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Webber SC, Barclay R, Ripat J, Nowicki S, Tate R. Factors associated with social participation and community ambulation in people with osteoarthritis: Findings from the Canadian Longitudinal Study on Aging. Int J Rheum Dis 2023; 26:360-369. [PMID: 36502535 DOI: 10.1111/1756-185x.14520] [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: 09/20/2022] [Revised: 11/19/2022] [Accepted: 11/22/2022] [Indexed: 12/14/2022]
Abstract
AIM Walking in the community allows participation in meaningful activities which positively influences self-rated health and quality of life. Our objective was to identify factors associated with social participation and community ambulation in a representative sample of Canadian adults with osteoarthritis (OA). METHODS Data were from >3800 participants in the Baseline Tracking Dataset of the Canadian Longitudinal Study on Aging with OA of the hip and/or knee. Outcomes included frequency of participation in 8 community-based activities (past year, social participation), and frequency walking outside the home (past 7 days, community ambulation). Explanatory variables (15 for social participation, 11 for community ambulation) established in previous literature were evaluated. Variables significant in univariate binary logistic regression models were entered into multivariable models. RESULTS Frequency of social participation was greater for females, and individuals with higher levels of education. Those who were younger, dissatisfied with life, and had difficulty walking 2-3 blocks were less likely to participate. Having fewer chronic conditions, being younger, being single/widowed and being interviewed in spring/summer were associated with more frequent ambulation. Lower self-rated health, difficulty walking 2-3 blocks, pain and being female were associated with less frequent walking outside the home. CONCLUSION Many factors influence frequency of social participation and community ambulation. The ability to walk short distances is positively associated with both outcomes. This important factor can and should be addressed clinically to improve health and quality of life in people with OA.
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Affiliation(s)
- Sandra C Webber
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ruth Barclay
- Department of Physical Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie Ripat
- Department of Occupational Therapy, College of Rehabilitation Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Scott Nowicki
- Department of Community Health Sciences, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Robert Tate
- Department of Community Health Sciences, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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2
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Yuan B, Li J, Lan J. Labor Participation of Retirement-Aged Workers: Understanding the Influencing Mechanism of Health Status and Social Pension Insurance Participation. J Occup Environ Med 2022; 64:e60-e69. [PMID: 34817454 DOI: 10.1097/jom.0000000000002444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Delayed retirement initiative is taken as one of the proposed solutions to population aging. Rare research attention has been paid to determinants in decisions-making of late retirement. METHOD This study applies data from CHARLS survey (2018) that traces the health status among older adults in China, and implements the stepwise multiple regression analysis adjusted with robust standard errors on individual level. RESULTS The difficulty in instrumental activities of daily living (IADLs) and chronic conditions could increase the intention of retirement-aged workers to withdraw from late career participation; and the overlay of both would interact to reinforce such intention. Besides, the employment-related social pension participation could further strengthen the jointly contributing effect of both on withdrawal from late career participation. CONCLUSION The triple interaction mechanism in retirement-aged workers' decisions of late retirement needs considering in the policy formulation of delayed retirement initiative.
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Affiliation(s)
- Bocong Yuan
- School of Tourism Management, Sun Yat-sen University, Guangzhou, China (Yuan and Lan); Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University, Zhuhai, China (Dr Li)
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3
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Shen S. Chronic Disease Burden, Sexual Frequency, and Sexual Dysfunction in Partnered Older Adults. JOURNAL OF SEX & MARITAL THERAPY 2019; 45:706-720. [PMID: 31018802 DOI: 10.1080/0092623x.2019.1610127] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This research evaluates the relationship between chronic disease burden and partnered sexuality of older adults by using data from the National Social Life, Health, and Aging Project. Ordinary least squares and logistic regressions identify how chronic disease burden is associated with sexual frequency and sexual dysfunction for men (N = 893) and women (N = 641). Results indicate that an increasing chronic disease burden is negatively associated with men's sexual frequency, while a greater burden of chronic disease is related to a greater risk of lubrication problems for women and orgasm problems for men. The findings reveal gender differences in how disease is linked to older adults' sexual lives.
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Affiliation(s)
- Shannon Shen
- Social Sciences, Texas A&M University - San Antonio , San Antonio , TX , USA
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4
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Webber SC, Ripat JD, Pachu NS, Strachan SM. Exploring physical activity and sedentary behaviour: perspectives of individuals with osteoarthritis and knee arthroplasty. Disabil Rehabil 2019; 42:1971-1978. [DOI: 10.1080/09638288.2018.1543463] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Sandra C. Webber
- Rady Faculty of Health Sciences, Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Jacquie D. Ripat
- Rady Faculty of Health Sciences, Department of Occupational Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada
| | - Navjot S. Pachu
- Applied Health Sciences Program, University of Manitoba, Winnipeg, Canada
| | - Shaelyn M. Strachan
- Faculty of Kinesiology and Recreation Management, University of Manitoba, Winnipeg, Canada
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5
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Sezgin Ozcan D, Koseoglu BF, Balci KG, Polat CS, Ozcan OU, Balci MM, Aydoğdu S. Musculoskeletal pain and related factors in coronary artery disease: An observational cross-sectional study. J Back Musculoskelet Rehabil 2019; 31:839-847. [PMID: 29865028 DOI: 10.3233/bmr-170847] [Citation(s) in RCA: 2] [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 AND AIM In patients diagnosed with coronary artery disease (CAD), we aimed to determine the characteristics and risk factors of co-occurring musculoskeletal pain and examine its effects on functional capacity, psychological status and health-related quality of life. PATIENTS AND METHODS A total of 100 patients with (n= 50) and without (n= 50) musculoskeletal pain were enrolled. All patients were assessed on sociodemographic and clinical properties. The Duke Activity Status Index (DASI), the Hospital Anxiety and Depression Scale (HADS) and the Short Form-36 (SF-36) were applied as clinical assessment scales. RESULTS Patients with musculoskeletal pain were mostly female, and had a lower education level and annual income. The pain was mostly nociceptive, intermittent, sharp/stabbing in character, and located in the chest and spine. Having musculoskeletal pain resulted in lower levels on the DASI and all subgroups of the SF-36, and higher levels on the HADS. Female gender, lower education level and severity of emotional distress proved to be independent risk factors for the development of musculoskeletal pain. CONCLUSIONS In CAD, the co-occurrence of musculoskeletal pain leads to a further decrease in health-related quality of life and functional status, and increased severity of anxiety and depression. This stresses the importance of the detection and optimal treatment of musculoskeletal pain in patients diagnosed with CAD.
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Affiliation(s)
- Didem Sezgin Ozcan
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Belma Fusun Koseoglu
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Kevser Gulcihan Balci
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Cemile Sevgi Polat
- Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Training and Research Hospital, Ankara, Turkey
| | - Ozgur Ulas Ozcan
- Department of Cardiology, Ankara University School of Medicine, Ankara, Turkey
| | - Mustafa Mucahit Balci
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
| | - Sinan Aydoğdu
- Department of Cardiology, Turkiye Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey
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6
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The impacts of state and trait anxiety as moderated by perceived social support among Nigerian patients with rheumatoid arthritis. Reumatologia 2018; 56:155-163. [PMID: 30042603 PMCID: PMC6052375 DOI: 10.5114/reum.2018.76903] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 05/08/2018] [Indexed: 01/10/2023] Open
Abstract
Objectives To assess the levels of state and trait anxiety and determine their relationships with perceived social support among Nigerian patients with rheumatoid arthritis (RA). Material and methods A cross-sectional study of 50 patients satisfying the 2010 American College of Rheumatology/European League against Rheumatism Classification Criteria for RA was conducted. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI), perceived social support by the Interpersonal Support Evaluation List (ISEL), health-related quality of life (HRQoL) by the Medical Outcome Study 36-Item Short Form Health Survey (SF-36) and disability by the Health Assessment Questionnaire-Disability Index (HAQ-DI). Results The mean state anxiety (STAI-S), trait anxiety (STAI-T) and ISEL scores among the patients were 35.2 ±10.2, 36.7 ±8.8 and 87.2 ±21.2 respectively. Pathological degrees of state and trait anxiety were found among 7 (14%) and 5 (10.4%) patients respectively. There was a negative correlation between the STAI-T score and the ISEL score (r = -0.362, p = 0.011). However, the correlation between STAI-S and ISEL was not statistically significant (r = -0.193, p = 0.179). A moderate-to-high correlation was found between each of STAI-S and STAI-T and all subscales and component summaries of the SF-36. ISEL score correlated significantly with role emotional (r = 0.377, p = 0.008), mental health (r = 0.482, p ≤ 0.001) and bodily pain (r = 0.320, p = 0.025) domains and the mental component summary (r = 0.380, p = 0.007) of SF-36. HAQ-DI correlated strongly with both STAI-S (r = 0.735, p ≤ 0.001) and STAI-T (r = 0.575, p ≤ 0.001) but not with ISEL. Conclusions State and trait anxiety correlate negatively with all aspects of HRQoL and disability, and there is a notable relationship between perceived social support and trait anxiety as well as the mental aspect of HRQoL.
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Wang Z, Zou Z, Dong B, Ma J, Arnold L. Association between the Great China Famine exposure in early life and risk of arthritis in adulthood. J Epidemiol Community Health 2018; 72:790-795. [PMID: 29680802 DOI: 10.1136/jech-2017-210334] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/05/2018] [Accepted: 04/06/2018] [Indexed: 01/15/2023]
Abstract
BACKGROUND The association between famine exposure in early life and risk of arthritis (combination of osteoarthritis and inflammatory arthritis) in adulthood is unclear. The aim of this study is to explore the association. METHODS A total of 4124 subjects were selected from the national data of the China Health and Retirement Longitudinal Study in 2011-2012. Doctor-diagnosed arthritis was self-reported in participants' questionnaire. Birthdates were used to categorise participants into famine-exposed and non-exposed groups. Logistic regression model was used to explore the association of famine exposure in early life with the risk of arthritis in adulthood. RESULTS The prevalence of arthritis in both infant-exposed and preschool-exposed groups was significantly higher than those in the non-exposed group (35.0% and 30.6% vs 27.3%; p<0.05). Compared with the non-exposed group, the infant-exposed group showed a significantly elevated risk of arthritis in adulthood after adjusting for confounding factors (OR=1.65; 95% CI 1.29 to 2.11; p<0.001). In the stratified analysis, we found that participants who lived in severely affected areas (OR=1.91; 95% CI 1.41 to 2.59; p<0.001), who are female (OR=2.21; 95% CI 1.57 to 3.11; p<0.001) and those with a body mass index ≥24.0 kg/m2 (OR=2.46; 95% CI 1.70 to 3.55; p<0.001) in the infant-exposed group had increased risk of arthritis in adulthood. Similar results were additionally observed when age-balanced control group was used. CONCLUSION Great China Famine exposure in infancy may be associated with an elevated risk of arthritis in adulthood, particularly in women and participants with adiposity. These findings suggest nutrition intervention in infancy and weight control in later life may reduce the risk of arthritis in adulthood.
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Affiliation(s)
- Zhenghe Wang
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Zhiyong Zou
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Bin Dong
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Jun Ma
- School of Public Health and Institute of Child and Adolescent Health, Peking University Health Science Center, Beijing, China
| | - Luke Arnold
- Population Health, South Western Sydney Primary Health Network, Sydney, New South Wales, Australia
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8
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Wang V, Allen K, Van Houtven CH, Coffman C, Sperber N, Mahanna EP, Colón-Emeric C, Hoenig H, Jackson GL, Damush TM, Price E, Hastings SN. Supporting teams to optimize function and independence in Veterans: a multi-study program and mixed methods protocol. Implement Sci 2018; 13:58. [PMID: 29678137 PMCID: PMC5910600 DOI: 10.1186/s13012-018-0748-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
Background Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, and share responsibility for outcomes. However, a one-size-fits-all approach is rarely effective. In partnership with VA national clinical leaders and local clinical champions, the Optimizing Function and Independence VA Quality Enhancement Research Initiative program (Function QUERI) will evaluate efforts to implement team-based clinical programs for Veterans at risk for functional decline and disability. Methods Function QUERI will implement and evaluate three innovative, evidence-based clinical programs in VA medical centers: (1) a group physical therapy program for knee osteoarthritis (Group PT); (2) assisted early mobility for hospitalized older veterans (STRIDE), a supervised walking program for hospitalized older veterans; and (3) implementation of helping invested family members improve veteran experiences study (iHI-FIVES), a skills training program for caregivers of disabled Veterans. A common reason for clinical care gaps in these populations is poor communication and coordination among the many interdisciplinary providers involved in their care. To facilitate the implementation of the clinical programs, Function QUERI will evaluate the impact of complexity science-based implementation intervention to promote team readiness (CONNECT), an implementation intervention designed as a bundle of interaction-oriented activities to promote team function and readiness for change, on the implementation of clinical programs across multiple sites. The evaluation will use a mixed methods design. Group PT is a local, single-site quality improvement project where a modified CONNECT intervention will be tested to inform the remaining program implementation projects. For STRIDE and iHI-FIVES projects, we will randomize participating sites to implement the clinical program, with the CONNECT intervention or not, and will use a stepped-wedge cluster randomized trial design. Discussion Function QUERI will translate its findings across its projects to identify the contextual factors and components from CONNECT that improve team processes and function to optimize effective implementation for future rollout of VA clinical programs. Synthesizing findings within and across projects, we will specify dimensions of team characteristics and function that enhance capacity for clinical innovation and uptake of evidence-based programs. Trial registration NCT03300336 Registered September 28, 2017, NCT03474380 Registered March 15, 2018. Electronic supplementary material The online version of this article (10.1186/s13012-018-0748-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Virginia Wang
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA. .,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA. .,Department of Medicine, Duke University School of Medicine, Durham, NC, USA.
| | - Kelli Allen
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Medicine and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney H Van Houtven
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Cynthia Coffman
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Nina Sperber
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Elizabeth P Mahanna
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA
| | - Cathleen Colón-Emeric
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Geriatric Research Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Helen Hoenig
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Physical Medicine and Rehabilitation Service, Durham VA Health Care System, Durham, NC, USA
| | - George L Jackson
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Teresa M Damush
- Health Services Research and Development Center for Health Information and Communication, Roudebush Veterans Affairs Medical Center, 1481 W. 10th St., HSRD 11H, Indianapolis, IN, 46202, USA.,Department of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA.,Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Erika Price
- San Francisco VA Care System, 94121, 4150 Celement St., Box 111, San Francisco, CA, USA.,Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Susan N Hastings
- Health Services Research and Development Center of Innovation, Durham Veterans Affairs Health Care System, 508 Fulton St., Durham, NC, 27705, USA.,Department of Medicine, Duke University School of Medicine, Durham, NC, USA.,Geriatric Research Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
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Kostadinović M, Nikolić D, Šantrić-Milićević M. The role of gender and comorbidity on function and movement in elderly population: Importance of physical activity. MEDICINSKI PODMLADAK 2018. [DOI: 10.5937/mp69-16796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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10
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KOMUKAI K, FUJIMOTO S, SUGITA S, MITSUTAKE S, WACHIGAI H, KOBAYASHI M. Definitions and Evaluation Indexes of Social Participation in Rehabilitation: A Qualitative Systematic Literature Review. ACTA ACUST UNITED AC 2017. [DOI: 10.1589/rika.32.683] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | - Shuhei FUJIMOTO
- Department of Health Informatics, Graduate School of Public Health, Kyoto University
- Link & Communication Inc
| | | | - Seigo MITSUTAKE
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology
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11
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Qian J, Ren X. Association between comorbid conditions and BADL/IADL disability in hypertension patients over age 45: Based on the China health and retirement longitudinal study (CHARLS). Medicine (Baltimore) 2016; 95:e4536. [PMID: 27495110 PMCID: PMC4979864 DOI: 10.1097/md.0000000000004536] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 07/05/2016] [Accepted: 07/14/2016] [Indexed: 11/25/2022] Open
Abstract
Hypertension usually coexists with other chronic conditions and can cause disability in relation to activities of daily living. We examined the association between the number and categories of comorbid conditions and disability affecting activities of daily living in hypertension patients.The data were collected from the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS), which contains information about chronic conditions and disability. Additionally, socio-demographic characteristics of 3754 hypertension patients aged 45 and older were included in this study. Comorbid conditions included dyslipidemia, stroke, and 12 other chronic conditions. Disability in relation to activities of daily living was assessed using the basic activities of daily living (BADL) and the instrumental activities of daily living (IADL) instruments. Differences in BADL/IADL disability among patients with different comorbid conditions were compared using the chi-square test, and the influence of chronic conditions and socio-demographic characteristics on BADL/IADL disability was analyzed using logistic models.Without considering the influence of specific chronic conditions on BADL/IADL, hypertension patients with additional comorbid conditions were more likely to suffer from BADL/IADL disability. When considering the effect of specific chronic conditions, the number of comorbid conditions did not significantly influence BADL/IADL disability. Dyslipidemia, chronic lung disease, stroke, memory-related diseases, and arthritis/rheumatism were associated with BADL disability. Chronic lung diseases, heart diseases, stroke, stomach/digestive system diseases, emotional/nervous/psychiatric problems, memory-related diseases, arthritis/rheumatism, and asthma were associated with IADL disability. Additionally, female, people with lower education level, people living in village, and people living in middle and western China were more likely suffer from BADL/IADL disability.Comorbid conditions were associated with disability in activities of daily living in hypertension patients aged 45 and older. The specific comorbid conditions had a stronger effect on disability in activities of daily living than the number of comorbid conditions. In addition, we should pay attention to socioeconomic factors related to disability.
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Affiliation(s)
| | - Xiaohui Ren
- Department of Health-related Social and Behavioral Science, West China School of Public Health, Sichuan University, Chengdu, China
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12
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Group Versus Individual Physical Therapy for Veterans With Knee Osteoarthritis: Randomized Clinical Trial. Phys Ther 2016; 96:597-608. [PMID: 26586865 DOI: 10.2522/ptj.20150194] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 11/10/2015] [Indexed: 01/26/2023]
Abstract
BACKGROUND Efficient approaches are needed for delivering nonpharmacological interventions for management of knee osteoarthritis (OA). OBJECTIVE This trial compared group-based versus individual physical therapy interventions for management of knee OA. DESIGN AND METHODS Three hundred twenty patients with knee OA at the VA Medical Center in Durham, North Carolina, (mean age=60 years, 88% male, 58% nonwhite) were randomly assigned to receive either the group intervention (group physical therapy; six 1-hour sessions, typically 8 participants per group) or the individual intervention (individual physical therapy; two 1-hour sessions). Both programs included instruction in home exercise, joint protection techniques, and individual physical therapist evaluation. The primary outcome measure was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; range=0-96, higher scores indicate worse symptoms), measured at baseline, 12 weeks, and 24 weeks. The secondary outcome measure was the Short Physical Performance Battery (SPPB; range=0-12, higher scores indicate better performance), measured at baseline and 12 weeks. Linear mixed models assessed the difference in WOMAC scores between arms. RESULTS At 12 weeks, WOMAC scores were 2.7 points lower in the group physical therapy arm compared with the individual physical therapy arm (95% confidence interval [CI]=-5.9, 0.5; P=.10), indicating no between-group difference. At 24 weeks, WOMAC scores were 1.3 points lower in the group physical therapy arm compared with the individual physical therapy arm (95% CI=-4.6, 2.0; P=.44), indicating no significant between-group difference. At 12 weeks, SPPB scores were 0.1 points lower in the group physical therapy arm compared with the individual physical therapy arm (95% CI=-0.5, 0.2; P=.53), indicating no difference between groups. LIMITATIONS This study was conducted in one VA medical center. Outcome assessors were blinded, but participants and physical therapists were not blinded. CONCLUSIONS Group physical therapy was not more effective than individual physical therapy for primary and secondary study outcomes. Either group physical therapy or individual physical therapy may be a reasonable delivery model for health care systems to consider.
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13
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Williams QI, Gunn AH, Beaulieu JE, Benas BC, Buley B, Callahan LF, Cantrell J, Genova AP, Golightly YM, Goode AP, Gridley CI, Gross MT, Heiderscheit BC, Hill CH, Huffman KM, Kline A, Schwartz TA, Allen KD. Physical therapy vs. internet-based exercise training (PATH-IN) for patients with knee osteoarthritis: study protocol of a randomized controlled trial. BMC Musculoskelet Disord 2015; 16:264. [PMID: 26416025 PMCID: PMC4587879 DOI: 10.1186/s12891-015-0725-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 09/18/2015] [Indexed: 12/19/2022] Open
Abstract
Background Physical activity improves pain and function among individuals with knee osteoarthritis (OA), but most people with this condition are inactive. Physical therapists play a key role in helping people with knee OA to increase appropriate physical activity. However, health care access issues, financial constraints, and other factors impede some patients from receiving physical therapy (PT) for knee OA. A need exists to develop and evaluate other methods to provide physical activity instruction and support to people with knee OA. This study is examining the effectiveness of an internet-based exercise training (IBET) program designed for knee OA, designed by physical therapists and other clinicians. Methods/Design This is a randomized controlled trial of 350 participants with symptomatic knee OA, allocated to three groups: IBET, standard PT, and a wait list (WL) control group (in a 2:2:1 ratio, respectively). The study was funded by the Patient Centered Outcomes Research Institute, which conducted a peer review of the proposal. The IBET program provides patients with a tailored exercise program (based on functional level, symptoms, and current activity), video demonstrations of exercises, and guidance for appropriate exercise progression. The PT group receives up to 8 individual visits with a physical therapist, mirroring standard practice for knee OA and with an emphasis on a home exercise program. Outcomes are assessed at baseline, 4 months (primary time point) and 12 months (to assess maintenance of treatment effects). The primary outcome is the Western Ontario and McMaster Universities Osteoarthritis Index, and secondary outcomes include objective physical function, satisfaction with physical function, physical activity, depressive symptoms and global assessment of change. Linear mixed models will be used to compare both the IBET and standard PT groups to the WL control group, examine whether IBET is non-inferior to PT (a treatment that has an established evidence base for knee OA), and explore whether participant characteristics are associated with differential effects of IBET and/or standard PT. This research is in compliance with the Helsinki Declaration and was approved by the Institutional Review Board of the University of North Carolina at Chapel Hill. Discussion The IBET program could be disseminated widely at relatively low cost and could be an important resource for helping patients with knee OA to adopt and maintain appropriate physical activity. This trial will provide an important evaluation of the effectiveness of this IBET program for knee OA. Trial registration NCT02312713
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Affiliation(s)
- Quinn I Williams
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, 125 MacNider Hall CB# 7005, Chapel Hill, NC, 27599, USA.
| | - Alexander H Gunn
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, 125 MacNider Hall CB# 7005, Chapel Hill, NC, 27599, USA.
| | | | - Bernadette C Benas
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, 125 MacNider Hall CB# 7005, Chapel Hill, NC, 27599, USA.
| | - Bruce Buley
- Comprehensive Physical Therapy Center, Chapel Hill, NC, USA.
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, 125 MacNider Hall CB# 7005, Chapel Hill, NC, 27599, USA.
| | - John Cantrell
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Andrew P Genova
- Comprehensive Physical Therapy Center, Chapel Hill, NC, USA.
| | - Yvonne M Golightly
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Adam P Goode
- Department of Orthopedic Surgery, Division of Physical Therapy, Duke University Medical Center, Durham, NC, USA.
| | | | - Michael T Gross
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Bryan C Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA.
| | - Carla H Hill
- Division of Physical Therapy, Department of Allied Health Sciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kim M Huffman
- Department of Medicine, Division of Rheumatology, Duke University Medical Center, Durham, NC, USA. .,Physical Medicine and Rehabilitation Service, Durham VA Medical Center, Durham, NC, USA.
| | - Aaron Kline
- Advanced Physical Therapy of Smithfield, Smithfield, NC, USA.
| | - Todd A Schwartz
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Kelli D Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Bldg., CB# 7280, Chapel Hill, NC, 27599, USA. .,Department of Medicine, University of North Carolina at Chapel Hill, 125 MacNider Hall CB# 7005, Chapel Hill, NC, 27599, USA. .,Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, NC, USA.
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Allam A, Kostova Z, Nakamoto K, Schulz PJ. The effect of social support features and gamification on a Web-based intervention for rheumatoid arthritis patients: randomized controlled trial. J Med Internet Res 2015; 17:e14. [PMID: 25574939 PMCID: PMC4296094 DOI: 10.2196/jmir.3510] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 10/16/2014] [Accepted: 11/08/2014] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is chronic systematic disease that affects people during the most productive period of their lives. Web-based health interventions have been effective in many studies; however, there is little evidence and few studies showing the effectiveness of online social support and especially gamification on patients' behavioral and health outcomes. OBJECTIVE The aim of this study was to look into the effects of a Web-based intervention that included online social support features and gamification on physical activity, health care utilization, medication overuse, empowerment, and RA knowledge of RA patients. The effect of gamification on website use was also investigated. METHODS We conducted a 5-arm parallel randomized controlled trial for RA patients in Ticino (Italian-speaking part of Switzerland). A total of 157 patients were recruited through brochures left with physicians and were randomly allocated to 1 of 4 experimental conditions with different types of access to online social support and gamification features and a control group that had no access to the website. Data were collected at 3 time points through questionnaires at baseline, posttest 2 months later, and at follow-up after another 2 months. Primary outcomes were physical activity, health care utilization, and medication overuse; secondary outcomes included empowerment and RA knowledge. All outcomes were self-reported. Intention-to-treat analysis was followed and multilevel linear mixed models were used to study the change of outcomes over time. RESULTS The best-fit multilevel models (growth curve models) that described the change in the primary outcomes over the course of the intervention included time and empowerment as time-variant predictors. The growth curve analyses of experimental conditions were compared to the control group. Physical activity increased over time for patients having access to social support sections plus gaming (unstandardized beta coefficient [B]=3.39, P=.02). Health care utilization showed a significant decrease for patients accessing social support features (B=-0.41, P=.01) and patients accessing both social support features and gaming (B=-0.33, P=.03). Patients who had access to either social support sections or the gaming experience of the website gained more empowerment (B=2.59, P=.03; B=2.29, P=.05; respectively). Patients who were offered a gamified experience used the website more often than the ones without gaming (t91=-2.41, P=.02; U=812, P=.02). CONCLUSIONS The Web-based intervention had a positive impact (more desirable outcomes) on intervention groups compared to the control group. Social support sections on the website decreased health care utilization and medication overuse and increased empowerment. Gamification alone or with social support increased physical activity and empowerment and decreased health care utilization. This study provides evidence demonstrating the potential positive effect of gamification and online social support on health and behavioral outcomes. TRIAL REGISTRATION International Standard Randomized Controlled Trial Number (ISRCTN): 57366516; http://www.controlled-trials. com/ISRCTN57366516 (Archived by webcite at http://www.webcitation.org/6PBvvAvvV).
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Affiliation(s)
- Ahmed Allam
- Institute of Communication and Health, Faculty of Communication Sciences, University of Lugano (Università della Svizzera italiana), Lugano, Switzerland.
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15
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Li C, Liu T, Sun W, Wu L, Zou ZY. Prevalence and risk factors of arthritis in a middle-aged and older Chinese population: the China health and retirement longitudinal study. Rheumatology (Oxford) 2014; 54:697-706. [PMID: 25288780 DOI: 10.1093/rheumatology/keu391] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES The aims of this study were to estimate the prevalence of arthritis and to identify risk factors of arthritis in a middle-aged and older Chinese adult population. METHODS The China Health and Retirement Longitudinal Study (CHARLS) national survey data were used to estimate overall arthritis prevalence and prevalence by age and gender groups taking into account the complex survey design and response rate. The PROC SURVEYLOGISTIC procedure (SAS 9.3; SAS Institute, Cary, NC, USA) was applied to identify factors associated with arthritis using the CHARLS national survey data. Significant factors were further evaluated in the longitudinal CHARLS pilot study. RESULTS The overall prevalence of arthritis among middle-aged and older Chinese adults was 31.4% (95% CI 30.3, 32.4). Prevalence increased with age. Females had a higher prevalence of arthritis than males in each age group. In the cross-sectional analysis, age, gender, education, BMI, sleep duration, vigorous physical activity and self-reported doctor-diagnosed chronic lung disease, hypertension, chronic liver disease, cardiovascular disease, stroke, chronic kidney disease and chronic digestive disease were associated with arthritis. Age, gender, vigorous physical activity and cardiovascular disease were confirmed to be risk factors of arthritis in the longitudinal analysis. Participants with cardiovascular disease were 1.67 times (95% CI 1.02, 2.74) more likely to have self-reported arthritis in a 4-year period of follow-up in the CHARLS pilot study. CONCLUSION Middle-aged and older Chinese adults had a high prevalence of arthritis. Cardiovascular disease is a novel risk factor for arthritis in this population.
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Affiliation(s)
- Changwei Li
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, Department of Global Health and Environmental Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, USA and Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Tingting Liu
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, Department of Global Health and Environmental Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, USA and Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Wenjie Sun
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, Department of Global Health and Environmental Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, USA and Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Lang Wu
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, Department of Global Health and Environmental Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, USA and Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China
| | - Zhi-Yong Zou
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, Department of Global Health and Environmental Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, MN, USA and Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
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16
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The process of acceptance among rheumatoid arthritis patients in Switzerland: a qualitative study. Pain Res Manag 2014; 19:61-8. [PMID: 24527466 DOI: 10.1155/2014/168472] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, painful disease with many injurious psychological effects. Acceptance is an important component of pain management and is associated with improved quality of life, and lower levels of pain and depression. While studies have begun to identify the stages of acceptance, little is known about factors influencing the ease and speed with which patients pass through these stages. OBJECTIVE To explore the main stages through which RA patients pass and the strategies they adopt to learn to live with the pain, and to identify factors shaping patients' capacities to achieve acceptance. METHODS A qualitative study involving 20 semistructured interviews with RA patients in the Italian-speaking region of Switzerland was conducted. Analysis of the data followed the precepts of grounded theory. RESULTS Although the present study revealed that acceptance is not a smooth or linear process, five main stages in patients' struggles to accommodate the newly imposed limitations were, nonetheless, identified: naming the illness; realizing the illness; resisting the illness; 'hitting the bottom'; and integrating the illness. Diagnosis proved to be an especially tortuous stage in the case of RA, and the effects of delayed diagnosis continued to be felt during the subsequent stages. Patients' understanding of the notion of acceptance and the strategies that they used to achieve it were also explored. CONCLUSIONS Diagnosis of RA is notoriously difficult. Beyond the clinical difficulties, structural reasons for late diagnosis (symptoms being neglected by patients and medical professionals) were identifed. Delayed diagnosis hindered the acceptance process throughout, and led to more resistant behaviour and to a struggle to achieve the optimal formula for acceptance - accepting the losses of prepain life while still pursuing personal goals.
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van der Burg LRA, Boonen A, van Amelsvoort LGPM, Jansen NWH, Landewé RBM, Kant I. Effects of Cardiovascular Comorbidities on Work Participation in Rheumatic Diseases: A Prospective Cohort Study Among Working Individuals. Arthritis Care Res (Hoboken) 2013; 66:157-63. [DOI: 10.1002/acr.22095] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Accepted: 07/29/2013] [Indexed: 01/08/2023]
Affiliation(s)
| | - Annelies Boonen
- CAPHRI School for Public Health and Primary Care, Maastricht University, and Maastricht University Medical Center; Maastricht The Netherlands
| | | | - Nicole W. H. Jansen
- CAPHRI School for Public Health and Primary Care, Maastricht University; Maastricht The Netherlands
| | | | - Ijmert Kant
- CAPHRI School for Public Health and Primary Care, Maastricht University; Maastricht The Netherlands
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Examining the relationship between chronic conditions, multi-morbidity and labour market participation in Canada: 2000–2005. AGEING & SOCIETY 2013. [DOI: 10.1017/s0144686x13000457] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTRelatively little attention has been paid to understanding and addressing the potential health-related barriers faced by older workers to stay at work. Using three representative samples from the Canadian Community Health Survey, we examined the relationship between seven physical chronic conditions and labour market participation in Canada between 2000 and 2005. We found that all conditions were associated with an increased probability of not being able to work due to health reasons. In our adjusted models, heart disease was associated with the greatest probability of not working due to health reasons. Arthritis was associated with the largest population attributable fraction. Other variables associated with not being able to work due to health reasons included older age, female gender and lower educational attainment. We also found particular combinations of chronic conditions (heart disease and diabetes; and arthritis and back pain) were associated with a greater risk than the separate effects of each condition independently. The results of this study demonstrate that chronic conditions are associated with labour market participation limitations to differing extents. Strategies to keep older workers in the labour market in Canada will need to address barriers to staying at work that result from the presence of chronic conditions, and particular combinations of conditions.
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Marzolini S, Oh PI, Alter D, Stewart DE, Grace SL. Musculoskeletal Comorbidities in Cardiac Patients: Prevalence, Predictors, and Health Services Utilization. Arch Phys Med Rehabil 2012; 93:856-62. [DOI: 10.1016/j.apmr.2011.11.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 08/02/2011] [Accepted: 11/23/2011] [Indexed: 11/17/2022]
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Balance dysfunction and falls in people with lower limb arthritis: factors contributing to risk and effectiveness of exercise interventions. Eur Rev Aging Phys Act 2011. [DOI: 10.1007/s11556-011-0086-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
Chronic musculoskeletal conditions in the lower extremities, particularly arthritis, and the chronic pain associated with them, are independent risk factors for falls, with approximately 50% of people with arthritis reporting one or more falls. Despite this, few studies have specifically addressed balance dysfunction, falls risk and falls incidence in people with arthritis. This review aimed to identify potential factors contributing to the increased risk of falls in people with lower limb osteoarthritis or rheumatoid arthritis and to summarise the evidence base for effective exercise interventions targeted to reduce their risk of falls. A systematic search of the literature was conducted in February 2010 and included the following databases: MEDLINE (Ovid), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Cochrane Library and PsycINFO. Only three studies that investigated exercise programmes for people with lower limb arthritis met all inclusion criteria, but none used falls as an outcome measure. To broaden the review, systematic reviews that assessed the effectiveness of exercise interventions for fall prevention in older people were also included. The presence of any form of lower limb arthritis and the associated consequences including pain, balance impairment, reduced muscle strength and reduced function are all associated with increased risk of falling. Due to the link between musculoskeletal pain and the increased risk of falls, further research needs to investigate which type of exercise programme will be effective in reducing the risk of falls in populations with arthritis in the lower limbs.
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Brinks J, Franklin BA. Suboptimal Exercise Compliance: Common Barriers to an Active Lifestyle and Counseling Strategies to Overcome Them. Am J Lifestyle Med 2011. [DOI: 10.1177/1559827610391971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Adherence to a structured exercise program provides numerous health benefits, including reductions in body weight, fat stores, and blood pressure, improved blood glucose management and lipid/lipoprotein profiles, increased cardiorespiratory fitness, decreased cardiovascular risk, and enhanced psychosocial well-being. Despite these benefits, many individuals find it difficult to comply with a regular exercise program, predisposing them to an increased risk of chronic diseases and other medical conditions. Several barriers to participation in structured exercise, including time and financial constraints, psychosocial factors, and physical limitations, contribute to low adherence rates. Accordingly, health care professionals should use varied counseling strategies to assist their patients in overcoming habitual physical inactivity and our increasingly hypokinetic lifestyle. Motivational interviewing, goal setting, using stages of readiness to change, and identifying physical/psychosocial limitations are effective ways for helping patients to achieve the health and fitness benefits of structured exercise, increased lifestyle physical activity, or both.
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Affiliation(s)
- Jenna Brinks
- Department of Medicine, Division of Cardiology, Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital, Royal Oak, Michigan,
| | - Barry A. Franklin
- Department of Medicine, Division of Cardiology, Cardiac Rehabilitation and Exercise Laboratories, William Beaumont Hospital, Royal Oak, Michigan
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Slater M, Perruccio AV, Badley EM. Musculoskeletal comorbidities in cardiovascular disease, diabetes and respiratory disease: the impact on activity limitations; a representative population-based study. BMC Public Health 2011; 11:77. [PMID: 21291555 PMCID: PMC3040146 DOI: 10.1186/1471-2458-11-77] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2010] [Accepted: 02/03/2011] [Indexed: 01/21/2023] Open
Abstract
Background The purpose of this study was to quantify the contribution of comorbidity to activity limitations in populations with chronic cardiovascular disease, diabetes or respiratory disease (index conditions), with emphasis on musculoskeletal comorbidity (arthritis or back problems). Methods Analysis of the 2005 Canadian Community Health Survey 3.1 (age 20+ years, n = 115,915). Prevalence ratios for activity limitations in people with the index conditions and co-occurring musculoskeletal disease, adjusted for age, gender, and socioeconomic factors, were used to estimate population associated fractions (PAF). Results Comorbid arthritis and back problems significantly increased the risk of activity limitations across all index conditions with prevalence ratios of 1.60 and 1.46 for cardiovascular disease, 1.51 and 1.36 for diabetes, and 1.38 and 1.44 for respiratory disease for arthritis and back problems respectively. Arthritis and back problems accounted for at least 13% and 9% of activity limitations in the index populations. Conclusions While chronic musculoskeletal conditions are not always considered priorities in chronic disease prevention, they account for a substantial proportion of activity restrictions seen in people with cardiovascular disease, diabetes and respiratory disease, with implications for prevention and control strategies.
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Affiliation(s)
- Morgan Slater
- Toronto Western Research Institute, University Health Network, Toronto, Canada
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Abstract
This article uses the Disablement Model conceptual framework to guide an analysis of the importance of osteoarthritis (OA) in the development of disability. The Disablement Model describes the development and progression of disablement from impairments to specific functional limitations and disability, and the hypothesized role of predisposing risk factors, extra-individual factors, and intra-individual factors. A wide range of population and clinical studies have characterized the unequivocal contribution of arthritis to the development of functional limitations and disability. Evidence overwhelmingly supports a significant, moderate independent contribution of arthritis to the onset and progression of functional limitations and disability. With respect to important risk factors for the development of functional limitations and disability among those with OA, the evidence provides strong support for the role of physical impairments along with other predisposing and intra-individual factors such as age, body mass index, obesity, lack of exercise, comorbid conditions, depression, and depressive symptoms. Extra-individual factors included need for aids and assistance, and lack of access to public or private transportation. Future disablement research must clarify the causal mechanisms behind a potential risk factor's impact on disability and delineate the interplay between and among the various hypothesized steps in the disablement process.
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Goeppinger J, Lorig KR, Ritter PL, Mutatkar S, Villa F, Gizlice Z. Mail-delivered arthritis self-management tool kit: A randomized trial and longitudinal followup. ACTA ACUST UNITED AC 2009; 61:867-75. [DOI: 10.1002/art.24587] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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