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Yazici H, Ogun H, Yazici Y. A probable ecologic bias in the article on the progression of knee osteoarthritis: comment on the article by Lo et al. Arthritis Rheumatol 2023; 75:1683. [PMID: 36940246 DOI: 10.1002/art.42503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 03/07/2023] [Indexed: 03/22/2023]
Affiliation(s)
| | - Hande Ogun
- School of Medicine, Istanbul University - Cerrahpasa, Istanbul, Turkey
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Lo GH, Driban JB. Reply. Arthritis Rheumatol 2023; 75:1684. [PMID: 36924110 DOI: 10.1002/art.42501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 03/07/2023] [Indexed: 03/18/2023]
Affiliation(s)
- Grace H Lo
- Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX
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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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The Longitudinal Aging Study Amsterdam: cohort update 2019 and additional data collections. Eur J Epidemiol 2019; 35:61-74. [PMID: 31346890 PMCID: PMC7058575 DOI: 10.1007/s10654-019-00541-2] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/20/2019] [Indexed: 10/27/2022]
Abstract
The Longitudinal Aging Study Amsterdam (LASA) is a prospective cohort study of older adults in the Netherlands, initially based on a nationally representative sample of people aged 55-84 years. The study has been ongoing since 1992, and focuses on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. Strengths of the LASA study include its multidisciplinary character, the availability of over 25 years of follow-up, and the cohort-sequential design that allows investigations of longitudinal changes, cohort differences and time trends in functioning. The findings from LASA have been reported in over 600 publications so far (see www.lasa-vu.nl). This article provides an update of the design of the LASA study and its methods, on the basis of recent developments. We describe additional data collections, such as additional nine-monthly measurements in-between the regular three-yearly waves that have been conducted among the oldest old during 2016-2019, and the inclusion of a cohort of older Turkish and Moroccan migrants.
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Tak ECPM, van Meurs JB, Bierma-Zeinstra SMA, Hofman A, Hopman-Rock M. Changes in disability in older adults with generalized radiographic osteoarthritis: A complex relationship with physical activity. Musculoskeletal Care 2017; 15:364-372. [PMID: 28394082 DOI: 10.1002/msc.1182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The aim of the present study was to report on factors associated with changes in disability after 5 years, with a focus on physical activity (PA) in community-dwelling older adults with generalized radiographic osteoarthritis (GROA). METHODS Assessment of GROA (hand, knee, hip) and disability (Health Assessment Questionnaire) in the Rotterdam Study (cohort RS-1, N = 7,983; with GROA, n = 821). A good outcome at follow-up was defined as improved or mild disability, and a poor outcome as worsened or severe disability. Factors potentially associated with outcome were demographics, joint complaints, other chronic health problems or limitations (body mass index, number of chronic conditions, cognition), and level of different types of PA. Some of these assessments were repeated in between 1997 and 1999 (RS-3), and between 2002 and 2004 (RS-4). RESULTS A total of 309 older adults with GROA and valid measures on RS-3 and RS-4 showed mild to moderate disability, with minor increases over 5 years (follow-up N = 287 RS-3 to RS-4). PA levels decreased with increasing disability, especially in sport and walking. PA was univariately associated with a better outcome at follow-up but when adjusted for other factors (higher age, having knee pain and stiffness, and having more than two other chronic conditions) was associated with negative changes in general and lower limb disability, although not with upper limb disability. CONCLUSIONS This was the first study to report that community-dwelling older adults with GROA show moderate levels of disability, and that reduced levels of disability are associated with higher levels of PA, but when adjusted for other confounders this association is lost. Further research is needed to study the complex relationships between PA and other determinants of disability.
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Affiliation(s)
- E C P M Tak
- Netherlands Organization for Applied Scientific Research, TNO, Research Center Body@Work TNO VUmc, Leiden, the Netherlands
| | - J B van Meurs
- Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Orthopaedics, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - A Hofman
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - M Hopman-Rock
- Netherlands Organization for Applied Scientific Research, TNO, Research Center Body@Work TNO VUmc, Leiden, the Netherlands
- Department of Public and Occupational Health/EMGO Institute for Health and Care Research (EMGO+), VU University Medical Center, Amsterdam, the Netherlands
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Kwee RM, Wirth W, Hafezi-Nejad N, Zikria BA, Guermazi A, Demehri S. Role of physical activity in cartilage damage progression of subjects with baseline full-thickness cartilage defects in medial tibiofemoral compartment: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2016; 24:1898-1904. [PMID: 27327782 DOI: 10.1016/j.joca.2016.06.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 05/21/2016] [Accepted: 06/11/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the association between physical activity and cartilage damage progression in medial tibiofemoral compartment (MTFC) using 2-year follow-up magnetic resonance imaging (MRI) in subjects with denuded areas of subchondral bone (dABs) at the central weight-bearing medial femur (cMF) at baseline MRI examination. METHODS One hundred subjects from the Osteoarthritis Initiative (OAI) progression cohort with dABs at the cMF at 3T MRI at baseline (51% men; mean age 62.2 years, range 45-79) were included. Sagittal 3D dual-echo steady-state with water excitation images were used to assess 2-year MTFC cartilage change. Associations between 2-year average Physical Activity Scale for the Elderly (PASE) and 2-year MTFC cartilage change were assessed by linear regression analysis. Subgroup analyses were performed. RESULTS No associations between PASE and 2-year MTFC cartilage change were observed in the entire cohort. Similarly, in the subgroup with cartilage loss during the 2 years, the non-refuted confidence intervals for the regression coefficients were tightly clustered around the null value (regression coefficients for: mean cMF.ThCtAB = -0.00059; 98.75% CI: -0.00130 to 0.00012), cMF.dAB% = 0.02176; 98.75% CI: -0.02514 to 0.06865, Mean MT.ThCtAB = -0.00013; 98.75% CI: -0.00064 to 0.00038, MT.dAB% = 0.02543; 98.75% CI: -0.01485 to 0.06571. CONCLUSION In the entire group of subjects with dABs at the cMF at baseline, no association between physical activity and 2-year MTFC cartilage change was detected. Due to the limited sample size of our study, small-sized effects may not have been detected in our study.
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Affiliation(s)
- R M Kwee
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Radiology, Zuyderland Medical Center, Heerlen, The Netherlands
| | - W Wirth
- Institute of Anatomy, Paracelsus Medical University, Salzburg, Austria; Chondrometrics GmbH, Ainring, Germany
| | - N Hafezi-Nejad
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B A Zikria
- Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Guermazi
- Department of Radiology, Boston University School of Medicine, Boston, MA, USA
| | - S Demehri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Jacob EA, Blum L, Bedair HS, Freiberg AA, Quraishi SA. The Association of Vitamin D Status and Pre-operative Physical Activity in Patients with Hip or Knee Osteoarthritis. JOURNAL OF RESTORATIVE MEDICINE 2015; 4:3-10. [PMID: 30505632 PMCID: PMC6261296 DOI: 10.14200/jrm.2015.4.0101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Vitamin D is important for musculoskeletal health and may have significant implications for maintaining physical activity in elderly patients. Our goal was to investigate whether serum 25-hydroxyvitamin D (25OHD) levels are associated with pre-operative physical activity in patients who are offered elective knee or hip joint replacement surgery. METHODS We performed a single-center, retrospective analysis of patients who had elective knee or hip replacement surgery from 2002 to 2012. To investigate the association of serum 25OHD levels with pre-operative physical activity, as assessed by the University of California, Los Angeles (UCLA) activity scale, we performed a multivariable logistic regression analysis while controlling for age, sex, race, body mass index, American Society of Anesthesiologists physical status score, and season. RESULTS We identified 182 patients who met inclusion criteria. Mean (± standard deviation) 25OHD level and UCLA activity scale score were 29±13 ng/mL and 4±2, respectively. Patients with 25OHD levels <20 ng/mL were almost three times more likely to have UCLA activity scale scores ≤3 [adjusted odds ratio 2.78; 95% confidence interval 1.72-9.17]. Further adjusting for "type of 25OHD assay" or "type of joint surgery" did not materially change this result. CONCLUSION In our cohort of knee or hip joint replacement surgery patients, 25OHD levels were associated with pre-operative physical activity scores. Prospective, randomized, clinical trials are needed to verify whether optimizing pre-operative vitamin D status may improve physical activity and influence clinical decision-making in knee or hip joint replacement surgery candidates.
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Affiliation(s)
| | - Livnat Blum
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Hany S. Bedair
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andrew A. Freiberg
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sadeq A. Quraishi
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Silverwood V, Blagojevic-Bucknall M, Jinks C, Jordan JL, Protheroe J, Jordan KP. Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage 2015; 23:507-15. [PMID: 25447976 DOI: 10.1016/j.joca.2014.11.019] [Citation(s) in RCA: 522] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 11/25/2014] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a leading cause of pain and disability and leads to a reduced quality of life. The aim was to determine the current evidence on risk factors for onset of knee pain/OA in those aged 50 and over. A systematic review and meta-analysis was conducted of cohort studies for risk factors for the onset of knee pain. Two authors screened abstracts and papers and completed data extraction. Where possible, pooled odds ratios (OR) were calculated via random effects meta-analysis and population attributable fractions (PAFs) derived. 6554 papers were identified and after screening 46 studies were included. The main factors associated with onset of knee pain were being overweight (pooled OR 1.98, 95% confidence intervals (CI) 1.57-2.20), obesity (pooled OR 2.66 95% CI 2.15-3.28), female gender (pooled OR 1.68, 95% CI 1.37-2.07), previous knee injury (pooled OR 2.83, 95% CI 1.91-4.19). Hand OA (pooled OR 1.30, 95% CI 0.90-1.87) was found to be non-significant. Smoking was found not to be a statistically significant risk or protective factor (pooled OR 0.92, 95% CI 0.83-1.01). PAFs indicated that in patients with new onset of knee pain 5.1% of cases were due to previous knee injury and 24.6% related to being overweight or obese. Clinicians can use the identified risk factors to identify and manage patients at risk of developing or increasing knee pain. Obesity in particular needs to be a major target for prevention of development of knee pain. More research is needed into a number of potential risk factors.
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Affiliation(s)
- V Silverwood
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - M Blagojevic-Bucknall
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - C Jinks
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - J L Jordan
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - J Protheroe
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
| | - K P Jordan
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire, ST5 5BG, UK
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Øiestad BE, Juhl CB, Eitzen I, Thorlund JB. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthritis Cartilage 2015; 23:171-7. [PMID: 25450853 DOI: 10.1016/j.joca.2014.10.008] [Citation(s) in RCA: 271] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 10/12/2014] [Accepted: 10/19/2014] [Indexed: 02/02/2023]
Abstract
The objective of this study was to perform a systematic review and meta-analysis on the association between knee extensor muscle weakness and the risk of developing knee osteoarthritis. A systematic review and meta-analysis was conducted with literature searches in Medline, SPORTDiscus, EMBASE, CINAHL, and AMED. Eligible studies had to include participants with no radiographic or symptomatic knee osteoarthritis at baseline; have a follow-up time of a minimum of 2 years, and include a measure of knee extensor muscle strength. Hierarchies for extracting data on knee osteoarthritis and knee extensor muscle strength were defined prior to data extraction. Meta-analysis was applied on the basis of the odds ratios (ORs) of developing symptomatic knee osteoarthritis or radiographic knee osteoarthritis in subjects with knee extensor muscle weakness. ORs for knee osteoarthritis and 95% confidence intervals (CI) were estimated and combined using a random effects model. Twelve studies were eligible for inclusion in the meta-analysis after the initial searches. Five cohort studies with a follow-up time between 2.5 and 14 years, and a total number of 5707 participants (3553 males and 2154 females), were finally included. The meta-analysis showed an overall increased risk of developing symptomatic knee osteoarthritis in participants with knee extensor muscle weakness (OR 1.65 95% CI 1.23, 2.21; I(2) = 50.5%). This systematic review and meta-analysis showed that knee extensor muscle weakness was associated with an increased risk of developing knee osteoarthritis in both men and women.
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Affiliation(s)
- B E Øiestad
- Norwegian Research Center for Active Rehabilitation, Department of Orthopedics, Oslo University Hospital, Oslo, Norway.
| | - C B Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark; Department of Orthopedics, University Hospital of Copenhagen, Gentofte, Denmark.
| | - I Eitzen
- Department of Orthopedics, Oslo University Hospital, Oslo, Norway.
| | - J B Thorlund
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
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Peeters GMEEG, Pisters MF, Mishra GD, Brown WJ. The influence of long-term exposure and timing of physical activity on new joint pain and stiffness in mid-age women. Osteoarthritis Cartilage 2015; 23:34-40. [PMID: 25452157 DOI: 10.1016/j.joca.2014.06.040] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 05/06/2014] [Accepted: 06/12/2014] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the influence of long-term exposure and timing of physical activity (PA) on new joint pain/stiffness in mid-age women. METHODS Data were from 5105 participants (born 1946-51) in the Australian Longitudinal Study on Women's Health (ALSWH) who completed survey items on PA (1998, 2001 and 2004) and joint pain/stiffness (2007 and 2010). PA was categorized in five levels at each survey and summed into a cumulative PA score (CPA, range 0-12). Associations were analysed using logistic regression, with separate models for the cumulative model (using CPA), the sensitive periods model (i.e., PA measured at each survey in one regression model) and the critical periods model (i.e., separate regression models for PA at each survey). RESULTS 951 (18.6%) participants reported new-onset joint pain/stiffness. In the cumulative model, CPA was associated joint pain/stiffness when included as a continuous variable (adjusted odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.95-0.99), but not when included as a categorical variable. In both the sensitive periods and critical periods models, low to high levels of PA in 2001 and 2004 had stronger inverse associations with joint pain/stiffness than PA levels in 1998. The model fit was better for the sensitive periods than the cumulative or critical periods models. CONCLUSIONS In mid-age women, PA between the ages 47 and 58 was associated with a lower risk of joint pain/stiffness 9 years later. Associations were stronger for PA in the last 6 years than for earlier PA.
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Affiliation(s)
- G M E E Geeske Peeters
- The University of Queensland, School of Human Movement Studies, Brisbane, Australia; The University of Queensland, School of Population Health, Brisbane, Australia.
| | - M F Pisters
- Physical Therapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rehabilitation, Nursing Science and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - G D Mishra
- The University of Queensland, School of Population Health, Brisbane, Australia.
| | - W J Brown
- The University of Queensland, School of Human Movement Studies, Brisbane, Australia.
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The role of activity level in orthopaedics: an important prognostic and outcome variable. J Am Acad Orthop Surg 2014; 22:430-6. [PMID: 24966249 DOI: 10.5435/jaaos-22-07-430] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
A patient's activity level is increasingly recognized as an important factor that can influence orthopaedic outcomes. Validated, reliable activity measurement tools now exist for the shoulder, hip, knee, and ankle. These tools can be directly applied as outcome measures that determine whether interventions restored function. It is now evident that activity level is a powerful prognostic factor for outcomes in orthopaedic procedures such as anterior cruciate ligament reconstruction, articular cartilage repair, and total joint arthroplasty. Yet despite the recent increase in studies that have made use of quantitative, joint-specific activity scales, much room remains for further understanding of the exact role of activity level in the progression, treatment, and patient perception of musculoskeletal disorders, particularly in the shoulder and ankle, as well as in pediatric patients.
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Bennell K, Hinman RS, Wrigley TV, Creaby MW, Hodges P. Exercise and osteoarthritis: cause and effects. Compr Physiol 2013; 1:1943-2008. [PMID: 23733694 DOI: 10.1002/cphy.c100057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is a common chronic joint condition predominantly affecting the knee, hip, and hand joints. Exercise plays a role in the development and treatment of OA but most of the literature in this area relates to knee OA. While studies indicate that exercise and physical activity have a generally positive effect on healthy cartilage metrics, depending upon the type of the activity and its intensity, the risk of OA development does appear to be moderately increased with sporting participation. In particular, joint injury associated with sports participation may be largely responsible for this increased risk of OA with sport. Various repetitive occupational tasks are also linked to greater likelihood of OA development. There are a number of physical impairments associated with OA including pain, muscle weakness and altered muscle function, reduced proprioception and postural control, joint instability, restricted range of motion, and lower aerobic fitness. These can result directly from the OA pathological process and/or indirectly as a result of factors such as pain, effusion, and reduced activity levels. These impairments and their underlying physiology are often targeted by exercise interventions and evidence generally shows that many of these can be modified by specific exercise. There is currently little clinical trial evidence to show that exercise can alter mechanical load and structural disease progression in those with established OA, although a number of impairments, that are amenable to change with exercise, appears to be associated with increased mechanical load and/or disease progression in longitudinal studies.
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Affiliation(s)
- Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia.
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Shiozawa S, Hirata RP, Graven-Nielsen T. Reorganised anticipatory postural adjustments due to experimental lower extremity muscle pain. Hum Mov Sci 2013; 32:1239-52. [DOI: 10.1016/j.humov.2013.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 12/20/2012] [Accepted: 01/27/2013] [Indexed: 12/16/2022]
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14
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Rijs KJ, van der Pas S, Geuskens GA, Cozijnsen R, Koppes LLJ, van der Beek AJ, Deeg DJH. Development and validation of a physical and psychosocial job-exposure matrix in older and retired workers. ACTA ACUST UNITED AC 2013; 58:152-70. [PMID: 24190953 DOI: 10.1093/annhyg/met052] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES A general population job-exposure matrix (GPJEM) including physical and psychosocial demands as well as psychosocial resources applicable to older and retired workers was developed. Its validity was evaluated by examining associations of physical demands and iso-strain (combination of high psychosocial demands and low resources) with health. METHODS Physical and psychosocial work exposures reported by 55-64 year olds were derived from the Netherlands Working Conditions Survey and linked to the Netherlands Standard Classification of Occupations 1992. A GPJEM with low, moderate, and high probability of exposure to demands and resources was developed. To examine associations with health, two groups of the Longitudinal Aging Study Amsterdam were selected: current (i.e. at the time of the interview, 55-64 years) and former workers (55-84 years). Linear and logistic regression models were applied. RESULTS Use of force and work in uncomfortable positions were significantly associated with functional limitations and self-perceived health (SPH), but not hip or knee osteoarthritis (OA), in current and former workers. A moderate probability of repetitive movements was associated with functional limitations in former workers. A high probability of repetitive movements was associated with functional limitations in current and former workers as well as with SPH and hip and knee OA in former workers. Respondents formerly exposed to iso-strain had significantly higher diastolic blood pressure and more often hypertension. No such associations were found in current workers. No association was found with cardiovascular disease. CONCLUSIONS The results suggest that our GPJEM accurately classifies jobs according to physical demands and, although less clearly, iso-strain.
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Affiliation(s)
- Kelly J Rijs
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, 1081BT Amsterdam, The Netherlands
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Lin W, Alizai H, Joseph G, Srikhum W, Nevitt M, Lynch J, McCulloch C, Link T. Physical activity in relation to knee cartilage T2 progression measured with 3 T MRI over a period of 4 years: data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2013; 21:1558-66. [PMID: 23831632 PMCID: PMC3874212 DOI: 10.1016/j.joca.2013.06.022] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 06/12/2013] [Accepted: 06/17/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study was to analyze the longitudinal association between physical activity levels and early degenerative cartilage changes in the knee, measured using T2 relaxation times over a period of 4 years in individuals without clinical or radiographic evidence of OA. DESIGN Cartilage T2 was measured at baseline and after 2 and 4 years in 205 subjects aged 45-60 years from the Osteoarthritis Initiative (OAI) incidence and normal cohorts with no knee pain (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score of zero), and a Kellgren Lawrence (KL) score of <2 at baseline. Physical activity was scored using the Physical Activity Scale for the Elderly (PASE) questionnaire, which was obtained yearly over 4 years. The relationship between physical activity and T2 was studied using a mixed model linear regression, including random effects, and adjusted for age, sex, and body mass index (BMI). RESULTS T2 values for all PASE tertiles progressed over the 4-year period. T2 progression was increased in the highest tertile of physical activity compared to the mid-tertile at the medial tibia (MT) (P = 0.041), patella (Pat) (P = 0.019), and average T2 of all knee compartments combined (P = 0.033). Subjects with the lowest 15% PASE scores showed significantly higher T2 progression compared to the mid-level physical activity group at the lateral femur (LF) (P = 0.025), lateral tibia (LT) (P = 0.043), medial femur (MF) (P = 0.044), tibiofemoral compartment (P = 0.017), patellofemoral compartment (P = 0.016), lateral compartments (P = 0.003), and average of all compartments (P = 0.043). CONCLUSION High and very low PASE scores were associated with greater progression of cartilage T2 measurements in asymptomatic, middle-aged individuals, suggesting accelerated cartilage matrix biochemical degeneration over time.
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Affiliation(s)
- W. Lin
- Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - H. Alizai
- Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - G.B. Joseph
- Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - W. Srikhum
- Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA
| | - M.C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107, USA
| | - J.A. Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107, USA
| | - C.E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, 185 Berry Street, Suite 5700, San Francisco, CA 94107, USA
| | - T.M. Link
- Musculoskeletal and Quantitative Imaging Research, Department of Radiology and Biomedical Imaging, University of California San Francisco, 185 Berry Street, Suite 350, San Francisco, CA 94107, USA, Address correspondence and reprint requests to: T.M. Link, Department of Radiology and Biomedical Imaging, UCSF, 400 Parnassus Ave, A-367, Box 0628, San Francisco, CA 94143, USA. (T.M. Link)
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Wood AM, Brock TM, Heil K, Holmes R, Weusten A. A Review on the Management of Hip and Knee Osteoarthritis. Int J Chronic Dis 2013; 2013:845015. [PMID: 26464847 PMCID: PMC4590943 DOI: 10.1155/2013/845015] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 07/25/2013] [Accepted: 09/02/2013] [Indexed: 01/12/2023] Open
Abstract
Arthritis is the most common chronic condition affecting patients over the age of 70. The prevalence of osteoarthritis increases with age, and with an aging population, the effect of this disease will represent an ever-increasing burden on health care. The knee is the most common joint affected in osteoarthritis, with up to 41% of limb arthritis being located in the knee, compared to 30% in hands and 19% in hips. We review the current concepts with regard to the disease process and risk factors for developing hip and knee osteoarthritis. We then explore the nonsurgical management of osteoarthritis as well as the operative management of hip and knee arthritis. We discuss the indications for surgical treatment of hip and knee arthritis, looking in particular at the controversies affecting young and obese patients in both hip and knee replacements. Patient and implant related outcomes along with survivorships are addressed as well as the experiences and controversies described in national joint registries.
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Affiliation(s)
| | - Timothy M. Brock
- Trauma and Orthopaedics, Wansbeck Hospital, Woodhorn Road, Ashington NE63 9JJ, UK
| | - Kieran Heil
- University of Glasgow Medical School, Glasgow, Scotland, UK
| | - Rachel Holmes
- Trauma and Orthopaedics, Wansbeck Hospital, Woodhorn Road, Ashington NE63 9JJ, UK
| | - Axel Weusten
- Trauma and Orthopaedics, Wansbeck Hospital, Woodhorn Road, Ashington NE63 9JJ, UK
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17
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Martin KR, Kuh D, Harris TB, Guralnik JM, Coggon D, Wills AK. Body mass index, occupational activity, and leisure-time physical activity: an exploration of risk factors and modifiers for knee osteoarthritis in the 1946 British birth cohort. BMC Musculoskelet Disord 2013; 14:219. [PMID: 23883324 PMCID: PMC3726290 DOI: 10.1186/1471-2474-14-219] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/19/2013] [Indexed: 12/15/2022] Open
Abstract
Background Knee osteoarthritis (kOA) risk is increased by obesity and physical activities (PA) which mechanically stress the joint. We examined the associations of midlife kOA with body mass index (BMI) and activity exposure across adult life and their interaction. Methods Data are from a UK birth cohort of 2597 participants with a clinical assessment for kOA at age 53. At ages 36, 43 and 53 BMI (kg/m2), self-reported leisure-time PA, and occupational activity (kneeling/squatting; lifting; climbing; sitting; assigned using a job-exposure matrix) were ascertained. Associations were explored using the multiplicative logistic model. Results BMI was strongly and positively associated with kOA in men and women. Men and women in manual occupations also had greater odds of kOA; there was a weak suggestion that kOA risk was higher among men exposed to lifting or kneeling at work. For men, the only evidence of a multiplicative interaction between BMI and activities was for lifting (p = 0.01) at age 43; BMI conferred higher kOA risk among those most-likely to lift at work (OR per increase in BMI z-score: 3.55, 95% CI: 1.72-7.33). For women, the only evidence of an interaction was between BMI and leisure-time PA (p = 0.005) at age 43; BMI conferred higher kOA risk among those at higher PA levels (OR per increase in BMI z-score: 1.59, 95% CI: 1.26-2.00 in inactive; 1.70, 95% CI: 1.14-2.55 (less-active); and 4.44; 95% CI: 2.26-8.36 (most-active). Conclusions At the very least, our study suggests that more active individuals (at work and in leisure) may see a greater reduction in risk of kOA from avoiding a high BMI than those less active.
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Affiliation(s)
- Kathryn R Martin
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, Maryland 20814, USA.
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18
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Ratzlaff CR, Koehoorn M, Cibere J, Kopec JA. Is lifelong knee joint force from work, home, and sport related to knee osteoarthritis? Int J Rheumatol 2012; 2012:584193. [PMID: 22848225 PMCID: PMC3405641 DOI: 10.1155/2012/584193] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2012] [Revised: 05/14/2012] [Accepted: 05/14/2012] [Indexed: 11/17/2022] Open
Abstract
Purpose. To investigate the association of cumulative lifetime knee joint force on the risk of self-reported medically-diagnosed knee osteoarthritis (OA). Methods. Exposure data on lifetime physical activity type (occupational, household, sport/recreation) and dose (frequency, intensity, duration) were collected from 4,269 Canadian men and women as part of the Physical Activity and Joint Heath cohort study. Subjects were ranked in terms of the "cumulative peak force index", a measure of lifetime mechanical knee force. Multivariable logistic regression was conducted to obtain adjusted effects for mean lifetime knee force on the risk of knee OA. Results. High levels of total lifetime, occupational and household-related force were associated with an increased in risk of OA, with odds ratio's ranging from approximately 1.3 to 2. Joint injury, high BMI and older age were related to risk of knee OA, consistent with previous studies. Conclusions. A newly developed measure of lifetime mechanical knee force from physical activity was employed to estimate the risk of self-reported, medically-diagnosed knee OA. While there are limitations, this paper suggests that high levels of total lifetime force (all domains combined), and occupational force in men and household force in women were risk factors for knee OA.
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Affiliation(s)
- Charles R Ratzlaff
- Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 75 Francis Street PBB3, Boston, MA 02115, USA
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Pereira D, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E. The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review. Osteoarthritis Cartilage 2011; 19:1270-85. [PMID: 21907813 DOI: 10.1016/j.joca.2011.08.009] [Citation(s) in RCA: 505] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Revised: 07/31/2011] [Accepted: 08/17/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints. METHOD A systematic review was carried out in PUBMED and SCOPUS databases comprising the date of publication period from January 1995 to February 2011. We attempted to summarise data on the incidence and prevalence of OA according to different methods of assessment: self-reported, radiographic and symptomatic OA (clinical plus radiographic). Prevalence estimates were combined through meta-analysis and between-study heterogeneity was quantified. RESULTS Seventy-two papers were reviewed (nine on incidence and 63 on prevalence). Higher OA prevalences are seen when radiographic OA definition was used for all age groups. Prevalence meta-analysis showed high heterogeneity between studies even in each specific joint and using the same OA definition. Although the knee is the most studied joint, the highest OA prevalence estimates were found in hand joints. OA of the knee tends to be more prevalent in women than in men independently of the OA definition used, but no gender differences were found in hip and hand OA. Insufficient data for incidence studies didn't allow us to make any comparison according to joint site or OA definition. CONCLUSIONS Radiographic case definition of OA presented the highest prevalences. Within each joint site, self-reported and symptomatic OA definitions appear to present similar estimates. The high heterogeneity found in the studies limited further conclusions.
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Affiliation(s)
- D Pereira
- Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Portugal
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20
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McWilliams DF, Leeb BF, Muthuri SG, Doherty M, Zhang W. Occupational risk factors for osteoarthritis of the knee: a meta-analysis. Osteoarthritis Cartilage 2011; 19:829-39. [PMID: 21382500 DOI: 10.1016/j.joca.2011.02.016] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 02/09/2011] [Accepted: 02/25/2011] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Systematic reviews agree that knee osteoarthritis (OA) is related to occupational activities, but have not quantified the overall risks. METHODS Systematic review of observational studies of knee OA and occupation. Job titles, elite sport, heavy work, kneeling, and other activities were included. Relative risk estimate and 95% confidence interval (CI) compared to sedentary work were retrieved or calculated for meta-analysis. Publication bias was examined with Egger tests and heterogeneity was determined with I(2) values and Q tests. Subgroup analysis was performed to examine causes of heterogeneity. A random effects model was performed to combine the data. RESULTS Studies of knee OA (n=51), persistent knee pain (n=12) and knee OA progression (n=3) were retrieved. Occupational risks for knee OA were examined in a total of 526,343 subjects in 8 cohort/prospective/longitudinal studies, 25 cross-sectional studies and 18 case control studies. The overall odds ratio (OR) was 1.61 (95% CI 1.45-1.78) with significant heterogeneity (I(2)=83.6%). Study designs showed a positive association between knee OA and occupational activities; cohort (OR 1.38, 95% CI 1.10-1.74), cross-sectional (OR 1.57, 95% CI 1.37-1.81) and case control (OR 1.80, 95% CI 1.48-2.19). Overall there was evidence of publication bias (P<0.0001) which was apparent in the cross-sectional and case control studies (P<0.0001 and P=0.0247 respectively). CONCLUSIONS Some occupational activities increase the risk of knee OA, although the influences of publication bias and heterogeneity are important limitations of this study. Prospective studies would greatly improve the evidence base.
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Terwee CB, Bouwmeester W, van Elsland SL, de Vet HCW, Dekker J. Instruments to assess physical activity in patients with osteoarthritis of the hip or knee: a systematic review of measurement properties. Osteoarthritis Cartilage 2011; 19:620-33. [PMID: 21251989 DOI: 10.1016/j.joca.2011.01.002] [Citation(s) in RCA: 136] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 11/30/2010] [Accepted: 01/03/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE There is no consensus on the best approach for measuring physical activity in patients with osteoarthritis (OA) of the hip or knee. The aims of this study were (1) to identify all physical activity measures that have been validated in patients with OA of the hip or knee and to systematically review their measurement properties, and (2) to give recommendations on which instrument is most suitable for what purpose. DESIGN A search was performed in PubMed, Embase, and Sportdiscus (complete databases until November 10, 2010). Three reviewers independently evaluated the quality of the included studies, using the Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist. Subsequently, the reviewers independently evaluated the quality of the included physical activity instruments, using the recently developed QAPAQ checklist for appraising the qualitative attributes and measurement properties of physical activity questionnaires. RESULTS Nine studies were included, in which 12 measurement instruments were evaluated: five single-item rating scales, six multi-item questionnaires, and one pedometer. In general, the methodological quality of the studies was poor to moderate. Only the Lower-Extremity Activity Scale (LEAS) and the pedometer received positive ratings for content validity. The LEAS and Baecke questionnaire received positive ratings for reliability. The University of California at Los Angeles (UCLA), the Tegner score, and the LEAS received positive ratings for construct validity. The Daily Activity Questionnaire (DAQ) received a positive rating for criterion validity. Responsiveness was not evaluated for any of the included instruments. CONCLUSION For monitoring physical activity levels of populations the UCLA or LEAS seem most useful. For studies measuring physical activity as a risk factor for developing OA or as a protective factor against functional decline there is not enough evidence for any instrument to conclude that it has adequate measurement properties. For follow-up studies on wear in joint replacement patients we recommend to use accelerometers. However, more validation studies of adequate quality are needed for all included instruments.
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Affiliation(s)
- C B Terwee
- Department of Epidemiology and Biostatistics and the EMGO Institute of Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
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22
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Clifford A, O'Connell M, Gabriel S, Miller LE, Block JE. The KineSpring load absorber implant: rationale, design and biomechanical characterization. J Med Eng Technol 2011; 35:65-71. [PMID: 21142591 DOI: 10.3109/03091902.2010.535592] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Osteoarthritis (OA) of the knee is the leading cause of disability in the adult population. Although a number of treatments for knee OA are available, none effectively prevent OA progression. Currently, a wide therapeutic gap exists for patients who have unsuccessfully exhausted conservative OA treatments but who are hesitant or ineligible to undergo invasive surgery. The KineSpring device is a novel, joint preserving, minimally invasive implant that reduces medial compartment loading without significantly impacting the loading of the lateral compartment. This article describes the rationale for and the design of the KineSpring device and summarizes results of initial biomechanical testing in an OA cadaver model.
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Affiliation(s)
- A Clifford
- Moximed, Inc., 26460 Corporate Avenue, Hayward, CA 94545, USA
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23
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Verweij LM, van Schoor NM, Dekker J, Visser M. Distinguishing four components underlying physical activity: a new approach to using physical activity questionnaire data in old age. BMC Geriatr 2010; 10:20. [PMID: 20438623 PMCID: PMC2873369 DOI: 10.1186/1471-2318-10-20] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2009] [Accepted: 05/03/2010] [Indexed: 11/17/2022] Open
Abstract
Background It is evident that physical activity has many benefits, but it often remains unclear which types of activity are optimal for health and functioning in old age. The aim of this methodological study was to propose a method for distinguishing four components underlying self reported physical activity of older adults: intensity, muscle strength, turning actions and mechanical strain. Methods Physical activity was assessed by the validated LAPAQ questionnaire among 1699 older adults of the Longitudinal Aging Study Amsterdam. Based on expert consultation and literature review, the four component scores for several individual daily and sports activities were developed. Factor analysis was performed to confirm whether the developed components indeed measured different constructs of physical activity. Results Based on the factor analyses, three components were distinguished: 1. intensity and muscle strength loaded on the same factor, 2. mechanical strain and 3. turning actions. Analyses in gender, age and activity level subgroups consistently distinguished three factors. Conclusion Future research using these components may contribute to our understanding of how specific daily and sports activities may have a different influence on health and physical functioning in old age.
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Affiliation(s)
- Lisanne M Verweij
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
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Peeters GMEEG, Verweij LM, van Schoor NM, Pijnappels M, Pluijm SMF, Visser M, Lips P. Which types of activities are associated with risk of recurrent falling in older persons? J Gerontol A Biol Sci Med Sci 2010; 65:743-50. [PMID: 20159779 DOI: 10.1093/gerona/glq013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study explored the associations between various types of activities, their underlying physical components, and recurrent falling in community-dwelling older persons. METHODS This study included 1,329 community-dwelling persons (>or=65 years) of the Longitudinal Aging Study Amsterdam (LASA). The time spent in walking, cycling, light and heavy household activities, and two sports was measured using the LASA Physical Activity Questionnaire (LAPAQ). Physical activity components included strength, intensity, mechanical strain, and turning. Time to second fall in a 6-month period was measured during 3 years with fall calendars. Cox proportional hazards models were adjusted for confounders and stratified for physical performance and sex in case of significant (p < .10) interaction. RESULTS During 3 years, 325 (24.5%) persons became recurrent fallers. In women, doing light (hazard ratios [HRs] = 0.40, 95% confidence intervals [CIs] = 0.20-0.79) or heavy household activities (HR = 0.63, CI = 0.44-0.79) was associated with a decreased risk of recurrent falling. In persons with good physical performance, doing sports (HR = 1.56, CI = 1.07-2.28), high intensity (HR > 1.75, CI = 1.09-3.16), and high mechanical strain (HR = 1.70, CI = 1.01-2.83) activities was associated with an increased risk of recurrent falling. CONCLUSIONS The results suggest that the relationship between physical activity and recurrent falling differs per type of activity and is modified by physical performance. Doing household activities was associated with a decreased risk of recurrent falling in women. In physically fit older persons, doing sports or activities with high intensity or mechanical strain demands was associated with an increased risk of recurrent falling.
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Affiliation(s)
- G M E E Geeske Peeters
- Department of Internal Medicine, Section Endocrinology, VU University Medical Center, Postbus 7057, 1007 MB Amsterdam, The Netherlands
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Kerrigan DC, Franz JR, Keenan GS, Dicharry J, Della Croce U, Wilder RP. The Effect of Running Shoes on Lower Extremity Joint Torques. PM R 2009; 1:1058-63. [DOI: 10.1016/j.pmrj.2009.09.011] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2009] [Revised: 08/26/2009] [Accepted: 09/22/2009] [Indexed: 11/24/2022]
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