, Tokai, Japan
| | - Yuri Yamamoto
- Department of Rehabilitation, Nagoya Orthopaedic and Joint Replacement Clinic, Kitanagoya, Japan
| | - Akito Kataoka
- Department of Rehabilitation, Nagoya Orthopaedic and Joint Replacement Clinic, Kitanagoya, Japan
| | - Hideki Warashina
- Department of Orthopedics, Nagoya Orthopaedic and Joint Replacement Clinic, Kitanagoya, Japan
| | - Tomoe Inoue
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinya Ozeki
- Department of Rehabilitation, Mariana Home-Nursing Station, Nagoya, Japan
| | - Hideshi Sugiura
- Department of Integrated Health Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Tak ECPM, Verweij LM, Chorus AMJ, Hopman-Rock M. What Are the Predictors of Self-Reported Change in Physical Activity in Older Adults with Knee or Hip Osteoarthritis? Int J Behav Med 2023; 30:199-210. [PMID: 35322346 PMCID: PMC10036423 DOI: 10.1007/s12529-022-10080-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although physical activity (PA) has been shown to be beneficial in older adults with osteoarthritis (OA), most show low levels of PA. This study evaluated if self-efficacy, attitude, social norm, and coping styles predicted change in PA in older adults with OA in the knee and/or hip. METHODS Prospective study following 105 participants in a self-management intervention with baseline, post-test (6 weeks), and follow-up (6 months). Univariate associations and multivariate regression with self-reported change in PA as the dependent variable were measured. Potential predictors in the model: demographic, illness-related, and behavioral variables (attitude, self-efficacy, social norm, and intention), coping style, and pain coping. RESULTS Forty-eight percent of participants reported increased PA at 6 weeks and 37% at 6 months which corresponded with registered PA levels. At 6 weeks, use of the pain coping style "resting," intention, and participation in the intervention was univariately and multivariately, positively associated with more self-reported change, whereas being single and less use of the pain coping style "distraction" predicted less change. Higher pain severity only predicted less change multivariately. At 6 months, univariate associations for age, general coping style "seeking support," and participation in the intervention were found; higher age was associated multivariately with less self-reported change. CONCLUSION At short term, self-reported change of PA was predicted by the behavioral factors intention and several pain coping styles. Together with other predictors of self-reported change (pain severity, higher age, being single), these could be addressed in future interventions for enhancing PA in older adults with OA.
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Affiliation(s)
| | - Lisanne M Verweij
- Department of Quality and Patient Care, Erasmus MC, University Medical Centre, Rotterdam, the Netherlands
| | | | - Marijke Hopman-Rock
- Department of Public and Occupational Health, AmsterdamUMC (Location Vumc), Van der Boechorststraat 7 1081BT, Amsterdam, the Netherlands.
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Chantrain VA, Guillaume S, Foubert A, Meeus M, Lobet S, Lambert C, Lecouvet F, Hermans C, Roussel NA. Discordance between joint pain and imagery severity in the ankle joint and contributors of lower limb activity limitations in adults with haemophilia: A cross-sectional study. Haemophilia 2023; 29:648-657. [PMID: 36696283 DOI: 10.1111/hae.14749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/19/2022] [Accepted: 01/06/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION People with haemophilia (PwH) suffer from knee and ankle joint pain, but the association with structural damage remains underexplored. They report activity limitations but it is unclear which factors contribute to lower limb activity limitations (LL-AL). AIMS This study aimed (i) to analyse the association between ankle joint pain and structure and (ii) explore the contribution of haemophilia-related, individual and psychological factors to LL-AL in PwH. METHODS This study included 104 moderate/severe PwH. Ankle pain intensity was assessed with a numeric rating scale and pain sensitivity with algometry (pressure pain threshold (PPTA )). Ankle structure was assessed with MRI (IPSG-MRI) and ultrasound (HEAD-US), joint health with the Haemophilia Joint Health Score (HJHS). The HAL-LOWCOM subscore evaluated LL-AL. A Spearman correlation analysed the correlation between ankle pain and structure. The contribution of haemophilia-related factors (joint health, overall pain (Brief Pain Inventory-Pain Severity (BPI-PS)), functional status (2-Minute-Walking-Distance, Timed Up and Go); individual factors (age, BMI) and psychological factors (fear and avoidance beliefs over physical activity (FABQ-PA) and work (FABQ-Work), anxiety and depression) to LL-AL was explored using a regression analysis. RESULTS Only low correlations were found between ankle pain intensity and structure (IPSG-MRI, HEAD-US). PPTA was unrelated to structure. Altogether, HJHS, overall pain (BPI-PS), FABQ-Work and age explained 69% of HAL-LOWCOM variance, with 65% explained by the combination of HJHS and BPI-PS. CONCLUSION No meaningful associations were found between ankle pain and structural damage, suggesting that other factors may contribute to PwH's ankle pain. In contrast, mainly haemophilia-related factors explained LL-AL variance.
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Affiliation(s)
- Valérie-Anne Chantrain
- Research Group (MOVANT), Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Pain in Motion, International Research Group.,Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.,Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Sylvain Guillaume
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Anthe Foubert
- Research Group (MOVANT), Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Pain in Motion, International Research Group.,Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Mira Meeus
- Research Group (MOVANT), Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium.,Pain in Motion, International Research Group.,Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Sébastien Lobet
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.,Neuromusculoskeletal Lab (NMSK), Secteur des Sciences de la Santé, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain (UCLouvain), Brussels, Belgium.,Secteur de kinésithérapie, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Catherine Lambert
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Frédéric Lecouvet
- Department of Radiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Cedric Hermans
- Haemostasis and Thrombosis Unit, Division of Hematology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Nathalie Anne Roussel
- Research Group (MOVANT), Department of Rehabilitation Sciences and Physiotherapy (REVAKI), University of Antwerp, Wilrijk, Belgium
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Baumbach L, Grønne DT, Møller NC, Skou ST, Roos EM. Changes in physical activity and the association between pain and physical activity - a longitudinal analysis of 17,454 patients with knee or hip osteoarthritis from the GLA:D® registry. Osteoarthritis Cartilage 2023; 31:258-266. [PMID: 36272673 DOI: 10.1016/j.joca.2022.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Investigate change in physical activity following an 8-week education and exercise therapy program for patients with knee/hip osteoarthritis, focusing on those with low physical activity level. Furthermore, to evaluate associations between changes in pain intensity and physical activity. METHOD Data from the Good Life with osteoArthritis in Denmark (GLA:D®) registry, at baseline, immediately after completion, and 12 months after entering the program was used. Measures of interest were UCLA activity scale (1-10) and Visual Analog Scale for pain intensity (0-100 mm). Changes in physical activity levels (low 1-4, moderate 5-6, and high 7-10) over three time points were investigated. Asymmetric fixed effects regression models were used to evaluate the association between clinically relevant change in pain (≥15 mm) and change in physical activity level from baseline to 12 months. RESULTS 37% with low activity level at baseline (n = 4,836) and 69% of all patients (n = 17,454) reached or maintained at least a moderate physical activity level at follow-ups. Surprisingly, both an improvement (β = 1.44, P < 0.001) and a worsening (β = 1.18, P < 0.001) in pain intensity was associated with increased physical activity in low activity patients. For all patients a similar trend was observed (β = 0.51, P < 0.001 and β = 0.11, P = 0.215, respectively). CONCLUSION In low active knee or hip OA patients, a third of patients participating in an education and exercise therapy program reached and maintained at least a moderate physical activity level for 1 year. The improvement in physical activity was not dependent on pain reduction.
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Affiliation(s)
- L Baumbach
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Germany; Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - D T Grønne
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - N C Møller
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - S T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark
| | - E M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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Okura K, Shibata K, Suda T, Kimoto M, Saito A, Wakasa M, Kimura Y, Okada K. Gait-related self-efficacy is directly associated with daily step counts in individuals with knee osteoarthritis. Knee 2022; 39:124-131. [PMID: 36191399 DOI: 10.1016/j.knee.2022.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/05/2022] [Accepted: 09/15/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND In addition to physical factors, psychological factors such as self-efficacy (SE) reportedly affect physical activity (PA) levels in individuals with knee osteoarthritis (OA). However, the relationship between PA and SE for walking tasks in patients with knee OA remains unclear. The present study aimed to investigate the direct and indirect pathways of SE for walking tasks and the influence of previously reported factors on PA level in individuals with knee OA. METHODS A cross-sectional design was employed. Eighty-five individuals with knee OA were enrolled. The daily step count (Steps) was considered an objective level of PA. The SE for the walking task was assessed using a modified Gait Efficacy Scale (mGES). Data on gait speed (GS), the visual analog scale (VAS) score for knee pain, Kellgren-Lawrence (K-L) grade of radiographic severity of knee OA, age, and body mass index were collected. Path analysis was performed to investigate the direct and indirect effects of these variables on Steps. RESULTS After exclusion, 70 participants were included. The alternative model, which included Steps, mGES, GS, VAS, K-L grade, and age, showed a good fit. mGES and age had a direct effect on Steps (standardized path coefficients: 0.337 and -0.542, respectively), while the other variables had indirect effects. CONCLUSIONS The SE for walking tasks was directly associated with Steps representative of the PA level. This finding suggests that SE for the walking task may be important in improving PA levels in individuals with knee OA.
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Affiliation(s)
- Kazuki Okura
- Division of Rehabilitation, Akita University Hospital, Akita, Japan; Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan.
| | | | - Tomohiro Suda
- Division of Rehabilitation, Akita University Hospital, Akita, Japan; Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Minoru Kimoto
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Akira Saito
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Masahiko Wakasa
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
| | - Yoshiaki Kimura
- Department of Orthopedic Surgery, Akita City Hospital, Akita, Japan
| | - Kyoji Okada
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan
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Decreased physical activity in patients with ankle osteoarthritis. A case-control study comparing daily step counts. Foot Ankle Surg 2022; 28:66-71. [PMID: 33551322 DOI: 10.1016/j.fas.2021.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/03/2020] [Accepted: 01/25/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to compare physical activity levels and the proportion of patients who met physical activity recommendations in patients with ankle osteoarthritis and controls. METHODS Ankle osteoarthritis patients (n = 50) and controls (n = 50) were recruited. physical activity was measured using an accelerometer-based monitor. Physical activity parameters, including the step count/day, the proportion of patients who met physical activity recommendations of ≥7000 steps/day, and moderate to vigorous physical activity minutes/day, were compared between the patient groups. RESULTS The patients with ankle osteoarthritis walked 3998 steps/day, while the controls walked 6531 steps/day (P < .001). Only 7 (14%) ankle osteoarthritis patients and 17 (34%) controls met the physical activity recommendations of ≥7000 steps/day (P = .01). Time spent performing moderate to vigorous physical activity was 58 and 78 min/day in the ankle osteoarthritis and controls, respectively. CONCLUSIONS The physical activity level of ankle osteoarthritis patients was lower than that of controls. Only a limited proportion of ankle osteoarthritis patients met the physical activity recommendation.
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Terpstra SES, van der Velde JHPM, de Mutsert R, Schiphof D, Reijnierse M, Rosendaal FR, van de Stadt LA, Kloppenburg M, Loef M. The association of clinical and structural knee osteoarthritis with physical activity in the middle-aged population: the NEO study. Osteoarthritis Cartilage 2021; 29:1507-1514. [PMID: 34311090 DOI: 10.1016/j.joca.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/02/2021] [Accepted: 07/17/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate if knee osteoarthritis (OA) is associated with lower physical activity in the general middle-aged Dutch population, and if physical activity is associated with patient-reported outcomes in knee OA. DESIGN Clinical knee OA was defined in the Netherlands Epidemiology of Obesity population using the ACR criteria, and structural knee OA on MRI. We assessed knee pain and function with the Knee Injury and Osteoarthritis Score (KOOS), health-related quality of life (HRQoL) with the Short Form-36, and physical activity (in Metabolic Equivalent of Task (MET) hours) with the Short Questionnaire to Assess Health-enhancing physical activity. We analysed the associations of knee OA with physical activity, and of physical activity with knee pain, function, and HRQoL in knee OA with linear regression adjusted for potential confounders. RESULTS Clinical knee OA was present in 14% of 6,212 participants, (mean age 56 years, mean BMI 27 kg/m2, 55% women, 24% having any comorbidity) and structural knee OA in 12%. Clinical knee OA was associated with 9.60 (95% CI 3.70; 15.50) MET hours per week more physical activity, vs no clinical knee OA. Structural knee OA was associated with 3.97 (-7.82; 15.76) MET hours per week more physical activity, vs no structural knee OA. In clinical knee OA, physical activity was not associated with knee pain, function or HRQoL. CONCLUSIONS Knee OA was not associated with lower physical activity, and in knee OA physical activity was not associated with patient-reported outcomes. Future research should indicate the optimal treatment advice regarding physical activity for individual knee OA patients.
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Affiliation(s)
- S E S Terpstra
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - J H P M van der Velde
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - R de Mutsert
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - D Schiphof
- Department of General Practice, Erasmus Medical Center, Rotterdam, The Netherlands.
| | - M Reijnierse
- Department of Radiology, Leiden University Medical Center, The Netherlands.
| | - F R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - L A van de Stadt
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
| | - M Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
| | - M Loef
- Department of Rheumatology, Leiden University Medical Center, The Netherlands.
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10
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Fawole HO, Felson DT, Frey-Law LA, Jafarzadeh SR, Dell'Isola A, Steultjens MP, Nevitt MC, Lewis CE, Riskowski JL, Chastin S. Is the association between physical activity and fatigue mediated by physical function or depressive symptoms in symptomatic knee osteoarthritis? The Multicenter Osteoarthritis Study. Scand J Rheumatol 2021; 50:372-380. [PMID: 33749506 PMCID: PMC8448897 DOI: 10.1080/03009742.2020.1854850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2020] [Indexed: 02/08/2023]
Abstract
Objectives: To examine whether physical activity (PA) was associated with fatigue, and quantify the extent of potential mediation through depressive symptoms or physical function (PF) on the relationship between PA and fatigue in symptomatic knee osteoarthritis (KOA).Method: This longitudinal study used data from the Multicenter Osteoarthritis Study (n = 484), comprising subjects aged ≥ 50 years. Baseline PA was quantified via an ankle-worn accelerometer. The outcome was fatigue, measured using a 0-10 rating scale at 2 year follow-up. Mediators included gait speed as a measure of PF and depressive symptoms at 2 year follow-up. Mediation analysis was carried out after adjustment for baseline confounders. Stratified analysis by baseline fatigue status [no/low (< 4) and high (≥ 4) fatigue] was performed.Results: A significant direct association was found between PA and fatigue at 2 years [unstandardized coefficient (B) = -0.054; 95% confidence interval (CI) -0.107, -0.002, p = 0.041]. The PA-fatigue relationship was not mediated by gait speed (B = -0.006; 95% CI -0.018, 0.001) or depressive symptoms (B = 0.009; 95% CI 0.009, 0.028). In the subgroup with high baseline fatigue, direct associations were found between PA and fatigue (gait speed model:, B = -0.107; 95% CI -0.212, -0.002, p = 0.046; depressive symptoms model: B = -0.110; 95% CI -0.120, -0.020, p = 0.017); but in the no/low baseline fatigue group, no significant association was found between PA and fatigue.Conclusion: In the symptomatic KOA population, higher baseline PA was directly associated with reduced fatigue 2 years later, especially in those with high baseline fatigue. However, this relationship was not mediated by depressive symptoms or PF.
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Affiliation(s)
- H O Fawole
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Nigeria
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - D T Felson
- School of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - L A Frey-Law
- Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, USA
| | - S R Jafarzadeh
- School of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - A Dell'Isola
- Department of Clinical Sciences Lund, Orthopaedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - M P Steultjens
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - C E Lewis
- Department of Epidemiology, School of Public Health, University of Alabama, Birmingham, AL, USA
| | - J L Riskowski
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sfm Chastin
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
- Department of Movement and Sports Science, Ghent University, Ghent, Belgium
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11
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The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study. ACTA ACUST UNITED AC 2021; 57:medicina57090890. [PMID: 34577813 PMCID: PMC8470884 DOI: 10.3390/medicina57090890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 11/28/2022]
Abstract
Background and Objectives: The degenerative pathology of the hip joint appears in young age groups, related to fem-oroacetabular impingement, and in advanced age, due to other inflammatory causes, with greater potential for severity in the presence of comorbidities. Objectives: To evaluate the participation of the main causes of osteoarthritis in relation to physical activities, s Body Mass Index (BMI) and television time (TV). Materials and Methods: 54 patients with surgical indication treated at an orthopedic referral university hospital were stratified into groups (Impact: I, Osteonecrosis/rheumatic: II, Infectious/traumatic: III), and the influence of comorbidities on physical activity performance, relative to BMI and TV time. Results: It was observed that the impact group was the most frequent (51.8%), with 79.6% under the age of 60 years. This group followed the general mean (p < 0.05), using the variables of comorbidity and the level of physical activity. Pain intensity, TV time, BMI showed no correlation with physical activity. Conclusion: Morphostructural changes (group I) represented the most frequent etiological group, and severe pain was common in almost the entire sample. Unlike BMI, comorbidity showed a significant relationship with the level of physical activity.
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12
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Uritani D, Koda H, Sugita S. Effects of self-management education programmes on self-efficacy for osteoarthritis of the knee: a systematic review of randomised controlled trials. BMC Musculoskelet Disord 2021; 22:515. [PMID: 34090406 PMCID: PMC8180097 DOI: 10.1186/s12891-021-04399-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 05/18/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Enhancing self-efficacy to manage symptoms and functions is an important aspect of self-management for patients with knee osteoarthritis (OA). Many reports have investigated the effects of self-management education programmes for arthritis patients. However, a study that exclusively focuses on patients with OA in the same joints is required to clarify the effects of self-management programmes because individuals with knee OA experience physical and psychological difficulties different from those experienced by individuals with other arthritis diseases. Furthermore, previous studies have reported a wide range of delivery styles of self-management education programmes. This systematic review aimed to evaluate the effects of group-based and face-to-face self-management education programmes conducted by health professionals targeting self-efficacy for knee OA exclusively. METHODS The MEDLINE, CENTRAL, EMBASE, CINAHL, Web of Science, and PEDro databases were searched to identify quantitative measures used in randomised controlled trials (RCTs) to assess the effects of self-management education programmes targeting self-efficacy in patients with knee OA. We included studies in which medical professional-delivered self-management education programmes were conducted in a group-based and face-to-face manner in community or outpatient settings. RESULTS Seven RCTs from five countries were included in this review. Our retrieved studies included various types of self-management education programmes such as cognitive behavioural counselling, pain management education, physical education, weight management education, and arthritis self-efficacy management education, and control arms. They assessed various aspects of self-efficacy, including pain, physical function, arthritis symptoms excluding pain, weight management, mobility, and self-regulation. The total score of the Arthritis Self-Efficacy Scale was also measured. Some studies have reported beneficial effects of group-based and face-to-face self-management education programmes on self-efficacy for management of pain and other symptoms and for self-regulatory, knee OA. However, the results of the included studies were varied and inconsistent. CONCLUSIONS The current review only included seven studies, and there was a wide range of clinical heterogeneity among these studies. Thus, the effects of group-based and face-to-face self-management education programmes conducted by health professionals on self-efficacy for knee OA exclusively are inconclusive to date. Therefore, high-quality studies are required to provide significant information on clinicians, patients, and healthcare professionals in the future.
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Affiliation(s)
- Daisuke Uritani
- Department of Physical Therapy, Faculty of Health Science, Kio University, 4-2-2, Umaminaka, Koryocho, Kitakatsuragigun, 6350832, Nara, Japan.
| | - Hitoshi Koda
- Department of Rehabilitation Sciences, Faculty of Allied Health Sciences, Kansai University of Welfare Sciences, 3-11-1 Asahigaoka, Kashihara city, 5820026, Osaka, Japan
| | - Sho Sugita
- Luxem Co., Ltd, 1-10-1 Higashiikuta, Tama-ku, Kawasaki city, 2140031, Kanagawa, Japan
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13
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Östlind E, Sant'Anna A, Eek F, Stigmar K, Ekvall Hansson E. Physical activity patterns, adherence to using a wearable activity tracker during a 12-week period and correlation between self-reported function and physical activity in working age individuals with hip and/or knee osteoarthritis. BMC Musculoskelet Disord 2021; 22:450. [PMID: 33992121 PMCID: PMC8126142 DOI: 10.1186/s12891-021-04338-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 05/06/2021] [Indexed: 04/16/2023] Open
Abstract
Background A majority of individuals with osteoarthritis (OA) are insufficiently physically active. Self-monitoring with wearable activity trackers (WAT) could promote physical activity (PA), and increased knowledge of PA patterns and adherence to using a WAT is needed. The aim of this study was to describe PA patterns and adherence to WAT-use during an intervention among participants of working age with hip and/or knee OA. The study further explores the correlation between self-reported joint function and PA. Methods Individuals of working age with hip and/or knee OA who used a WAT, Fitbit Flex 2, for 12 weeks were included. Participants monitored their PA in the Fitbit-app. An activity goal of 7,000 steps/day was set. Steps and minutes in light (L), moderate and vigorous (MV) PA were collected from the Fitbit. Self-reported joint function (HOOS/KOOS) was completed. Data was analyzed with linear mixed models and Spearman’s rank correlation. Results Seventy-five participants (45–66 years) walked on average 10 593 (SD 3431) steps/day, spent 248.5 (SD 42.2) minutes in LPA/day, 48.1 (SD 35.5) minutes in MVPA/day, 336.0 (SD 249.9) minutes in MVPA/week and used the Fitbit for an average of 88.4 % (SD 11.6) of the 12-week period. 86.7 % took > 7,000 steps/day and 77.3 % spent > 150 min in MVPA/week. Mean daily steps/week decreased significantly over the 12 weeks (β-coefficient − 117, 95 % CI -166 to -68, p = < 0.001) as well as mean daily minutes in LPA/week (β-coefficient − 2.3, 95 % CI -3.3 to -1.4, p = < 0.001), mean daily minutes in MVPA/week (β-coefficient − 0.58, 95 % CI -1.01 to -0.16, p = 0.008) and mean adherence to Fitbit-use per week (β-coefficient − 1.3, 95 % CI -1.8 to -0.8, p = < 0.001). There were no significant correlations between function (HOOS/KOOS) and PA. Conclusions The majority of participants reached 7,000 steps/day and the recommended 150 min in MVPA per week. However, PA decreased slightly but gradually over time. Adherence to using the Fitbit was high but also decreased during the intervention. Understanding PA patterns and the use of a Fitbit to promote PA could be beneficial in tailoring interventions for individuals with hip and/or knee OA.
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Affiliation(s)
- Elin Östlind
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden. .,Dalby healthcare center, Region Skåne, Lund, Sweden.
| | | | - Frida Eek
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden
| | - Kjerstin Stigmar
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden.,Skåne University Hospital, Lund, Sweden
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14
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Tateuchi H, Akiyama H, Goto K, So K, Kuroda Y, Ichihashi N. Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading. Arthritis Res Ther 2021; 23:129. [PMID: 33910597 PMCID: PMC8080338 DOI: 10.1186/s13075-021-02514-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/19/2021] [Indexed: 01/24/2023] Open
Abstract
Background Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed. Methods Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types. Results The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC. Conclusions Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02514-x.
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Affiliation(s)
- Hiroshige Tateuchi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Haruhiko Akiyama
- Department of Orthopaedic Surgery, School of Medicine, Gifu University, Gifu, Japan
| | - Koji Goto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazutaka So
- Department of Orthopaedic Surgery, Osaka Red Cross Hospital, Osaka, Japan
| | - Yutaka Kuroda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriaki Ichihashi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
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15
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Foucher KC, Huang CH, Aydemir B. Walking energetics and abductor strength are associated with physical activity in older women with hip osteoarthritis. Gait Posture 2021; 85:151-156. [PMID: 33578307 PMCID: PMC8085128 DOI: 10.1016/j.gaitpost.2021.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/13/2021] [Accepted: 01/22/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) can hinder physical activity in older adults for reasons that are not fully understood. Functional barriers may exist such as reduced muscle strength around the affected joint, potentially affecting physical activity. Aging-associated declines in energy capacity may also be exacerbated by OA. These factors may work together to influence physical activity in people with OA. RESEARCH QUESTION Our objective was to evaluate the combined role of walking energetics and hip abductor strength on physical activity in older women with hip OA. METHODS We evaluated 30 women with moderately symptomatic hip OA (61 ± 10 yrs; 30.7 ± 4.9 kg/m2) in this cross-sectional observational study. We measured physical activity using the UCLA activity score and quantified activity frequency and intensity using accelerometers worn for seven days (7 ± 2 days). We used a portable oxygen exchange system to measure energy used during walking at preferred speeds (relative to total energy capacity assessed using a six-minute walk test) and a dynamometer to measure hip abductor strength. We used Pearson correlations and regression analysis to test our hypotheses. RESULTS Greater energy used during walking was associated with lower self-reported physical activity (R=-0.626, p < 0.001), more sedentary time (R = 0.567, p = 0.002), and less light activity time (R=-0.644, p < 0.001). Lower hip abductor strength was associated with lower self-reported physical activity (R = 0.406, p = 0.039). While there was no association between hip abductor strength and energy used during walking, together these variables predicted 55.5 % of the variance in self-reported physical activity. SIGNIFICANCE Results suggest intervention targets to promote physical activity in this population.
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Affiliation(s)
- Kharma C. Foucher
- Corresponding Author: Kharma C. Foucher, MD, PhD, Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA,
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16
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Fawole HO, Idowu OA, Abaraogu UO, Dell'Isola A, Riskowski JL, Oke KI, Adeniyi AF, Mbada CE, Steultjens MP, Chastin SFM. Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis. Rheumatol Adv Pract 2021; 5:rkab013. [PMID: 33928211 PMCID: PMC8068317 DOI: 10.1093/rap/rkab013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 01/22/2021] [Indexed: 02/01/2023] Open
Abstract
Objective The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. Methods A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case–control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). Results Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. Conclusion Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations.
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Affiliation(s)
- Henrietta O Fawole
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Opeyemi A Idowu
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Ukachukwu O Abaraogu
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Medical Rehabilitation, University of Nigeria, Enugu, Nigeria
| | - Andrea Dell'Isola
- Department of Clinical Sciences, Orthopaedics, Clinical Epidemiology Unit, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jody L Riskowski
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Kayode I Oke
- Department of Physiotherapy, College of Medical Sciences, University of Benin, Benin-city
| | - Ade F Adeniyi
- Department of Physiotherapy, University of Ibadan, Oyo State
| | - Chidozie E Mbada
- Department of Medical Rehabilitation, Obafemi Awolowo University, Osun State, Nigeria
| | - Martijn P Steultjens
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Sebastien F M Chastin
- Centre for Living, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.,Department of Movement and Sports Science, Ghent University, Ghent, Belgium
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17
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Assogba TF, Niama-Natta DD, Kpadonou TG, Lawson T, Mahaudens P, Detrembleur C. Disability and functioning in primary and secondary hip osteoarthritis in Benin. Afr J Disabil 2020; 9:675. [PMID: 33354532 PMCID: PMC7736690 DOI: 10.4102/ajod.v9i0.675] [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: 08/19/2019] [Accepted: 08/27/2020] [Indexed: 11/23/2022] Open
Abstract
Background In Africa, primary hip osteoarthritis seems to be less frequent than in Europe. Sickle cell disease is responsible for aseptic osteonecrosis of the femoral head associated with secondary hip osteoarthritis. Very little evidence is available on the influence of aetiology (primary and secondary) and radiographic status on pain and disability in a Beninese population with hip osteoarthritis. Objectives The aim of this study was to compare the impacts of aetiology and radiographic status on pain, disability and quality of life in a Beninese population with hip osteoarthritis. Method This was a descriptive cross-sectional study, including participants recruited in the Clinic of Physical Medicine and Rehabilitation at the National Teaching Hospital in Cotonou. Assessment was based on the International Classification of Functioning, Disability and Health model. The main outcomes were severity of osteoarthritis, pain, range of motion, muscle strength, gait speed and quality of life. Statistical comparisons between the aetiologies were performed using a t-test or rank sum test. One-way analysis of variance was used to test the effect of radiographic status. Results Forty-nine participants (26 women and 23 men; mean age [standard deviation] 40.5 [17.9] years) were recruited. According to the aetiology (59.2% and 40.8% of primary and secondary osteoarthritis, respectively), there were no significant differences for any of the outcomes. Grades I, II, III and IV osteoarthritis were observed in 22.4%, 14.3%, 26.5% and 36.7% of the participants, respectively. Participants with grade IV osteoarthritis were more affected than those with grades I, II and III based on the Kellgren and Lawrence classification. Conclusion Aetiology did not influence pain, gait speed or quality of life. Participants with grade IV osteoarthritis had more pain, were more limited in walking and had a more impaired quality of life.
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Affiliation(s)
- Todègnon F Assogba
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium.,Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Didier D Niama-Natta
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Toussaint G Kpadonou
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Teefany Lawson
- Clinique Universitaire de Médecine Physique et de Réadaptation, Centre National Hospitalier et Universitaire Hubert K. Maga, Cotonou, Benin
| | - Philippe Mahaudens
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium.,Service d'Orthopédie et de Traumatologie de l'Appareil Locomoteur, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christine Detrembleur
- Neuro Musculo Skeletal Lab (NMSK), Faculté des Sciences de la Motricité, Université Catholique de Louvain, Brussels, Belgium
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18
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Bitar S, Omorou AY, Van Hoye A, Guillemin F, Rat AC. Five-year Evolution Patterns of Physical Activity and Sedentary Behavior in Patients with Lower-limb Osteoarthritis and Their Sociodemographic and Clinical Correlates. J Rheumatol 2020; 47:1807-1814. [PMID: 32173658 DOI: 10.3899/jrheum.190854] [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] [Accepted: 02/28/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The present study aimed to identify trajectories of physical activity (PA) components (frequency, duration, intensity, and type) and screen-based sedentary behavior (SB) as well as baseline predictors of each trajectory in patients with hip and/or knee osteoarthritis (OA). METHODS We included 878 patients with a 5-year follow-up from the KHOALA cohort. PA and SB were measured by the Modifiable Activity Questionnaire. We used group-based trajectory analysis to identify the trajectories of PA components and screen-based SB, and multivariable logistic regression to determine predictors of the identified trajectories. RESULTS Two groups of trajectories were identified for each PA component and 3 for SB. High and decreasing PA duration was associated with female sex (OR 0.3, 95% CI 0.1-0.5) as was low and stable, more so than high and decreasing prevalence of weight-bearing activities (OR 0.6, 95% CI 0.4-0.9). Patients with impaired patient-reported outcome measures and obese patients often featured low versus high and decreasing prevalence of weight-bearing activities. Predictors of moderate and high versus low and slightly increasing screen-based SB trajectories were male sex, age < 60 years, single status (OR 1.5, 95% CI 1.1-2.1), obesity (OR 2.1, 95% CI 1.4-3.1), smoking (OR 2.0, 95% CI 1.1-3.7), and less physical jobs. Predictors of moderate and high versus low screen-based SB trajectories were all sociodemographic: male sex, age < 60 years, single status, obesity, smoking, and less physical jobs. CONCLUSION Sociodemographic and clinical predictors of trajectories vary between PA components; they are associated mainly with PA frequency and type. No clinical characteristics were associated with screen-based SB.
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Affiliation(s)
- Sarah Bitar
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy;
| | - Abdou Y Omorou
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy
| | | | - Francis Guillemin
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy
| | - Anne-Christine Rat
- A.C. Rat, MD, PhD, Université de Lorraine, APEMAC, Nancy, and Centre Hospitalier Universitaire Caen Normandie, Service de Rhumatologie Département, Caen, France
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19
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de Hoop AMS, Kloek CJJ, Pisters MF, Veenhof C. Movement behaviour patterns in patients with hip and/or knee osteoarthritis in the physical therapy setting: a cross-sectional study. BMC Musculoskelet Disord 2020; 21:651. [PMID: 33023578 PMCID: PMC7539450 DOI: 10.1186/s12891-020-03644-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 09/14/2020] [Indexed: 12/13/2022] Open
Abstract
Background Osteoarthritis is one of the most common chronic joint diseases, mostly affecting the knee or hip through pain, joint stiffness and decreased physical functioning in daily life. Regular physical activity (PA) can help preserve and improve physical functioning and reduce pain in patients with osteoarthritis. Interventions aiming to improve movement behaviour can be optimized by tailoring them to a patients’ starting point; their current movement behaviour. Movement behaviour needs to be assessed in its full complexity, and therefore a multidimensional description is needed. Objectives The aim of this study was to identify subgroups based on movement behaviour patterns in patients with hip and/or knee osteoarthritis who are eligible for a PA intervention. Second, differences between subgroups regarding Body Mass Index, sex, age, physical functioning, comorbidities, fatigue and pain were determined between subgroups. Methods Baseline data of the clinical trial ‘e-Exercise Osteoarthritis’, collected in Dutch primary care physical therapy practices were analysed. Movement behaviour was assessed with ActiGraph GT3X and GT3X+ accelerometers. Groups with similar patterns were identified using a hierarchical cluster analysis, including six clustering variables indicating total time in and distribution of PA and sedentary behaviours. Differences in clinical characteristics between groups were assessed via Kruskall Wallis and Chi2 tests. Results Accelerometer data, including all daily activities during 3 to 5 subsequent days, of 182 patients (average age 63 years) with hip and/or knee osteoarthritis were analysed. Four patterns were identified: inactive & sedentary, prolonged sedentary, light active and active. Physical functioning was less impaired in the group with the active pattern compared to the inactive & sedentary pattern. The group with the prolonged sedentary pattern experienced lower levels of pain and fatigue and higher levels of physical functioning compared to the light active and compared to the inactive & sedentary. Conclusions Four subgroups with substantially different movement behaviour patterns and clinical characteristics can be identified in patients with osteoarthritis of the hip and/or knee. Knowledge about these subgroups can be used to personalize future movement behaviour interventions for this population. Trial registration Dutch clinical trial registration number of e-Exercise Osteoarthritis: NTR4224.
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Affiliation(s)
- Anne Maria Sjoerdtje de Hoop
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. .,Research Centre for Healthy and Sustainable Living, Research group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.
| | - Corelien Jacoba Johanna Kloek
- Research Centre for Healthy and Sustainable Living, Research group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Martijn Frits Pisters
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.,Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, The Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science & Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.,Research Centre for Healthy and Sustainable Living, Research group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, The Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands
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Koh HJ, In Y, Kim ES, Hwang JW, Kim JY, Lim SJ, Park HJ. Does central sensitization affect hyperalgesia after staged bilateral total knee arthroplasty? A randomized controlled trial. J Int Med Res 2020; 48:300060520938934. [PMID: 32924685 PMCID: PMC8580502 DOI: 10.1177/0300060520938934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective Osteoarthritis (OA) patients who undergo staged bilateral total knee
arthroplasty (TKA) feel postoperative hyperalgesia in the second operated
knee compared with the first knee. Ketamine is an important drug for central
temporal summation and inhibition of secondary mechanical hyperalgesia. This
study investigated whether central sensitization has a significant effect on
hyperalgesia after consecutive operations. Methods Seventy-one of 80 OA patients were randomly allocated to the ketamine or
saline group. A bolus of ketamine (group K) or saline (group C) (0.5 mg/kg)
was injected before induction and at an infusion rate of 3 µg/kg/minute
during surgery. A visual analog scale (VAS) was used to assess resting and
moving pain and opioid consumption on postoperative days 1, 2, and 3. Results The difference in the VAS score between stages 1 and 2 (DV2-V1)
was higher in the ketamine compared with the saline group. DV2-V1
for movement between the two groups was not inferior for all periods.
Ketamine did not show a large analgesic effect on second-operated knee
hyperalgesia in staged bilateral TKAs. Conclusions We could not confirm that hyperalgesia was only related to central
sensitization with low-dose ketamine. Other factors might be also associated
with the hyperexcitability of nociceptive stimuli. Clinical Research Information Service (CRIS) trial registry no:
KCT0001481
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Affiliation(s)
- Hyun Jung Koh
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong In
- Department of Orthopedics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Sung Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae Woong Hwang
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ji Yeong Kim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Soo Jin Lim
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hue Jung Park
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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21
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Brisson NM, Gatti AA, Maly MR. Association of Pain and Steps Per Day in Persons With Mild-to-Moderate, Symptomatic Knee Osteoarthritis: A Mixed-Effects Models Analysis of Multiple Measurements Over Three Years. Arthritis Care Res (Hoboken) 2020; 72:114-121. [PMID: 30838814 DOI: 10.1002/acr.23842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 01/29/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Pain is a consistently reported barrier to physical activity by persons with knee osteoarthritis (OA). Nonetheless, few studies of knee OA have investigated the association of pain with daily walking levels. The current study assessed the relationship of 2 distinct measures of knee pain with objectively measured physical activity in adults with knee OA. METHODS This was a longitudinal, observational investigation of 59 individuals (48 women; mean ± SD age 61.1 ± 6.4 years, mean ± SD body mass index 28.1 ± 5.6 kg/m2 ) with clinical knee OA. Data were collected every 3 months for up to 3 years. Physical activity was characterized as the average steps per day taken over at least 3 days, mea-sured by accelerometry. Pain was measured using 2 patient-administered questionnaires: the pain subscale of the Knee Injury and Osteoarthritis Outcome Score (KOOS-pain) and the P4 pain scale (P4-pain). Mixed-effects models determined the association between pain and physical activity levels (over covariates) among adults with knee OA (α = 0.05). RESULTS All covariates (age [β = -3.65, P < 0.001], body mass index [β = -3.06, P < 0.001], season [spring/fall β = -6.91, P = 0.002; winter β = -14.92, P < 0.001]) were predictors of physical activity. Neither the inverted KOOS-pain (β = 0.04, P = 0.717) nor P4-pain (β = -0.37, P = 0.264) was associated with physical activity. CONCLUSION Knee pain is not associated with daily walking levels in persons with mild-to-moderate, symptomatic knee OA. While pain management remains an important target of interventions, strategies to increase steps per day in this population should focus on overcoming potentially more crucial barriers to activity participation.
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Affiliation(s)
- Nicholas M Brisson
- McMaster University, Hamilton, Ontario, Canada, and Charité-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Monica R Maly
- McMaster University, Hamilton, Ontario, Canada, and University of Waterloo, Waterloo, Ontario, Canada
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22
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Uritani D, Kasza J, Campbell PK, Metcalf B, Egerton T. The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis. BMC Musculoskelet Disord 2020; 21:269. [PMID: 32334578 PMCID: PMC7183118 DOI: 10.1186/s12891-020-03305-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/21/2020] [Indexed: 12/12/2022] Open
Abstract
Background The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA). Methods This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women, mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometer-based device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates. Results There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: − 117, 95% confidence interval [95%CI]: − 227 to − 8) and with pain catastrophizing (B: -44, 95%CI: − 86 to − 1). The association with self-efficacy was similar (B:117, 95%CI: − 12 to 246). However, the direction of the association with depressive symptoms was less clear (B: -59, 95%CI: − 138 to 19). Conclusions The results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing given the cross-sectional design of this study.
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Affiliation(s)
- Daisuke Uritani
- Department of Physical Therapy, Faculty of Health Science, Kio University, 4-2-2, Umaminaka, Koryocho, Kitakatsuragigun, Nara, 6350832, Japan.
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia
| | - Penny K Campbell
- Centre for Health, Exercise, and Sports Medicine, The University of Melbourne, 161 Barry Street, Melbourne, Victoria, 3010, Australia
| | - Ben Metcalf
- Centre for Health, Exercise, and Sports Medicine, The University of Melbourne, 161 Barry Street, Melbourne, Victoria, 3010, Australia
| | - Thorlene Egerton
- Centre for Health, Exercise, and Sports Medicine, The University of Melbourne, 161 Barry Street, Melbourne, Victoria, 3010, Australia
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Predicting physical activity recovery after hip and knee arthroplasty? A longitudinal cohort study. Braz J Phys Ther 2019; 25:30-39. [PMID: 31874729 DOI: 10.1016/j.bjpt.2019.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 10/08/2019] [Accepted: 12/10/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Recovery of physical activity (PA) after telerehabilitation following knee and hip arthroplasty (TKA-THA) has rarely been studied. An improved understanding of PA recovery is needed, as it could be influenced by many factors such as age, gender or pre-operative physical function. OBJECTIVES To assess PA recovery weekly for 3 months after TKA-THA and to determine perioperative factors that could help predict PA recovery at 3 months. METHODS From one week before until 3 months after surgery, 132 patients wore a fitness tracker continuously. Each patient received personalized and daily exercises and feedback through a tablet. Before and after surgery, patient-reported outcome measures of symptoms, pain, activities of daily living and quality of life were recorded. A one-way repeated-measure ANOVA was used to assess the time effect on step count for each post-operative week. To predict the absolute step count at 3 months post-surgery, a backward multiple linear regression was used. RESULTS Patients reached their pre-operative PA level at week 7, with no significant additional improvement by 3 months post-surgery. Pre-operative step count, the number of days using crutches and pre-operative symptoms explained 35% of the variability of step count at 3 months. CONCLUSION This patient population receiving telerehabilitation reached their pre-operative PA level at 7-week post-surgery with no further improvement over the subsequent 5 weeks. The PA level at 3 months could be predicted by pre-operative step count, duration of crutches use, and pre-operative symptoms.
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24
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Arab Alkabeya H, Hughes AM, Adams J. Factors Associated With Hand and Upper Arm Functional Disability in People With Rheumatoid Arthritis: A Systematic Review. Arthritis Care Res (Hoboken) 2019; 71:1473-1481. [PMID: 30320976 DOI: 10.1002/acr.23784] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/09/2018] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This original systematic review aimed to summarize evidence within observational studies on the factors associated with hand functional disability in adults with rheumatoid arthritis (RA). METHODS A rigorous extensive systematic literature search was conducted in 6 medical databases for peer-reviewed English language observational studies that explore the factors associated with hand function for people with RA. Factors were critically classified under the domains of the International Classification of Functioning, Disability and Health (ICF) framework and health-related factors. The methodologic quality was determined using the appraisal tool for cross-sectional studies. Factors related to hand function that were investigated in ≥2 studies were explored using a best-evidence synthesis. RESULTS Twenty articles from 1,271 citations met the inclusion criteria. All presented cross-sectional data (5 high-quality and 15 low-quality articles), resulting in limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicated that a diverse range of positive and negative factors were associated with hand function. However, key factors were hand strength, disease activity, and pain intensity. It is evident that few sociodemographic factors have been explored for the association with hand function. CONCLUSION Although the level of evidence was limited, modifiable factors such as grip strength, disease activity, and pain were identified as the most influential factors on hand function in people with RA. The findings of the present review indicate that important sociodemographic factors that impact hand function in individuals with RA have not yet been considered or reported in clinical research.
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Affiliation(s)
- Hisham Arab Alkabeya
- University of Southampton, Southampton, UK, and Arab American University, Jenin, Palestine
| | | | - Jo Adams
- University of Southampton, Southampton, UK
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25
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Timmermans EJ, de Koning EJ, van Schoor NM, van der Pas S, Denkinger MD, Dennison EM, Maggi S, Pedersen NL, Otero Á, Peter R, Cooper C, Siviero P, Castell MV, Herbolsheimer F, Edwards M, Limongi F, Deeg DJH, Schaap LA. Within-person pain variability and physical activity in older adults with osteoarthritis from six European countries. BMC Musculoskelet Disord 2019; 20:12. [PMID: 30611248 PMCID: PMC6320627 DOI: 10.1186/s12891-018-2392-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 12/21/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND This study examines the association of both pain severity and within-person pain variability with physical activity (PA) in older adults with osteoarthritis (OA). METHODS Data from the European Project on OSteoArthritis were used. At baseline, clinical classification criteria of the American College of Rheumatology were used to diagnose OA in older adults (65-85 years). At baseline and 12-18 months follow-up, frequency and duration of participation in the activities walking, cycling, gardening, light and heavy household tasks, and sports activities were assessed with the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire. Physical activity was calculated in kcal/day, based on frequency, duration, body weight and the metabolic equivalent of each activity performed. At baseline and 12-18 months follow-up, pain severity was assessed using the pain subscales of the Western Ontario and McMaster Universities OA Index and the Australian/Canadian Hand OA Index. Within-person pain variability was assessed using two-week pain calendars that were completed at baseline, 6 months follow-up and 12-18 months follow-up. RESULTS Of all 669 participants, 70.0% were women. Sex-stratified multiple linear regression analyses showed that greater pain severity at baseline was cross-sectionally associated with less PA in women (Ratio = 0.95, 95% CI = 0.90-0.99), but not in men (Ratio = 0.99, 95% CI = 0.85-1.15). The longitudinal analyses showed a statistically significant inverse association between pain severity at baseline and PA at follow-up in women (Ratio = 0.94, 95% CI = 0.89-0.99), but not in men (Ratio = 1.00, 95% CI = 0.87-1.11). Greater pain variability over 12-18 months was associated with more PA at follow-up in men (Ratio = 1.18, 95% CI = 1.01-1.38), but not in women (Ratio = 0.94, 95% CI = 0.86-1.03). CONCLUSIONS Greater pain severity and less pain variability are associated with less PA in older adults with OA. These associations are different for men and women. The observed sex differences in the various associations should be studied in more detail and need replication in future research.
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Affiliation(s)
- Erik J. Timmermans
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081HV, Amsterdam, Netherlands
| | - Elisa J. de Koning
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081HV, Amsterdam, Netherlands
| | - Natasja M. van Schoor
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081HV, Amsterdam, Netherlands
| | - Suzan van der Pas
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081HV, Amsterdam, Netherlands
| | - Michael D. Denkinger
- Geriatric Research Unit / Institute of Epidemiology and Medical Biometry, AGAPLESION Bethesda Hospital, Ulm University, Ulm, Germany
| | - Elaine M. Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Stefania Maggi
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Ángel Otero
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Richard Peter
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Paola Siviero
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Maria Victoria Castell
- Department of Preventive Medicine and Public Health, Unit of Primary Care and Family Medicine, Faculty of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Florian Herbolsheimer
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Ulm, Germany
| | - Mark Edwards
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Federica Limongi
- National Research Council, Aging Branch, Institute of Neuroscience, Padova, Italy
| | - Dorly J. H. Deeg
- Department of Epidemiology and Biostatistics, Amsterdam University Medical Center, VU University Medical Center, Amsterdam Public Health Research Institute, De Boelelaan 1089A, 1081HV, Amsterdam, Netherlands
| | - Laura A. Schaap
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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Cao S, Cao J, Li S, Wang W, Qian Q, Ding Y. Cross-cultural adaptation and validation of the Simplified Chinese version of Copenhagen Hip and Groin Outcome Score (HAGOS) for total hip arthroplasty. J Orthop Surg Res 2018; 13:278. [PMID: 30400966 PMCID: PMC6219004 DOI: 10.1186/s13018-018-0971-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/11/2018] [Indexed: 12/02/2022] Open
Abstract
Background To translate and cross-culturally adapt the Copenhagen Hip and Groin Outcome Score (HAGOS) into a Simplified Chinese version (HAGOS-C) and evaluate the reliability, validity, and responsiveness of the HAGOS-C in total hip arthroplasty (THA) patients. Methods The cross-cultural adaptation was performed according to the internationally recognized guidelines of the American Academy of Orthopaedic Surgeons Outcome Committee. A total of 192 participants were recruited in this study. The intra-class correlation coefficient (ICC) was used to determine reliability. Construct validity was analyzed by evaluating the correlations between HAGOS-C and EuroQoL 5-dimension (EQ-5D), as well as the short form (36) health survey (SF-36). Responsiveness of HAGOS-C was evaluated according to standard response means (SRM) and standard effect size (ES) between the first test and the third test (6 months after primary THA). Results The original version of the HAGOS was well cross-culturally adapted and translated into Simplified Chinese. HAGOS-C was indicated to have excellent reliability (ICC = 0.748–0.936, Cronbach’s alpha = 0.787–0.886). Moderate to substantial correlations between subscales of HAGOS-C and EQ-5D (r = 0.544–0.751, p < 0.001), as well as physical function (r = 0.567–0.640, p < 0.001), role physical (r = 0.570–0.613, p < 0.001), bodily pain (r = 0.467–0.604, p < 0.001), and general health (r = 0.387–0.432, p < 0.001) subscales of SF-36, were observed. The ES of 0.805–1.100 and SRM of 1.408–2.067 revealed high responsiveness of HAGOS-C. Conclusions HAGOS-C was demonstrated to have excellent acceptability, reliability, validity, and responsiveness in THA, which could be recommended for patients in mainland China.
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Affiliation(s)
- Shiqi Cao
- Department of Rehabilitation, Minimally Invasive Spine Center, Navy General Hospital, No. 6, Fucheng Road, Haidian District, Beijing, 100048, People's Republic of China. .,Joint Surgery and Sports Medicine Department, Changzheng Hospital, Navy Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China.
| | - Jia Cao
- Joint Surgery and Sports Medicine Department, Changzheng Hospital, Navy Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China
| | - Sirui Li
- College of Basic Medicine, Army Medical University, Chongqing, 400038, People's Republic of China
| | - Wei Wang
- Department of Orthopaedics, Chengdu Military General Hospital, No. 270, Tianhui Road, Jinniu District, Chengdu, 610083, People's Republic of China.
| | - Qirong Qian
- Joint Surgery and Sports Medicine Department, Changzheng Hospital, Navy Medical University, No. 415, Fengyang Road, Huangpu District, Shanghai, 200003, People's Republic of China.
| | - Yu Ding
- Department of Rehabilitation, Minimally Invasive Spine Center, Navy General Hospital, No. 6, Fucheng Road, Haidian District, Beijing, 100048, People's Republic of China
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Shim HY, Park M, Kim HJ, Kyung HS, Shin JY. Physical activity status by pain severity in patients with knee osteoarthritis: a nationwide study in Korea. BMC Musculoskelet Disord 2018; 19:380. [PMID: 30342512 PMCID: PMC6195748 DOI: 10.1186/s12891-018-2301-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 10/11/2018] [Indexed: 11/22/2022] Open
Abstract
Backgrounds Few reports have explored the extent to which physical activity is affected by pain severity in knee osteoarthritis (KOA) patients. We used national representative data to investigate the physical activity of KOA patients compared to the general population to determine what proportion of patients met physical activity recommendations and to explore how the proportion changes with pain severity. Methods We used data from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V; 2010–2012). In total, 1279 participants aged ≥50 years who had radiographic KOA and who evaluated knee pain on a numerical rating scale were selected. KOA was assessed using the Kellgren–Lawrence system. The Korean short version of the International Physical Activity Questionnaire was used to measure physical activity status. We used the physical activity recommendations of the American College of Rheumatology Work Group Panel when evaluating the extent of activity in KOA patients. Results Only 18.6% of KOA patients met the osteoarthritis expert panel recommendations, lower than in the general population (23.2%; p = 0.003). The percentages that met the recommendations in the none to mild pain group, moderate pain group, and severe pain group were 23.4%, 17.6%, and 18.3%, respectively (p = 0.341). In terms of flexibility, a somewhat higher percentage of those with moderate pain engaged in physical activity compared to those with little or no pain (17.1% vs. 12.3%), but the difference was not significant (p = 0.585). Conclusions Regardless of pain severity, overall physical activity was suboptimal in Korean KOA patients. It is important to emphasize to osteoarthritis patients in clinical settings the need for physical activity, and a policy-based effort is required to facilitate appropriate exercise. Electronic supplementary material The online version of this article (10.1186/s12891-018-2301-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hye-Young Shim
- Department of Preventive Medicine, School of Medicine, Eulji University, Deajeon, Republic of Korea.,Department of Rehabilitation Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Mira Park
- Department of Preventive Medicine, School of Medicine, Eulji University, Deajeon, Republic of Korea
| | - Hee-June Kim
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Hee-Soo Kyung
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
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Physical activity levels after hip and knee joint replacement surgery: an observational study. Clin Rheumatol 2018; 38:665-674. [PMID: 30284079 DOI: 10.1007/s10067-018-4317-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/24/2018] [Accepted: 09/25/2018] [Indexed: 12/14/2022]
Abstract
Usual care after hip or knee joint replacement does not adequately address the problem of low physical activity levels. We aimed to determine whether exercise delivered in a group setting in the early stage of outpatient rehabilitation influenced self-reported physical activity levels after hip or knee joint replacement. A case series of 79 participants referred to a 6-week outpatient orthopaedic exercise group after total hip or knee replacement were evaluated using the International Physical Activity Questionnaire (IPAQ) short form. Physical function was evaluated using Osteoarthritis Research Society International (OARSI) recommended performance-based tests (30 s Chair Stand Test, 40 m Fast Pace Walk Test, Stair Climb Test, Timed Up and Go Test, 6 Minute Walk Test). Measures were assessed at admission, discharge and 6 weeks after group discharge. Non-parametric analysis was conducted for IPAQ scores. Analysis of functional measures was conducted with linear mixed models with time modelled as a repeated measure. Standard multiple regression and correlation analysis were conducted. Fifty-four participants completed the study. Self-reported activity levels improved significantly at program discharge but not at 6-week follow-up. All performance-based measures improved significantly at program discharge. Fast-paced walking and 6 Minute Walk Test measures continued to improve at 6-week follow-up. Group dynamics present in an outpatient rehabilitation exercise program may increase physical activity levels during group participation but not after group cessation. Performance in all functional measures improved at group discharge.
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Li H, Xie S, Qi Y, Li H, Zhang R, Lian Y. TNF-α increases the expression of inflammatory factors in synovial fibroblasts by inhibiting the PI3K/AKT pathway in a rat model of monosodium iodoacetate-induced osteoarthritis. Exp Ther Med 2018; 16:4737-4744. [PMID: 30542428 DOI: 10.3892/etm.2018.6770] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 07/13/2018] [Indexed: 12/15/2022] Open
Abstract
Osteoarthritis is a degenerative disease that often causes patients to experience joint pain and deformity. It has been demonstrated that tumor necrosis factor (TNF)-α is associated with the progression of osteoarthritis; however, to the best of our knowledge, the mechanisms by which TNF-α simulates the progression of osteoarthritis and the signaling pathway(s) it influences remain unknown. Therefore, the aim of the present study was to investigate the therapeutic effects of TNF-α inhibitor in an iodoacetate-induced rat model of osteoarthritis and identify its potential mechanisms of action. Western blotting, ELISA and histological analyses were performed to assess the effects of the TNF-α inhibitor on osteoarthritis. The effects of TNF-α and phosphoinositide 3-kinase (PI3K) inhibition on synovial fibroblasts isolated from rats with osteoarthritis were tested in vitro. Furthermore, the expression of various inflammatory cytokines and the PI3K/protein kinase B (AKT) signaling pathway were assessed in vitro. The results indicated that the inflammatory factors TNF-α, interleukin (IL)-1β, IL-17a and IL-8 were upregulated in synovial fibroblasts taken from rats with osteoarthritis compared with normal rats. By contrast, TNF-α inhibition downregulated IL-1β, IL-17a and IL-8 expression in synovial fibroblasts in vitro. The PI3K/AKT pathway was also upregulated in synovial fibroblasts harvested from rats with osteoarthritis compared with that in normal rats. It was demonstrated that treatment with the TNF-α inhibitor downregulated the serum and protein levels of IL-1β, IL-17a and IL-8 in rats with osteoarthritis. Furthermore, treatment with the TNF-α inhibitor also decreased matrix metalloproteinase (MMP)-3, MMP-9, vascular endothelial growth factor and ADAMTS4 expression in synovial fibroblasts isolated from rats with osteoarthritis. Treatment with the TNF-α inhibitor also inhibited the PI3K/AKT pathway in synovial fibroblasts isolated from rats with osteoarthritis. Treatment with the PI3K inhibitor ameliorated TNF-α-induced increases in IL-1β, IL-17a and IL-8 expression in synovial fibroblasts isolated from rats with osteoarthritis. Furthermore, treatment with the TNF-α inhibitor decreased inflammation, as well as joint and cartilage destruction in vivo. Taken together, the results of the present study indicate that TNF-α inhibition may downregulate the expression of inflammatory factors in synovial fibroblasts, suggesting that TNF-α inhibition may be a novel method for treating osteoarthritis by downregulating the PI3K/AKT signaling pathway.
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Affiliation(s)
- Hongxi Li
- Department of Orthopedics, The Fourth Hospital Affiliated to Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Shujuan Xie
- Community Center, Harbin First Hospital, Harbin, Heilongjiang 150001, P.R. China
| | - Yunlong Qi
- Department of Orthopedics, The Fourth Hospital Affiliated to Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Huazhe Li
- Department of Orthopedics, The Fourth Hospital Affiliated to Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Rui Zhang
- Department of Orthopedics, The Second Hospital Affiliated to Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
| | - Yongyun Lian
- Department of Orthopedics, The Fourth Hospital Affiliated to Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China
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Oliveira CB, Franco MR, Maher CG, Ferreira PH, Morelhão PK, Damato TM, Gobbi C, Pinto RZ. Physical Activity–Based Interventions Using Electronic Feedback May Be Ineffective in Reducing Pain and Disability in Patients With Chronic Musculoskeletal Pain: A Systematic Review With Meta-Analysis. Arch Phys Med Rehabil 2018; 99:1900-1912. [DOI: 10.1016/j.apmr.2017.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 10/13/2017] [Accepted: 10/16/2017] [Indexed: 11/25/2022]
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31
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Suzuki Y, Iijima H, Tashiro Y, Kajiwara Y, Zeidan H, Shimoura K, Nishida Y, Bito T, Nakai K, Tatsumi M, Yoshimi S, Tsuboyama T, Aoyama T. Development of a questionnaire survey to evaluate lower limb function of patients with knee osteoarthritis. Clin Rheumatol 2018; 37:3115-3123. [PMID: 30091087 DOI: 10.1007/s10067-018-4229-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 07/12/2018] [Accepted: 07/20/2018] [Indexed: 11/27/2022]
Abstract
This study aimed to develop a self-questionnaire index relevant to lower limb functional assessment reflecting clinical symptoms and activity restrictions associated with activities of daily living (ADL) for patients with knee osteoarthritis. This cross-sectional study enrolled patients with knee osteoarthritis (Kellgren/Lawrence grade ≥ 1). Participants evaluated clinical symptoms and activity restrictions using self-reported questionnaires. Radiographic evaluation, knee joint range of motion (ROM), and lower limb muscle strength were assessed. Associations between clinical symptoms, activity restrictions, and knee and hip joint function were evaluated using multiple and logistic regression analysis. Overall, 142 participants were included in the final analysis. Patients with knee pain while rising from a chair had lower knee and hip extension strength (knee extension β = - 0.28; 95% confidence interval (CI), - 0.41 to - 0.14; P < 0.0001; hip extension β = - 0.26; 95% CI, - 0.42 to - 0.08; P = 0.0034), and restricted knee extension ROM (odds ratio [OR] = 2.17; 95% CI, 1.02-4.63; P = 0.041). Patients with knee pain during stair climbing, turning or who were unable to stand on one leg without external support had reduced hip abduction muscle strength (β = - 0.17; 95% CI, - 0.27 to - 0.07; P = 0.0008). Patients with knee pain while rising from a chair or stepping showed more severe knee joint degeneration on radiographic evaluation (OR = 3.26; 95% CI, 1.11-10.91; P = 0.03). The self-questionnaire index reflected clinical symptoms and activity restrictions associated with ADL and was significantly associated with lower limb function in individuals with knee osteoarthritis.
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Affiliation(s)
- Yusuke Suzuki
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hirotaka Iijima
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
- Department of System Design Engineering, Keio University, Yokohama, Japan
| | - Yuto Tashiro
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuu Kajiwara
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hala Zeidan
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kanako Shimoura
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yuichi Nishida
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tsubasa Bito
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kengo Nakai
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masataka Tatsumi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Soyoka Yoshimi
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tadao Tsuboyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tomoki Aoyama
- Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan.
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Travers JL, Schroeder KL, Blaylock TE, Stone PW. Racial/Ethnic Disparities in Influenza and Pneumococcal Vaccinations Among Nursing Home Residents: A Systematic Review. THE GERONTOLOGIST 2018; 58:e205-e217. [PMID: 28329831 PMCID: PMC6044397 DOI: 10.1093/geront/gnw193] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Indexed: 11/13/2022] Open
Abstract
This systematic review analyzes research examining racial/ethnic disparities in influenza and pneumococcal vaccination coverage between White and racial/ethnic minority (Black and Hispanic) nursing home residents. A review of the literature for years 1966-2014 using Medline, Web of Science, and PubMed was conducted. The Epidemiological Appraisal Instrument was used to appraise the quality of the 13 included studies. Overall, articles were strong in reporting and data analysis, but weak in sample selection and measurement quality. Disparities between vaccination coverage among racial/ethnic minorities versus Whites ranged from 2% to 20% for influenza and 6% to 15% for pneumococcal vaccination. Researchers reported racial/ethnic minorities were more likely to refuse vaccinations and less likely to have vaccinations offered and their vaccination status tracked compared to Whites. Policies/strategies that focus on ensuring racial/ethnic minorities are offered influenza and pneumococcal vaccinations and their vaccination status are tracked in nursing homes are warranted. Updated evaluation on vaccination disparities is also needed.
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Affiliation(s)
- Jasmine L Travers
- NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia
| | | | - Thomas E Blaylock
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York
| | - Patricia W Stone
- Center for Health Policy, Columbia University School of Nursing, New York, New York
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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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Foucher KC, Cinnamon CC, Ryan CA, Chmell SJ, Dapiton K. Hip abductor strength and fatigue are associated with activity levels more than 1 year after total hip replacement. J Orthop Res 2018; 36:1519-1525. [PMID: 29077218 PMCID: PMC5924444 DOI: 10.1002/jor.23783] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/21/2017] [Indexed: 02/04/2023]
Abstract
Despite improvements in pain and function, people who undergo total hip arthroplasty (THR) may not always return to desired levels of physical activity (PA). The factors associated with low activity levels are not fully understood. Abductor weakness and fatigue have both been proposed as factors that limit activity in older adults or people with hip osteoarthritis, but have not been investigated after THR. We hypothesized that abductor weakness and fatigue are associated with lower activity levels in people who have undergone a THR and that fatigue mediates the association between abductor strength and activity. We evaluated 16 subjects (24 ± 10 months post-THR; age 56.8 ± 8.4 yrs; BMI 31 ± 7 kg/m2 ). Fatigue was assessed using the PROMIS fatigue short-form 7a. Peak isometric hip abductor torque was assessed using a dynamometer with subjects in a sidelying position. We assessed activity level using the UCLA activity score. We used Pearson correlations to explore the associations among the variables. Next we used a three-step linear regression procedure to test whether or not fatigue acted as a mediator between abductor torque and UCLA activity scores. Higher abductor torque was associated with less fatigue (R2 = 0.275; p = 0.037) and with higher UCLA scores (R2 = 0.488, p = 0.003). Higher fatigue was associated with lower UCLA scores (R2 = 0. 307, p = 0.017), however there was no evidence of mediation. This suggests that addressing both abductor strength and fatigue may increase physical activity. Statement of Clinical Significance: Fatigue and abductor weakness should be evaluated in sedentary THR patients presenting for long-term follow-up. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1519-1525, 2018.
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Affiliation(s)
- Kharma C. Foucher
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Christopher C. Cinnamon
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Colleen A. Ryan
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
| | - Samuel J. Chmell
- Department of Orthopedics, University of Illinois at Chicago, 835 South Wood Street, Room E270, Chicago, IL 60612, USA
| | - Kris Dapiton
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, 1919 W. Taylor St., 650 AHSB, Chicago, IL 60612, USA
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35
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Yu FY, Xie CQ, Jiang CL, Sun JT, Huang XW. TNF‑α increases inflammatory factor expression in synovial fibroblasts through the toll‑like receptor‑3‑mediated ERK/AKT signaling pathway in a mouse model of rheumatoid arthritis. Mol Med Rep 2018; 17:8475-8483. [PMID: 29693122 DOI: 10.3892/mmr.2018.8897] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/09/2018] [Indexed: 11/06/2022] Open
Abstract
Osteoarthritis is a type of joint disease that may lead to other joint diseases. Previous research has demonstrated that tumor necrosis factor (TNF)‑α is associated with osteoarthritis activity and pathology. The possible mechanisms of the TNF‑α‑mediated signaling pathway have not been clearly elaborated in synovial fibroblasts. The present study aimed to investigate the potential mechanisms of TNF‑α in a mouse model of iodoacetate‑induced osteoarthritis. Reverse transcription‑quantitative polymerase chain reaction, ELISA, western blotting and immunohistochemistry were performed to evaluate the role of TNF‑α in the progression of osteoarthritis. The results revealed that the serum levels of TNF‑α, interleukin (IL)‑1β, IL‑4 and IL‑6 were significantly upregulated in a mouse model of iodoacetate‑induced osteoarthritis compared with healthy mice (P<0.01). TNF‑α, IL‑1β, IL‑4 and IL‑6 mRNA and protein levels were also significantly upregulated in synovial fibroblasts in the experimental mice (P<0.01). It was demonstrated that TNF‑α increased pro‑inflammation factors matrix metalloproteinase (MMP)‑3, MMP‑9, nuclear factor (NF)‑κB and receptor activator of NF‑κB ligand (RANKL) in synovial fibroblasts. It was also observed that the toll‑like receptor (TLR)‑3 was significantly upregulated and extracellular signal‑regulated kinase (ERK) and protein kinase B (AKT) were significantly downregulated in synovial fibroblasts in osteoarthritis mice (P<0.01). An in vitro assay demonstrated that TNF‑α inhibitor decreased mRNA and protein levels of IL‑1β, IL‑4 and IL‑6 in synovial fibroblasts. The knockdown of TLR‑3 abolished the TNF‑α upregulated mRNA and protein levels of IL‑1β, IL‑4 and IL‑6 in synovial fibroblasts. In addition, the knockdown of TLR‑3 also reversed TNF‑α‑upregulated ERK and AKT expression in synovial fibroblasts. In vivo assays demonstrated that TNF‑α inhibitor significantly decreased the deposition of IL‑1β, IL‑4 and IL‑6 as well as bone destruction and significantly increased the body weight and osteoarthritis score for osteoarthritic mice (P<0.01). TNF‑α inhibitor decreased TLR‑3 and significantly increased the expression and phosphorylation of ERK and AKT in articular cartilage (P<0.01). In conclusion the results of the present study indicate that TNF‑α serves an essential role in synovial fibroblasts in osteoarthritis, suggesting that inhibition of TNF‑α may decrease inflammation via the TLR‑3‑mediated ERK/AKT signaling pathway in a mouse model of monosodium iodoacetate‑induced osteoarthritis.
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Affiliation(s)
- Fang-Yuan Yu
- Department of Orthopedics, The 309th Hospital of People's Liberation Army, Beijing 100091, P.R. China
| | - Cong-Qin Xie
- Department of Orthopedics, The 309th Hospital of People's Liberation Army, Beijing 100091, P.R. China
| | - Chang-Liang Jiang
- Department of Orthopedics, The 309th Hospital of People's Liberation Army, Beijing 100091, P.R. China
| | - Ji-Tong Sun
- Department of Orthopedics, The 309th Hospital of People's Liberation Army, Beijing 100091, P.R. China
| | - Xun-Wu Huang
- Department of Orthopedics, The 309th Hospital of People's Liberation Army, Beijing 100091, P.R. China
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36
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Abdel-Aziem AA, Soliman ES, Mosaad DM, Draz AH. Effect of a physiotherapy rehabilitation program on knee osteoarthritis in patients with different pain intensities. J Phys Ther Sci 2018; 30:307-312. [PMID: 29545702 PMCID: PMC5851371 DOI: 10.1589/jpts.30.307] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 11/28/2017] [Indexed: 02/06/2023] Open
Abstract
[Purpose] To examine the effect of physiotherapy rehabilitation program on moderate knee osteoarthritis in patients with different pain intensities. [Subjects and Methods] Sixty subjects (37 men and 23 women) with moderate knee osteoarthritis participated in the current study. Randomization software was used to select the participating subjects' numbers from the clinic records. They were classified into three groups according to pain intensity: mild, moderate, and severe pain groups. All groups underwent a standard set of pulsed electromagnetic field, ultrasound, stretching exercises, and strengthening exercises. Pain intensity, knee range of motion, knee function, and isometric quadriceps strength were evaluated using the visual analogue scale, universal goniometer, Western Ontario and McMaster Universities osteoarthritis index, and Jamar hydraulic dynamometer, respectively. The evaluation was performed before and after a 4-week rehabilitation program. [Results] All groups showed significant differences in pain intensity, knee range of motion, isometric quadriceps strength, and knee function. The score change in moderate pain group was significantly greater than those in mild and severe pain groups. [Conclusion] Pain intensity is one of the prominent factors that are responsible for the improvement of knee osteoarthritis. Consequently, pain intensity should be considered during rehabilitation of knee osteoarthritis.
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Affiliation(s)
- Amr Almaz Abdel-Aziem
- Department of Biomechanics, Faculty of Physical Therapy, Cairo University: 7 Ahmed Elziat Street, Ben Elsaryat, El Dokki, Giza, Egypt
| | - Elsadat Saad Soliman
- Department for Musculoskeletal Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt
| | | | - Amira Hussin Draz
- Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Egypt
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Sanchez-Santos MT, Garriga C, Judge A, Batra RN, Price AJ, Liddle AD, Javaid MK, Cooper C, Murray DW, Arden NK. Development and validation of a clinical prediction model for patient-reported pain and function after primary total knee replacement surgery. Sci Rep 2018; 8:3381. [PMID: 29467465 PMCID: PMC5821875 DOI: 10.1038/s41598-018-21714-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 01/22/2018] [Indexed: 12/23/2022] Open
Abstract
To develop and validate a clinical prediction model of patient-reported pain and function after undergoing total knee replacement (TKR). We used data of 1,649 patients from the Knee Arthroplasty Trial who received primary TKR across 34 centres in the UK. The external validation included 595 patients from Southampton University Hospital, and Nuffield Orthopaedic Centre (Oxford). The outcome was the Oxford Knee Score (OKS) 12-month after TKR. Pre-operative predictors including patient characteristics and clinical factors were considered. Bootstrap backward linear regression analysis was used. Low pre-operative OKS, living in poor areas, high body mass index, and patient-reported anxiety or depression were associated with worse outcome. The clinical factors associated with worse outcome were worse pre-operative physical status, presence of other conditions affecting mobility and previous knee arthroscopy. Presence of fixed flexion deformity and an absent or damaged pre-operative anterior cruciate ligament (compared with intact) were associated with better outcome. Discrimination and calibration statistics were satisfactory. External validation predicted 21.1% of the variance of outcome. This is the first clinical prediction model for predicting self-reported pain and function 12 months after TKR to be externally validated. It will help to inform to patients regarding expectations of the outcome after knee replacement surgery.
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Affiliation(s)
- M T Sanchez-Santos
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Arthritis research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - C Garriga
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
| | - A Judge
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - R N Batra
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A J Price
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - A D Liddle
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - M K Javaid
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - C Cooper
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - D W Murray
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - N K Arden
- Musculoskeletal Epidemiology, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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Kanavaki AM, Rushton A, Efstathiou N, Alrushud A, Klocke R, Abhishek A, Duda JL. Barriers and facilitators of physical activity in knee and hip osteoarthritis: a systematic review of qualitative evidence. BMJ Open 2017; 7:e017042. [PMID: 29282257 PMCID: PMC5770915 DOI: 10.1136/bmjopen-2017-017042] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED Physical activity (PA), including engagement in structured exercise, has a key role in the management of hip and knee osteoarthritis (OA). However, maintaining a physically active lifestyle is a challenge for people with OA. PA determinants in this population need to be understood better so that they can be optimised by public health or healthcare interventions and social policy changes. OBJECTIVES The primary aim of this study is to conduct a systematic review of the existing qualitative evidence on barriers and facilitators of PA for patients with hip or knee OA. Secondary objective is to explore differences in barriers and facilitators between (1) lifestyle PA and exercise and (2) PA uptake and maintenance. METHODS Medline, Embase, Web of Science, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, Scopus, Grey literature and qualitative journals were searched. Critical Appraisal Skills Programme-Qualitative checklist and Lincoln and Guba's criteria were used for quality appraisal. Thematic synthesis was applied. FINDINGS Ten studies were included, seven focusing on exercise regimes, three on overall PA. The findings showed a good fit with the biopsychosocial model of health. Aiming at symptom relief and mobility, positive exercise experiences and beliefs, knowledge, a 'keep going' attitude, adjusting and prioritising PA, having healthcare professionals' and social support emerged as PA facilitators. Pain and physical limitations; non-positive PA experiences, beliefs and information; OA-related distress; a resigned attitude; lack of motivation, behavioural regulation, professional support and negative social comparison with coexercisers were PA barriers. All themes were supported by high and medium quality studies. Paucity of data did not allow for the secondary objectives to be explored. CONCLUSION Our findings reveal a complex interplay among physical, personal including psychological and social-environmental factors corresponding to the facilitation and hindrance of PA, particularly exercise, engagement. Further research on the efficacy of individualised patient education, psychological interventions or social policy change to promote exercise engagement and lifestyle PA in individuals with lower limb OA is required. TRIAL REGISTRATION NUMBER CRD42016030024.
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Affiliation(s)
- Archontissa M Kanavaki
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), University of Birmingham, Birmingham, UK
| | - Nikolaos Efstathiou
- Nursing, Institute of Clinical Sciences, Medical School, University of Birmingham, Birmingham, UK
- School of Nursing, University of Ottawa, Ottawa, Canada
| | - Asma Alrushud
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- Department of Health Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Rainer Klocke
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Abhishek Abhishek
- Academic Rheumatology Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
- MRC-Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
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Quicke JG, Foster NE, Ogollah RO, Croft PR, Holden MA. Relationship Between Attitudes and Beliefs and Physical Activity in Older Adults With Knee Pain: Secondary Analysis of a Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2017; 69:1192-1200. [PMID: 27696795 PMCID: PMC5601293 DOI: 10.1002/acr.23104] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/19/2016] [Accepted: 09/27/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate how attitudes and beliefs about exercise relate to physical activity behavior in older adults with knee pain attributable to osteoarthritis (OA). METHODS We conducted secondary data analyses of a randomized controlled trial of exercise interventions (ISRCTN: 93634563). Participants were adults ≥45 years old with knee pain attributable to OA (n = 514). Crude and adjusted cross-sectional and longitudinal associations between baseline Self-Efficacy for Exercise (SEE), Positive Outcome Expectations for Exercise (POEE), Negative Outcome Expectations for Exercise scores, and physical activity level, at baseline, 3 months, and 6 months (measured by self-report using the Physical Activity Scale for the Elderly [PASE]), and important increases in physical activity level (from baseline to 6-month followup) were investigated using multiple linear and logistic regression. RESULTS Cross-sectional associations were found between SEE and PASE scores (β = 4.14 [95% confidence interval (95% CI) 0.26, 8.03]) and POEE and PASE scores (β = 16.71 [95% CI 1.87, 31.55]), adjusted for sociodemographic and clinical covariates. Longitudinal associations were found between baseline SEE and PASE scores at 3 months (β = 4.95 [95% CI 1.02, 8.87]) and 6 months β = 3.71 (0.26, 7.16), and baseline POEE and PASE at 3 months (β = 34.55 [95% CI 20.13, 48.97]) and 6 months (β = 25.74 [95% CI 11.99, 39.49]), adjusted for baseline PASE score and intervention arm. However, no significant associations with important increases in physical activity level were found. CONCLUSION Greater exercise self-efficacy and more positive exercise outcome expectations were associated with higher current and future physical activity levels. These may be targets for interventions aimed at increasing physical activity.
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Affiliation(s)
- Jonathan G Quicke
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Nadine E Foster
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Reuben O Ogollah
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Peter R Croft
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Melanie A Holden
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire, UK
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Oliveira CB, Franco MR, Maher CG, Christine Lin CW, Morelhão PK, Araújo AC, Negrão Filho RF, Pinto RZ. Physical Activity Interventions for Increasing Objectively Measured Physical Activity Levels in Patients With Chronic Musculoskeletal Pain: A Systematic Review. Arthritis Care Res (Hoboken) 2017; 68:1832-1842. [PMID: 27111744 DOI: 10.1002/acr.22919] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 03/11/2016] [Accepted: 04/19/2016] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate whether physical activity interventions increase objectively measured physical activity levels of patients with chronic musculoskeletal pain (e.g., osteoarthritis, low back pain) compared to no/minimal intervention. METHODS We performed a systematic review with meta-analysis searching the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, SportDiscus, and Physiotherapy Evidence Database (PEDro) databases, and the main clinical trials registries. Quasirandomized or randomized controlled trials investigating the effect of physical activity interventions on objectively measured physical activity levels (e.g., using accelerometers or pedometers) of patients with chronic musculoskeletal pain compared with no/minimal intervention were considered eligible. Analyses were conducted separately for short-term (≤3 months), intermediate (>3 months and <12 months), and long-term (≥12 months) followups. Pooled effects were calculated using the standardized mean difference (SMD), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used in summary conclusions. RESULTS Eight published trials and 6 registered trials were included. For the short-term followup, pooling of 6 trials showed no significant effect (SMD 0.34, 95% confidence interval -0.09, 0.77) between a physical activity intervention and no/minimal intervention. Similarly nonsignificant results were found for the intermediate and long-term followups. The overall evidence according to the GRADE approach was classified as low quality. CONCLUSION Our findings suggest that physical activity-based interventions may lead to little or no difference in objectively measured physical activity levels of patients with chronic musculoskeletal pain compared with no/minimal interventions. Given the number of registered trials, the pooled effect found in this review is likely to change once the results of these trials become available.
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Affiliation(s)
- Crystian B Oliveira
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Marcia R Franco
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Christopher G Maher
- George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Chung-Wei Christine Lin
- George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
| | - Priscila K Morelhão
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | | | - Ruben F Negrão Filho
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil
| | - Rafael Z Pinto
- Faculdade de Ciências e Tecnologia, UNESP, Universidade Estadual Paulista, Presidente Prudente, São Paulo, Brazil, and George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia
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Daniali SS, Darani FM, Eslami AA, Mazaheri M. Relationship between Self-efficacy and Physical Activity, Medication Adherence in Chronic Disease Patients. Adv Biomed Res 2017; 6:63. [PMID: 28603704 PMCID: PMC5458405 DOI: 10.4103/2277-9175.190997] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND The global epidemic of unhealthy lifestyle causes to increase chronic disease. It has been proven that psychological factors such as self-efficacy are responsible to success in the process of lifestyle change. Low self-efficacy is usually related to low level of physical activity and medication adherence. Objective of the study was to investigate the effects of self-efficacy, other physical symptoms on physical activity and medication adherence in patients with chronic illness in public health centers. MATERIALS AND METHODS A cross-sectional study was conducted on 483 patients with chronic diseases attended to governmental health care centers in Isfahan. Participants were chosen by systematic random sampling. Inclusion criteria were having a chronic illness at least 6-month ago while prescription of medication and willing to take part in the survey. The parts of Stanford Self-management Questionnaire were used. Data were analyzed by SPSS 18 software using the descriptive and analytic statistics. P < 0.05 was considered significant. RESULTS Mean age of participants was 54.8 (7.22) years. The half of participants had low self-efficacy and 87.2% had low physical activity. Nearly 80% of patients had a good medication adherence. There was a significant relationship between self-efficacy and physical activity (P = 0.336, β = 1.01, P < 0.001). CONCLUSION Although chronic disease patients had a good medication adherence, other self-care behaviors such as physical activity has been neglected. It is seemed that concentration on psychological factors such as self-efficacy should be considered as a proximal factor to improve self-care.
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Affiliation(s)
- Seyde Shahrbanoo Daniali
- Department of Health, Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Firooze Mostafavi Darani
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmad Ali Eslami
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Mazaheri
- Department of Traditional Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Tanaka S, Matsumoto S, Kawashima T, Mitani S, Miura Y. Walking speed affects instrumental activities of daily living in patients with hip osteoarthritis. J Back Musculoskelet Rehabil 2017; 30:309-316. [PMID: 27791992 DOI: 10.3233/bmr-160524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The symptoms of hip osteoarthritis (OA) influence instrumental activities of daily living (IADL). Evidence form previous studies suggest that body functions and walking speed are important etiological factors for IADL. However, no studies have investigated which factors that have the greatest influence on IADL. OBJECTIVE The aims of this study were (1) to analyze factors related to IADL in patients with hip OA, including 10 m walking speed (10 mWS), and (2) to establish cut-off values for factors that predict maintenance of IADL. METHODS Forty-eight patients participated in this study. IADL was treated as dependent variable. Range of motion (ROM), muscle strength of the hips and knees, and 10 mWS were measured as independent variables. Other potential confounding factors were also measured. Data were analyzed using hierarchical multiple regression and Receiver Operating Characteristic curve analysis. RESULTS The hip flexion ROM on the affected side and 10 mWS were selected as significant variables in this study. The cut-off values obtained were 92.5 degrees for the hip flexion ROM on the affected side and 42.3 m/min for 10 mWS. CONCLUSIONS The suggested target associated with maintaining IADL in patients with hip OA is the cut-off value of 42.3 m/min for 10 mWS found in this study.
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Affiliation(s)
- Shigeharu Tanaka
- Department of Physical Therapy, Kawasaki Junior College of Rehabilitation, Kurashiki, Japan.,Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Shinsuke Matsumoto
- Department of Physical Therapy, Kawasaki Junior College of Rehabilitation, Kurashiki, Japan
| | - Takaki Kawashima
- Rehabilitation Center, Kawasaki Medical School Hospital, Kurashiki, Japan
| | - Shigeru Mitani
- Department of Bone and Surgery, Kawasaki Medical School, Kurashiki, Japan
| | - Yasushi Miura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Kobe, Japan
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Abstract
Wearable sensors, in particular inertial measurement units (IMUs) allow the objective, valid, discriminative and responsive assessment of physical function during functional tests such as gait, stair climbing or sit-to-stand. Applied to various body segments, precise capture of time-to-task achievement, spatiotemporal gait and kinematic parameters of demanding tests or specific to an affected limb are the most used measures. In activity monitoring (AM), accelerometry has mainly been used to derive energy expenditure or general health related parameters such as total step counts. In orthopaedics and the elderly, counting specific events such as stairs or high intensity activities were clinimetrically most powerful; as were qualitative parameters at the ‘micro-level’ of activity such as step frequency or sit-stand duration. Low cost and ease of use allow routine clinical application but with many options for sensors, algorithms, test and parameter definitions, choice and comparability remain difficult, calling for consensus or standardisation.
Cite this article: Grimm B, Bolink S. Evaluating physical function and activity in the elderly patient using wearable motion sensors. EFORT Open Rev 2016;1:112–120. DOI: 10.1302/2058-5241.1.160022.
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Affiliation(s)
- Bernd Grimm
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
| | - Stijn Bolink
- AHORSE Research Foundation, Zuyderland Medical Center, Heerlen, The Netherlands
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Zhaoyang R, Martire LM, Sliwinski MJ. Morning self-efficacy predicts physical activity throughout the day in knee osteoarthritis. Health Psychol 2017; 36:568-576. [PMID: 28277696 DOI: 10.1037/hea0000479] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the within-day and cross-day prospective effects of knee osteoarthritis (OA) patients' self-efficacy to engage in physical activity despite the pain on their subsequent physical activity assessed objectively in their natural environment. METHOD Over 22 days, 135 older adults with knee OA reported their morning self-efficacy for being physically active throughout the day using a handheld computer and wore an accelerometer to measure moderate activity and steps. RESULTS Morning self-efficacy had a significant positive effect on steps and moderate-intensity activity throughout that day, above and beyond the effects of demographic background and other psychosocial factors as well as spouses' support and social control. The lagged effect of morning self-efficacy on the next day's physical activity and the reciprocal lagged effect of physical activity on the next day's self-efficacy were not significant. Positive between-person effects of self-efficacy on physical activity were found. CONCLUSIONS Future research should aim to better understand the mechanisms underlying fluctuations in patients' daily self-efficacy, and target patients' daily self-efficacy as a modifiable psychological mechanism for promoting physical activity. (PsycINFO Database Record
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Ekram ARMS, Cicuttini FM, Teichtahl AJ, Crammond BR, Lombard CB, Liew SM, Urquhart DM, Wluka AE. Weight satisfaction, management strategies and health beliefs in knee osteoarthritis patients attending an outpatient clinic. Intern Med J 2017; 46:435-42. [PMID: 26762652 DOI: 10.1111/imj.13007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 12/23/2015] [Accepted: 01/06/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although weight control is important in managing knee osteoarthritis (OA), it is difficult to achieve. Understanding beliefs regarding weight management in people with knee OA may improve weight control. AIMS To examine differences in bodyweight satisfaction, weight management strategies and weight-related health-beliefs in obese, overweight and normal weight people with knee OA. METHODS The beliefs and attitudes to weight in 102 people with symptomatic knee OA were ascertained. Participants were classified as being obese, overweight or of normal weight. RESULTS Although obese and overweight participants were less satisfied with their bodyweight, they were more likely to want to lose weight and to report dieting compared with normal weight participants(P < 0.001 for all) and also more likely to report weight gain in the past 6 months (P < 0.001). While most participants rated food intake to be a main determinant of health, this belief was more common in normal weight participants (P = 0.04). When asked about their own weight gain, obese participants more frequently believed genetic and metabolic factors to be important than normal and overweight participants (P = 0.01). While 51 (53%) believed that increasing activity was more important than dietary change to avoid weight gain, this was more commonly believed by obese and overweight participants (P < 0.05). CONCLUSIONS Despite desiring and attempting to lose weight, obese people with symptomatic knee OA more commonly reported weight gain. Overweight and obese participants attributed weight gain to non-modifiable factors but believed physical activity is more important than dietary change in weight management. Thus, education regarding the importance of diet as compared with non-modifiable factors and physical activity may improve weight management in obese people with knee OA.
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Affiliation(s)
- A R M S Ekram
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Rajshahi Medical College and Hospital, Rajshahi, Bangladesh
| | - F M Cicuttini
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A J Teichtahl
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Baker IDI Heart and Diabetes Institute, Monash University, Melbourne, Victoria, Australia
| | - B R Crammond
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - C B Lombard
- Healthy Lifestyle Research, Department of Nutrition and Dietetics, Monash University, Melbourne, Victoria, Australia
| | - S M Liew
- Department of Orthopaedic Surgery, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Surgery, Monash University, Melbourne, Victoria, Australia
| | - D M Urquhart
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A E Wluka
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Kanavaki AM, Rushton A, Klocke R, Abhishek A, Duda JL. Barriers and facilitators to physical activity in people with hip or knee osteoarthritis: protocol for a systematic review of qualitative evidence. BMJ Open 2016; 6:e012049. [PMID: 27810971 PMCID: PMC5128852 DOI: 10.1136/bmjopen-2016-012049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION This protocol aims to describe the objective and methods to be followed in a systematic review of qualitative studies on barriers and facilitators to physical activity (PA) in people with hip or knee osteoarthritis (OA). METHODS AND ANALYSIS MEDLINE, EMBASE, PhychINFO, Web of Science, CINAHL, SPORTDiscus, Scopus and grey literature sources will be electronically searched. Hand search of qualitative research-centred journals, reference screening of relevant reviews and inquiries to researchers active in the field will complement the search. Studies will be selected if they apply qualitative or mixed-methods designs to directly explore factors that correspond to engagement in PA/exercise or, the perceptions regarding PA/exercise in people with hip or knee OA. The Critical Appraisal Skills Programme Qualitative Checklist and the evaluative criteria of credibility, transferability, dependability and confirmability will be applied for the study appraisal. 2 independent reviewers will perform the search, study selection and study appraisal. Thematic synthesis will be used for synthesising the findings of the primary studies and the process and product of the synthesis will be checked by a second researcher. ConQual approach will be used for assessing the confidence in the qualitative findings. ETHICS AND DISSEMINATION This systematic review will inform our understanding of the PA determinants and how to optimise behaviour change in people living with hip or knee OA. The review findings will be reported in a peer-reviewed journal and presented at national or international conferences. The study raises no ethical issues. TRIAL REGISTRATION NUMBER CRD42016030024.
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Affiliation(s)
- Archontissa M Kanavaki
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Alison Rushton
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Rainer Klocke
- Department of Rheumatology, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Abhishek Abhishek
- Faculty of Medicine and Health Sciences, Academic Rheumatology Unit, School of Medicine, University of Nottingham, Nottingham, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
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The Influence of Weather Conditions on Outdoor Physical Activity Among Older People With and Without Osteoarthritis in 6 European Countries. J Phys Act Health 2016; 13:1385-1395. [PMID: 27633622 DOI: 10.1123/jpah.2016-0040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Older adults with osteoarthritis (OA) often report that their disease symptoms are exacerbated by weather conditions. This study examines the association between outdoor physical activity (PA) and weather conditions in older adults from 6 European countries and assesses whether outdoor PA and weather conditions are more strongly associated in older persons with OA than in those without the condition. METHODS The American College of Rheumatology classification criteria were used to diagnose OA. Outdoor PA was assessed using the LASA Physical Activity Questionnaire. Data on weather parameters were obtained from weather stations. RESULTS Of the 2439 participants (65-85 years), 29.6% had OA in knee, hand and/or hip. Participants with OA spent fewer minutes in PA than participants without OA (Median = 42.9, IQR = 20.0 to 83.1 versus Median = 51.4, IQR = 23.6 to 98.6; P < .01). In the full sample, temperature (B = 1.52; P < .001) and relative humidity (B = -0.77; P < .001) were associated with PA. Temperature was more strongly associated with PA in participants without OA (B = 1.98; P < .001) than in those with the condition (B = 0.48; P = .47). CONCLUSIONS Weather conditions are associated with outdoor PA in older adults in the general population. Outdoor PA and weather conditions were more strongly associated in older adults without OA than in their counterparts with OA.
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Leijendekkers RA, van Hinte G, Frölke JP, van de Meent H, Nijhuis-van der Sanden MWG, Staal JB. Comparison of bone-anchored prostheses and socket prostheses for patients with a lower extremity amputation: a systematic review. Disabil Rehabil 2016; 39:1045-1058. [PMID: 27494092 DOI: 10.1080/09638288.2016.1186752] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE This study aimed to provide an overview of a) the used measurement instruments in studies evaluating effects on quality of life (QoL), function, activity and participation level in patients with a lower extremity amputation using bone-anchored prostheses compared to socket prostheses and b) the effects themselves. METHOD A systematic literature search was conducted in MEDLINE, Cochrane, EMBASE, CINAHL and Web of Science. Included studies compared QoL, function, activity and/or participation level in patients with bone-anchored or socket prostheses. A best-evidence synthesis was performed. RESULTS Out of 226 studies, five cohort and two cross-sectional studies were eligible for inclusion, all had methodological shortcomings. These studies used 10 different measurement instruments and two separate questions to assess outcome. Bone-anchored prostheses were associated with better condition-specific QoL and better outcomes on several of the physical QoL subscales, outcomes on the physical bodily pain subscale were inconclusive. Outcomes on function and activity level increased, no change was found at participation level. The level of evidence was limited. CONCLUSIONS There is a need for a standard set of instruments. There was limited evidence that bone-anchored prostheses resulted in higher QoL, function and activity levels than socket prostheses, in patients with socket-related problems. Implications for Rehabilitation Use of bone-anchored prostheses in combination with intensive outpatient rehabilitation may improve QoL, function and activity level compared with socket prosthesis use in patients with a transfemoral amputation and socket-related problems. All clinicians and researchers involved with bone-anchored prostheses should use and publish data on QoL, function, activity and participation level. There needs to be an agreement on a standard set of instruments so that interventions for patients with a lower extremity amputation are assessed consistently.
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Affiliation(s)
- Ruud A Leijendekkers
- a Department of Orthopaedics , Physical Therapy, Radboud University Medical Centre , Nijmegen , The Netherlands.,b Master Clinical Health Sciences, Program in Physical Therapy Science , University Utrecht and University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Gerben van Hinte
- a Department of Orthopaedics , Physical Therapy, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Jan Paul Frölke
- c Department of Surgery , Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Hendrik van de Meent
- d Department of Rehabilitation , Radboud University Medical Centre , Nijmegen , The Netherlands
| | - Maria W G Nijhuis-van der Sanden
- a Department of Orthopaedics , Physical Therapy, Radboud University Medical Centre , Nijmegen , The Netherlands.,e Scientific Centre for Quality of Care, Radboud University Medical Centre , Nijmegen , The Netherlands
| | - J Bart Staal
- e Scientific Centre for Quality of Care, Radboud University Medical Centre , Nijmegen , The Netherlands.,f Research Group Musculoskeletal Rehabilitation, HAN University of Applied Sciences , Nijmegen , The Netherlands
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Wang ZM, Chen YC, Wang DP. Resveratrol, a natural antioxidant, protects monosodium iodoacetate-induced osteoarthritic pain in rats. Biomed Pharmacother 2016; 83:763-770. [PMID: 27484345 DOI: 10.1016/j.biopha.2016.06.050] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 05/31/2016] [Accepted: 06/28/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic progressive joint disease characterized by advanced joint pain, subchondral bone sclerosis and articular cartilage degeneration. Resveratrol has been shown to have anti-inflammatory, cardioprotective and antioxidant properties and to inhibit platelet aggregation and coagulation. However, the effects of resveratrol on OA have not been examined. In this study, we investigate the protective effects of resveratrol on monosodium iodoacetate (MIA)-induced OA through inhibition of cyclooxygenase (COX-2) and inducible nitric oxide synthase (iNOS) signaling pathway in a rat model. METHODS A single intra-articular injection of MIA was injected into rats for the induction of OA. The mechanical, heat and cold hyperalgesia were measured at days 0, 7 and 14. The serum and synovial fluid levels of IL-1β, IL-10 and TNF-α and osteocalcin were measured by enzyme-linked immunosorbent assay. The mRNA and protein expressions of IL-1β, IL-10, TNF-α, Il-6, MMP-13 and COX-2 and iNOS were determined by RT-PCR and western blot, respectively. Osteoarthritic lesion in the knee joint was evaluated by histological analysis. RESULTS MIA-injected rats treated with resveratrol at a dose of either 5 or 10mg/kg body weight were significantly reduced hyperalgesia of mechanical, heat and cold and increased the vertical and horizontal movements. Subsequently, MIA-injected rats increased serum and synovial fluid levels of IL-1β, IL-10, IL-6, TNF-α, MMP-13 and osteoclastic activity marker, osteocalcin and its articular cartilage mRNA and protein expressions. Further, MIA-injected rats increased COX-2 and iNOS mRNA and protein expressions were decreased by resveratrol. The protective effect of resveratrol was comparable to a reference drug, etoricoxib. The cartilage damage induced by MIA were attenuated by resveratrol. CONCLUSIONS Taken together, resveratrol has the potential to improve MIA-induced cartilage damage by inhibiting the levels and expressions of inflammatory mediators suggesting that resveratrol may be a potential therapeutic agent for OA.
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Affiliation(s)
- Zhu-Min Wang
- Department of Bone and Hand Microsurgery, Shandong Wendeng Orthopedic and Traumatic Hospital, Shandong, China
| | - Yong-Cai Chen
- Department of Microsurgery, The First Affiliated Hospital of Henan University of Science and Technology, LuoYang, China
| | - Da-Peng Wang
- Department of Osteology, Zhengzhou Orthopaedics Hospital, No. 58 the Longhai Road, Two seven District, Zhengzhou City, Henan, 450000, China.
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Liao CD, Huang YC, Chiu YS, Liou TH. Effect of body mass index on knee function outcomes following continuous passive motion in patients with osteoarthritis after total knee replacement: a retrospective study. Physiotherapy 2016; 103:266-275. [PMID: 27647443 DOI: 10.1016/j.physio.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 04/05/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Obesity may influence postoperative rehabilitation outcomes after total knee replacement (TKR). The aim of this study was to evaluate the effects of body mass index (BMI) on the progression of inpatient rehabilitation using continuous passive motion (CPM) and its treatment outcomes. PARTICIPANTS AND SETTING A retrospective study was conducted in a rehabilitation centre. In total, 354 patients undergoing primary TKR were enrolled through medical chart review. INTERVENTION All patients commenced the CPM programme immediately after surgery and continued until hospital discharge. MAIN OUTCOME MEASURES Knee flexion, pain score, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function score. DESIGN Patients were divided into five BMI groups: normal weight (n=59), overweight (n=95), Class I obesity (n=90), Class II obesity (n=82) and Class III obesity (n=28). All outcome measures were recorded at admission; daily during the inpatient stay; at discharge; and at 1-, 3- and 6-month follow-up assessments. RESULTS During CPM exercises, obese patients had a smaller initial flexion angle (P<0.001) and a smaller daily increment in the CPM motion arc (P<0.001) compared with patients of normal weight. Severe obesity was associated with poor knee flexion [adjusted odds ratio (aOR) 11.9, 95% confidence interval (CI) 3.49 to 40.94, P<0.001] and WOMAC physical function score (aOR 5.09, 95% CI 1.62 to 16.03, P=0.005) at 6-month follow-up. CONCLUSIONS Obesity had a negative effect on progress during the CPM protocol, which commenced immediately after surgery and continued until discharge. Obesity was also associated with poorer self-reported function at 6-month follow-up.
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Affiliation(s)
- C-D Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Y-C Huang
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Y-S Chiu
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - T-H Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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