scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

2020 ◽  
Vol 5 (1) ◽  
pp. 29
Author(s):  
Nelson Sudiyono

Background: Canes have been recommended as walking aids for knee osteoarthritis to reduce the loading on the affected knee. Patients are usually recommended to hold the cane in the contralateral hand to the affected knee. Nevertheless, some patients prefer to hold the cane ipsilateral to the affected knee. However, the effect of using ipsilateral or contralateral tripod cane on functional mobility in patients with knee osteoarthritis is still unknown Objective: To compare the immediate effect of ipsilateral and contralateral tripod cane usage on functional mobility in patients with symptomatic knee osteoarthritis Method: This cross-sectional study involved 30 overweight or obese patients with symptomatic unilateral or bilateral knee osteoarthritis (Kellgren Lawrence grade 2 and 3) who never use a cane. Functional mobility was evaluated with Time Up and Go test in three conditions; without walking aid, with tripod cane contralateral and ipsilateral to the more painful knee. Results: The TUG time of aid-free walking is 4.75 (p < 0.001, 95% CI 3.79 - 5.71) seconds faster than ipsilateral cane use and 6.69 (p < 0.001, 95%CI 5.35 - 8.03) seconds faster than contralateral cane use. The TUG time of ipsilateral cane use is 1,94 (95% CI, 1.13 - 2.79) seconds faster than contralateral. Conclusion: Patients with symptomatic knee OA who use tripod cane ipsilateral to the more painful knee have higher functional mobility than the contralateral.


Author(s):  
Júlia Cristina Leite Nóbrega ◽  
Juliana Barbosa Medeiros ◽  
Tácila Thamires de Melo Santos ◽  
Saionara Açucena Vieira Alves ◽  
Javanna Lacerda Gomes da Silva Freitas ◽  
...  

Objective: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. Method: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil’s Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using “R” statistical software. Results: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. Conclusion: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.


2021 ◽  
pp. jrheum.210285
Author(s):  
Holly T. Philpott ◽  
Trevor B. Birmingham ◽  
Ryan Pinto ◽  
Codie A. Primeau ◽  
Dominique Arsenault ◽  
...  

Objective To examine the association between ultrasound (US)-detected knee inflammation and intermittent and constant pain experiences in patients with knee osteoarthritis (OA). Methods Participants with radiographically early- (KL ≤ 2) and late-stage (KL ≥ 3) disease and frequent symptoms underwent musculoskeletal US measures of inflammation using the OMERACT knee US scoring system. Pain experiences were captured using the Intermittent and Constant OA Pain (ICOAP) tool. We assessed the association between US-synovitis and ICOAP pain experiences using a series of linear, logistic, or multinomial logistic regression models (as appropriate for each variable), while adjusting for age, sex, body mass index (BMI), and radiographic stage. Secondary analyses were performed similarly by radiographic stage. Results Pain and synovitis measures from 248 patients (453 knees) were included. Worse synovitis was associated with higher ICOAP constant pain scores (β 8.05 [95%CI 0.67, 15.43]), but not intermittent pain scores. Moderate-to-severe synovitis was associated with a 4.73-fold increased relative risk [95%CI 1.06, 8.80] of a constant pain pattern. In secondary analyses, moderate-to-severe synovitis in early radiographic OA was associated with 2.70-higher odds [95%CI 1.04, 7.02] of any constant pain, 3.28-higher odds [95%CI 1.43, 7.52] of any intermittent pain, and with higher intermittent (β 10.47 [95%CI 1.03, 19.91]) and constant (β 12.62 [95%CI 3.02, 22.23]) pain scores. No associations identified for synovitis in those with late radiographic OA. Conclusion In patients with knee OA, moderate-to-severe synovitis is most strongly associated with constant pain. Inflammation may play context-specific roles across pain experiences, especially in earlier radiographic stages of knee OA.


2014 ◽  
Vol 27 (5) ◽  
pp. 392-398 ◽  
Author(s):  
Andréa Mathes Faustino ◽  
Lenora Gandolfi ◽  
Leides Barroso de Azevedo Moura

Objective To verify whether there is a connection between the functional capacity of the elderly and the presence of violent situations in their daily lives. Methods A population-based cross-sectional study developed with 237 elderly individuals. Standard and validated research instruments were used. Results Mean age of 70.25 years (standard deviation of 6.94), 69% were female, 76% were independent in basic activities of daily living and 54% had a partial dependence on at least one instrumental activity. The most prevalent violence was psychological and the relation between being dependent on basic activities of daily living and suffering physical violence was statistically significant. Conclusion When the elderly needs assistance to perform self-care activities, there is a greater chance of exposure to a situation of abuse, such as physical violence.


2015 ◽  
pp. 1-6
Author(s):  
C. SIORDIA ◽  
H.T. NGUYEN

Background: Within the assessment of frailty, self-rated health (SRH) questions remain frequently used in survey research attempting to quantify a subjective and global measure of health. Studies have largely ignored the fact that SRH questions may differ in their ability to predict level of difficulty with performing activities of daily living (ADLs)—a variance partially influenced by whether a comparative frame of reference in used in the SRH question. Specific Aim: Investigate if a Comparative-SRH (C-SRH) question with response options ranging on an adjectival scale ranging from 0 to 3; and a Non-Comparative-SRH (NC-SRH) question with an adjectival response scale from range 0 to 5; differ in their ability to predict level of difficulty in performing ADLs after accounting for demographic, psychosocial, and related health factors. Setting & Design: Cross-sectional study of community-dwelling adults (n=275; x age=68; female=54%; x BMI=31) from North Carolina participating in the Hispanic Aging Survey (HAS) were used in multivariable linear regressions to predict a granular measure of level of difficulty performing ADLs. Results: Only C-SRH has a statistically significant relationship with ADLs—where each increase in C-SRH (i.e., more positively self-rated health) is associated with a decrease in ADL level of difficult. Conclusions: Using a comparative frame of reference in SRH questions may have important implications when attempting to understand the statistical relationship between self-rated global health and physical function in the assessment of frailty in older adults.


2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.


2012 ◽  
Vol 13 (3) ◽  
pp. 741-750 ◽  
Author(s):  
Reza Amini ◽  
Robab Sahaf ◽  
Alireza Kaldi ◽  
Hamid Haghani ◽  
Keyvan Davatgaran ◽  
...  

2019 ◽  
Vol 32 (10) ◽  
pp. 654 ◽  
Author(s):  
Anamélia Oliveira ◽  
Paulo Nossa ◽  
Anabela Mota-Pinto

Introduction: The aim of this study is to assess functional capacity and determine the factors associated with functional decline in the elderly in adult day care centres and home care support in the County of Coimbra, Portugal.Material and Methods: Cross-sectional study. A total of 115 participants of both genders, aged between 65 and 98, were enrolled in the home care support and adult day care system of the County of Coimbra, Portugal. Functional capacity was assessed using the Barthel index and the Lawton index. Another questionnaire gathered social, demographic and health status information.Results: The basic activities of daily living were significantly associated with age, cohabitation, medication usage, falls and multiple morbidity. Analysis of the study’s variables and the instrumental activities of daily living found significant associations between age, institutional affiliation, perceived health status, hospitalizations, medication usage, physical exercise, multiple morbidities, falls, and fall prevention.Discussion: The results demonstrate that no statistically observable differences were found between gender and functional dependence. A significant association between the Barthel index and cohabitation was also found. We should also highlight that this sample revealed the extremely important role of families in determining the protection of highly dependent older people. Likewise, a significant association was observed between instrumental activities of daily living and levels of physical activity in which greater independence was found in those seniors who practiced physical exercise three or more times per week.Conclusion: The results of this study allow us to identify factors that may be associated with the functional decline in the elderly. Useful evidence for the adoption of intervention strategies in the elderly population was added, focused on the prevention of functional decline and maintenance of the functional capacities of the elderly.


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