1
|
Al-Mhanna SB, Batrakoulis A, Mohamed M, Alkhamees NH, Sheeha BB, Ibrahim ZM, Aldayel A, Muhamad AS, Rahman SA, Afolabi HA, Zulkifli MM, Hafiz Bin Hanafi M, Abubakar BD, Rojas-Valverde D, Ghazali WSW. Home-based circuit training improves blood lipid profile, liver function, musculoskeletal fitness, and health-related quality of life in overweight/obese older adult patients with knee osteoarthritis and type 2 diabetes: a randomized controlled trial during the COVID-19 pandemic. BMC Sports Sci Med Rehabil 2024; 16:125. [PMID: 38831437 PMCID: PMC11145895 DOI: 10.1186/s13102-024-00915-4] [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: 03/27/2024] [Accepted: 05/27/2024] [Indexed: 06/05/2024]
Abstract
BACKGROUND There is strong evidence showing the association between obesity, type 2 diabetes mellitus (T2DM), and knee pain resulting from osteoarthritis. Regular exercise has been reported as a foundational piece of the preventive therapy puzzle for knee osteoarthritis (KOA) patients. Nonetheless, evidence-based exercise protocols for people with comorbidities, such as obesity, T2DM, and KOA are limited. Therefore, the present trial aimed to assess the effectiveness of a 12-week home-based circuit training (HBCT) protocol on various indices related to cardiometabolic health, musculoskeletal fitness, and health-related quality of life (HRQoL) among overweight/obese older adult patients with KOA and T2DM during the COVID-19 lockdown. METHODS This is a randomized controlled trial study registered at the National Medical Research Register (ID: RSCH ID-21-01180-KGTNMRR ID-21-02367-FUM) and obtained approval on December 9, 2021. Seventy overweight or obese patients with KOA and T2DM (62.2 ± 6.1 years; 56% female) were randomly assigned to the intervention group (n = 35, HBCT) or the no-exercise control group (n = 35, CON). HBCT performed a 12-week progressive protocol (seven exercises; 15-30 repetitions per exercise, 1 min passive rest between exercises; 2-4 rounds per session; 20-60 min total session duration). Blood samples were collected, and assays were performed to assess the lipid profile, liver function, and fasting blood glucose (FBG). In addition, the 30-s Chair Stand Test (30CST) was used to evaluate lower body muscular strength and endurance while the Timed Up and Go (TUG) test was used to evaluate lower limb function, mobility, and the risk of falls for all the participants. HRQoL was assessed using the Osteoarthritis Knee and Hip Quality of Life (OAKHQoL). All the assessments were conducted at pre-, mid-, and post-training stages during the application or practice of the exercise protocol, rather than during the training sessions themselves. RESULTS HBCT significantly reduced total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), aminotransferase, alanine aminotransferase, FBG and knee pain (p < 0.05). Furthermore, HBCT induced meaningful increases in high-density lipoprotein (HDL-C), lower body muscular strength, endurance, function, mobility, and HRQoL in overweight/obese older adults with T2DM and KOA (p < 0.05). CONCLUSION The present outcomes recommend that an injury-free HBCT program may improve various indicators related to cardiometabolic health, musculoskeletal fitness, and HRQoL in elderly with overweight/obesity, T2DM and KOA. These findings offer valuable insights for clinicians and practitioners seeking evidence-based exercise interventions tailored for patients managing substantial metabolic and musculoskeletal health challenges in clinical practice.
Collapse
Affiliation(s)
- Sameer Badri Al-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, 602105, India.
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Nouf H Alkhamees
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Bodor Bin Sheeha
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
| | - Zizi M Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh, 11671, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Abdulaziz Aldayel
- Department of Exercise Physiology, King Saud University, Riyadh, Saudi Arabia
| | - Ayu Suzailiana Muhamad
- Exercise and Sports Science Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Shaifuzain Ab Rahman
- Department of Orthopaedic, Hospital University Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Maryam Mohd Zulkifli
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Muhammad Hafiz Bin Hanafi
- Rehabilitation Medicine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Bishir Daku Abubakar
- Department of Human Physiology, Federal University Dutse, Dutse, Jigawa State, Nigeria
| | - Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida Universidad Nacional de Costa Rica, Heredia, Costa Rica
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
| |
Collapse
|
2
|
Queiroga F, Cembalo SM, Epstein J, Maxwell L, Buttel T, Copenhaver C, Cross M, Hunter D, King L, Callahan L, March L, Beaton DE, Guillemin F. Assessing domain match and feasibility of candidate instruments matching with OMERACT endorsed domains to measure flare in knee and hip osteoarthritis. Semin Arthritis Rheum 2024; 65:152371. [PMID: 38340607 DOI: 10.1016/j.semarthrit.2024.152371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 02/12/2024]
Abstract
PURPOSE To evaluate the domain match (truth) and feasibility of candidate instruments assessing flare in knee and hip osteoarthritis (OA) according to the identified domains. MATERIAL AND METHODS From a literature review (575 papers), instruments were selected and evaluated using the truth and feasibility elements of the OMERACT Filter 2.2. These were evaluated by 26 experts, including patients, in two Delphi survey rounds. The final selection was obtained by a vote. RESULTS 44 instruments were identified. In Delphi Round 1, five instruments were selected. In Round 2, all instruments obtained at least 75 % in terms of content match with the endorsed domains and feasibility. In the final selection, the Flare-OA questionnaire obtained 100 % favorable votes. CONCLUSION Through consensus of the working group, the Flare-OA questionnaire was selected as the best candidate instrument to move into a full assessment of its measurement properties using the OMERACT Filter 2.2.
Collapse
Affiliation(s)
- F Queiroga
- Université de Lorraine, Grand Est Region, France.
| | | | - J Epstein
- Université de Lorraine, Grand Est Region, France
| | - L Maxwell
- University of Ottawa, Ontario, Canada
| | - T Buttel
- University of Sidney, Sydney, Australia
| | | | - M Cross
- University of Sidney, Sydney, Australia
| | - D Hunter
- University of Sidney, Sydney, Australia
| | - L King
- University of Toronto, Toronto, Canada
| | - L Callahan
- University of North Carolina, Chapel Hill, NC, United States
| | - L March
- University of Sidney, Sydney, Australia
| | | | - F Guillemin
- Université de Lorraine, Grand Est Region, France
| |
Collapse
|
3
|
Pisanty-Alatorre J, Bello-Chavolla OY, Vilchis-Chaparro E, Goycochea-Robles MV. Associations of current and childhood socioeconomic status and health outcomes amongst patients with knee or hip osteoarthritis in a Mexico City family-practice setting. BMC Musculoskelet Disord 2024; 25:91. [PMID: 38267883 PMCID: PMC10809569 DOI: 10.1186/s12891-023-07107-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/10/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVES To examine the association of current and childhood socioeconomic status (SES) with patient-reported functional status, quality of life and disability in patients with knee or hip osteoarthritis (OA). METHODS Cross-sectional study amongst individuals seeking care for any medical reason in a primary care family-practice clinic in Mexico City. We included individuals with self-reported doctor-diagnosed arthritis, recruited through waiting-room posters and invitations by treating family physicians. We administered a survey using validated Spanish language versions of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Osteoarthritis of Lower Limbs and Quality of Life (AMICAL), and the Stanford Health Assessment Questionnaire-Disability Index (HAQ-DI). To estimate current and childhood SES, we collected data on education level and occupation type for both the patient and their parents, as well as using a validated tool to estimate income quintile. RESULTS We recruited 154 patients and excluded 8 patients. There was a high correlation between outcome scores. Estimated income and education levels were correlated with WOMAC, AMICAL and HAQ-DI scores, and significant differences were found in all scores by occupation type. The associations for current SES variables and outcome scores remained significant independently of age, sex, BMI, and presence of diabetes or hypertension, and were largely explained by current income in mutually adjusted models. Childhood SES - in particular as measured through maternal education - was best correlated with AMICAL scores, though its effect seemed largely mediated by its association with current SES. CONCLUSIONS Current Socioeconomic Status impacts functional status, quality of life and disability amongst OA patients in Mexico City. The WOMAC, AMICAL and HAQ-DI scores correlate with each other and are all potentially useful markers of disease severity. More research is needed to elucidate the relationships between childhood SES and OA outcomes. Awareness of life-course SES may be useful in identifying patients at risk for worse outcomes.
Collapse
|
4
|
Queiroga F, Cross M, Thomas MJ, March L, Epstein J, Guillemin F. A scoping review of patient self-report measures of flare in knee and hip osteoarthritis (OA): A report from the OMERACT flares in OA working group. Semin Arthritis Rheum 2023; 63:152281. [PMID: 37948937 DOI: 10.1016/j.semarthrit.2023.152281] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE We aimed to analyze the content validity/domain match and feasibility of self-report instruments that could measure flare in osteoarthritis (OA), by extending our 2017 literature review on the definition of flare in knee and hip OA. METHOD We searched PubMed (Medline), Web of Science and PsycInfo (Ebsco Host) databases for original articles reporting research about flare (or synonyms) in humans with knee and hip OA, between 2017 and 2023. Four experts worked independently, checking the records, and assessing content validity and feasibility, writing justification for exclusion. RESULTS At literature review phase, 575 papers were filtered. After experts' analysis, 59 studies were included, and 44 instruments associated with flare in OA were identified. Most were studies about pain in knee or hip OA (35 %), cultural adaptation of a measure (33 %) or studies investigating psychometric properties of full (16 %) or short form (4 %) instruments. The assessment of domain match and feasibility revealed that 15 instruments were assigned a label of 'yes' or 'uncertain' as to whether or not there was a good match with the domain concept or whether the instrument was considered feasible to use. DISCUSSION Most identified instruments considered different aspects of pain and the associated discomfort in performing daily activities but did not include the central aspects of flare in OA, i.e. the change of state, nor the additional Outcome Measures in Rheumatology (OMERACT) endorsed domains for OA flare namely stiffness, swelling, psychological aspects, impact of symptoms including fatigue and sleep disturbance. Although it is possible that the period specified to conduct this literature review may have led to some recognized instruments being excluded, this review demonstrates the need for the research community to reach consensus on the best way to measure self-reported flares in future clinical trials and observational studies.
Collapse
Affiliation(s)
| | | | - Martin J Thomas
- Keele University, School of Medicine, Keele, Staffordshire, UK; Haywood Academic Rheumatology Centre, Midlands Partnership University NHS Foundation Trust, Haywood Hospital, Staffordshire, UK
| | - Lyn March
- Institute of Bone and Joint Research - Kolling Institute, University of Sydney, and Rheumatology Department, Royal North Shore, Hospital, Sydney, Australia
| | | | | |
Collapse
|
5
|
Beaudart C, Li N, Boonen A, Hiligsmann M. Burden of osteoarthritis in the Netherlands: a scoping review. Expert Rev Pharmacoecon Outcomes Res 2023; 23:1147-1167. [PMID: 37728892 DOI: 10.1080/14737167.2023.2260562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE To provide an overview of societal burden of osteoarthritis (OA) in the Netherlands. METHODS Medline (via Ovid) and Embase databases were searched in September 2022 for all publications providing prevalence/incidence, cost or health-related quality of life (HRQoL) data of OA (all sites) in the Netherlands. RESULTS Twenty-eight original studies were included in this scoping review; twelve reporting prevalence/incidence data of OA, seven reporting data on the economic burden of OA and twelve reporting HRQoL data of patients with OA. Most of the available data were from Dutch national cohorts. The prevalence of knee OA ranged from 6% to 18% across studies, from 4% to 7% for hip OA and from 12% to 56% for hand OA. OA was shown to be associated with impairment in work participation and long-term requirement of health care utilization, translating into substantial medical costs and societal costs of lost productivity. All studies comparing HRQoL among persons with OA with control persons showed a significantly lower HRQoL in patients with OA after adjustment for age, sex, and various risk factors. CONCLUSIONS OA is a highly prevalent disease in the Dutch population and is responsible for a significant economic and health burden.
Collapse
Affiliation(s)
- Charlotte Beaudart
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Research Institute for Life Sciences (NARILIS), Department of Biomedical Sciences, Faculty of Medicine, University of Namur, Namur, Belgium
| | - Nannan Li
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Annelies Boonen
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mickael Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| |
Collapse
|
6
|
Atukorala I, Hunter DJ. A review of quality-of-life in elderly osteoarthritis. Expert Rev Pharmacoecon Outcomes Res 2023; 23:365-381. [PMID: 36803292 DOI: 10.1080/14737167.2023.2181791] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
INTRODUCTION Osteoarthritis (OA) is the commonest joint disease in the world. Although aging is not invariably associated with OA, aging of the musculoskeletal system increases susceptibility to OA. Pain and reduced function due to OA, negatively impact health-related quality of life (HRQoL) in the elderly. AREAS COVERED We searched PubMed and Google Scholar with search term "osteoarthritis' combined with terms 'elderly' 'ageing' 'healthrelated quality of life' 'burden' "prevalence 'hip osteoarthritis' 'knee osteoarthritis' 'hand osteoarthritis' to identify relevant articles. This article discusses the global impact and joint-specific burden due to OA and the challenges in assessment of HRQoL in elderly with OA. We further describe some HRQoL determinants that particularly impact elderly persons with OA. These determinants include physical activity, falls, psychosocial consequences, sarcopaenia, sexual health, and incontinence. The usefulness of physical performance measures, as an adjunct to assessing HRQoL is explored. The review concludes by outlining strategies to improve HRQoL. EXPERT OPINION Assessment of HRQoL in elderly with OA is mandatory if effective interventions/treatment are to be instituted. But existent HRQoL assessments have shortcomings when used in elderly§. It is recommended that determinants of QoL which are unique to the elderly, be examined with greater detail and weightage in future studies.
Collapse
Affiliation(s)
- Inoshi Atukorala
- Senior Lecturer in Clinical Medicine & Consultant Rheumatologist, University Medical Unit, National Hospital Sri Lanka, & Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - David J Hunter
- Florance and Cope Chair of Rheumatology, Co-Director Sydney Musculoskeletal Health Flagship, University of Sydney, Camperdown, Australia
| |
Collapse
|
7
|
Alotaibi AD, Vennu V, BinNasser AS, Idres M, Mohammed A, Aldawai H, Bindawas SM. Development and Validation of a New Patient-Reported Outcome Measure in the Arabic Language for Patients with Knee Osteoarthritis in Saudi Arabia. Patient Prefer Adherence 2023; 17:187-198. [PMID: 36704123 PMCID: PMC9871047 DOI: 10.2147/ppa.s393163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/11/2023] [Indexed: 01/19/2023] Open
Abstract
PURPOSE In Western countries, several patient-reported outcomes (PROs) measures have been developed and validated for knee osteoarthritis (OA) patients. While few PROs have been adopted for these patients in Saudi Arabia, which do not reflect all aspects of the Saudi socio-cultural context. Given this shortcoming, this study aimed to develop a new PRO measure in Arabic that covers all concepts related to health, function, and participation encompassing environmental and personal factors. PATIENTS AND METHODS A cross-sectional study was conducted on 73 males and females aged ≥55 diagnosed with radiographic knee OA recruited from the orthopedic and physiotherapy departments of five hospitals in Riyadh, Saudi Arabia, between September 2016 and March 2017. Physicians confirmed knee OA according to the American College of Rheumatology standards. We examined the psychometric properties of the new Arabic PRO measure. RESULTS The internal consistency and test-retest (a one-week interval) reliabilities were found acceptable and excellent with Cronbach's alpha and the intra-class correlation coefficient, ranging from 0.69 to 0.85 and 0.88 to 0.91, respectively. The construct validity was found fair with the correlation between the subscales Body Function and Physical Function (rs =0.63), Activity & Participation and Physical Function (rs =0.72), and Body Function and Bodily Pain (rs =0.58). We found a weak to fair correlation between the new Arabic PRO measure's subscales and the SF-36 physical composite scale (PCS: rs =0.34-0.69) compared to the mental-composite scale (MCS: rs =0.16-0.55). CONCLUSION The 33-item new Arabic PRO measure is a well-accepted, reliable, and valid tool for use in knee OA patients in the Saudi cultural context.
Collapse
Affiliation(s)
- Ali D Alotaibi
- Ministry of Health, Dawadmi General Hospital, Riyadh, Saudi Arabia
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Ahmad Saleh BinNasser
- Department of Orthopedics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - May Idres
- Physical Therapy Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Asma Mohammed
- Physical Therapy Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Hasan Aldawai
- Physical Therapy Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Correspondence: Saad M Bindawas, Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box: 10219, Riyadh, 11433, Saudi Arabia, Tel +966114696226, Email
| |
Collapse
|
8
|
Ng WH, Jamaludin NI, Sahabuddin FNA, Ab Rahman S, Ahmed Shokri A, Shaharudin S. Comparison of the open kinetic chain and closed kinetic chain strengthening exercises on pain perception and lower limb biomechanics of patients with mild knee osteoarthritis: a randomized controlled trial protocol. Trials 2022; 23:315. [PMID: 35428274 PMCID: PMC9012068 DOI: 10.1186/s13063-022-06153-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 03/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Clinical recommendations suggest exercises as the main treatment modality for patients with knee osteoarthritis (OA). This study aimed to compare the effects of two different exercise interventions, i.e., open kinetic chain (OKC) and closed kinetic chain (CKC) exercises, on the pain and lower limb biomechanics of patients with mild knee OA.
Method
A total of 66 individuals with painful early knee OA, aged 50 years and above, with body mass index (BMI) between 18.9kg/m2 and 29.9 kg/m2 in Kelantan, Malaysia, will be recruited in this study. Participants will be randomly allocated into three different groups, either the OKC, CKC, or control groups. All three groups will attend an individual session with a physiotherapist. The participants in the OKC and CKC groups will perform the exercises three times weekly for 8 weeks at their home. The control group will receive education about clinical manifestations, risk factors, diagnosis, treatment, and nursing care for knee via printed materials. The primary outcomes include self-reported pain scores (visual analog scale), disability scores (Western Ontario and McMaster Universities Arthritis Index), and quality of life scores (Osteoarthritis Knee and Hip Quality of Life). Secondary outcomes include lower limb biomechanics during gait and sit-to-stand as well as isokinetic knee strength. The outcomes will be measured before and after the intervention.
Discussion
The present study will compare the effects of two different home-based exercise intervention programs among patients with mild knee OA. The study findings will provide vital information that can be used to design an effective exercise program that aims at delaying the OA progression.
Trial registration
The protocol was registered on 22 December 2020 at ClinicalTrials.gov (registration number: NCT04678609).
Collapse
|
9
|
Zbitou A, Rat AC, Ngueyon Sime W, Chary-Valckenaere I, Guillemin F. Characteristics of patients with knee and/or hip osteoarthritis undergoing spa treatment: the prospective KHOALA cohort study. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:573-590. [PMID: 35031867 DOI: 10.1007/s00484-021-02220-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 06/14/2023]
Abstract
Knee and hip osteoarthritis (KHOA) are a source of functional impairment. With aging, the management of osteoarthritis (OA) is a major issue in the search for improved quality of life. Spa treatment provides short- and mid-term symptom relief without serious side effects. This study aimed to identify characteristics of patients with KHOA associated with use of spa treatment. The prospective KHOALA cohort included 878 adults aged 40 to 75 years with symptomatic KHOA. We separately analyzed knee and hip OA data and compared patients who never had spa treatment with those who had at least one or multiple treatments during 5 years of follow-up in terms of socio-demographic characteristics, clinical data, quality of life (OAKHQOL, SF-36), physical activity (MAQ), functional impairment (WOMAC), and health care consumption (pharmacological and non-pharmacological treatments). Factors associated with at least one or multiple spa treatments were evaluated with regression logistic models. In all, 607 (69.1%) patients had knee OA (KOA), 222 (25.3%) hip OA (HOA) and 49 (5.6%) both, 91 (13.9%) with KOA, and 33 (12.2%) with HOA had at least one spa treatment. In the KOA cohort, the probability of at least one, two, or three spa treatments was increased with older age (odds ratio = 1.6 [95% confidence interval 1.2-2.2], 1.8 [1.2-2.8], 2.4 [1.4-4.2], respectively), greater use of physiotherapy (OR = 3.9 [2.1-7.1], 2.7 [1.3-5.6], 2.5 [1.1-5.9]), having a prosthesis (OR = 2.1 [1.2-3.8], 2.2 [1.1-4.3], 2.5 [1.1-5.5]), and low MAQ score (OR = 0.7 [0.6-0.9], 0.7 [0.5-1.0], 0.7 [0.5-1.0]). In the HOA cohort, female sex was associated with at least one (OR = 3.0 [1.1-8.0]) or two (OR = 5.1 [1.2-22.5]) spa treatments. In this cohort of KHOA, repeated spa treatment over 5 years was strongly associated with older age, greater use of physiotherapy and presence of a prothesis with KOA and female sex with HOA. This study may help to better understand spa treatment determinants in OA.
Collapse
Affiliation(s)
- Asma Zbitou
- CIC 1433, Clinical Epidemiology, CHRU Nancy, INSERM, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France
| | - Anne-Christine Rat
- EA 4360 APEMAC, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France
- UMR-S 1075 - Mobilités : vieillissement, pathologie, santé · COMETE, Caen-Normandy University, 2 rue des Rochambelles, 14032, Caen, France
- Department of Rheumatology, CHU Caen Normandy, Avenue de La Côte de Nacre, 14033, Caen, France
| | - Willy Ngueyon Sime
- CIC 1433, Clinical Epidemiology, CHRU Nancy, INSERM, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France
| | - Isabelle Chary-Valckenaere
- Department of Rheumatology, CHRU Nancy, Rue du Morvan, 54500, Vandœuvre Les Nancy, France
- UMR 7365 CNRS-UL IMoPA, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France
| | - Francis Guillemin
- CIC 1433, Clinical Epidemiology, CHRU Nancy, INSERM, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France.
- EA 4360 APEMAC, Université de Lorraine, Rue du Morvan, 54500, Vandœuvre Les Nancy, France.
| |
Collapse
|
10
|
Kamel SR, Ibrahim RS, Moens HM, Mohammed RM. Neuropathic pain in primary knee osteoarthritis patients: correlation with physical function, quality of life, disease severity, and serum beta nerve growth factor levels. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00086-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Neuropathic mechanisms are thought to play a role in knee osteoarthritis (KOA) pain. Neuropathic pain questionnaires can promote diagnosis of a neuropathic component. Thus, we aimed to assess the frequency of neuropathic pain in primary KOA patients (using clinical questionnaires) and to investigate its correlation with socio-demographic factors, physical function, quality of life, disease severity, and serum beta nerve growth factor (β-NGF) levels.
Results
Seventy primary KOA patients were included. Neuropathic pain was detected in 52.9% of patients based on Douleur Neuropathique en 4 Questions (DN4) questionnaire and in 38.6% of patients based on Leeds assessment neuropathic pain symptoms and signs questionnaire (LANSS). Serum β-NGF levels were significantly higher in KOA patients than controls (P<0.0001), and in KOA patients with neuropathic pain compared with patients with non-neuropathic pain. DN4 score was positively correlated with Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function, and it was also negatively correlated with Osteoarthritis knee hip quality of life questionnaire (OAKHQOL) pain scores (rs=0.459, P<0.001; rs= 0.258, P= 0.031; rs= 0.307, P= 0.010; rs = −0.337, P= 0.004, respectively), while LANSS scale was positively correlated with symptom duration, WOMAC stiffness, Lequesne pain, and Lequesne index (rs= 0.260, P= 0.020; rs= 0.343, P= 0.004; rs= 0.344, P= 0.004; rs= 0.322, P= 0.007) and negatively correlated with OAKHQOL physical, OAKHQOL mental health, OAKHQOL social support, and total OAKHQOL scores (rs= −0.258, P= 0.031;rs= −0.254, P= 0.034; rs= −0.283, P= 0.018; rs= −0.261, P= 0.029 respectively).
Conclusions
Neuropathic pain symptoms are frequent in primary KOA patients. KOA patients with neuropathic pain have worse quality of life, extreme disability, and higher serum β-NGF levels. Nerve growth factor inhibitors could have a potential role for not only relieving pain in KOA patients but also improving functional disability and quality of life in these patients.
Collapse
|
11
|
Bouchaala F, Laatar R, Lahiani M, Vuillerme N, Zouabi A, Borji R, Rebai H, Sahli S. Time-of-day effects on the postural control and symptoms in women with rheumatoid arthritis. Chronobiol Int 2021; 38:1290-1298. [PMID: 34016004 DOI: 10.1080/07420528.2021.1927069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present study was designed to assess time-of-day effects on postural balance and symptoms of rheumatoid arthritis (RA) patients. A total of 15 American College of Rheumatology functional class I and II RA patients and 15 healthy controls aged between 45 and 55 (mean age: 50 ± 3) years of age voluntarily participated. We conducted a case-control, repeated-measures in design study. Postural balance, axillary temperature, pain intensity, fatigue, and sleepiness were measured during five test sessions at 06:00, 10:00, 14:00, 18:00, and 22:00 h. Participants were randomized to the order of test sessions, and each session was separated by >36 hours to minimize/eliminate learning effects. Center of pressure area (CoParea) (p < .001), pain (p < .01), and sleepiness (p < .05) values were significantly higher at 06:00 and 22:00 h compared to 10:00, 14:00, and 18:00 h in the RA group. Fatigue significantly increased (p < .05) at 22:00 h in comparison to 10:00, 14:00, and 18:00 h in the RA group. Axillary temperature was significantly (p < .001) lower at 06:00 and at 22:00 h compared to 10:00, 14:00, and 18:00 h in the RA group. In the control group, there were no significant time-of-day difference in fatigue, but axillary temperature was significantly lower (p < .01) at 06:00 h compared to 10:00 h, 14:00, 18:00, and 22:00 h, sleepiness values were significantly higher (p < .05) at 06:00 and 22:00 h compared to 10:00, 14:00, and 18:00 h, and revealed CoParea values were significantly (p < .05) higher at 06:00 h compared to 14:00 h. Finally, in the RA group, significant correlations were found between values of CoParea and pain (r = 0.47; p < .001), sleepiness (r = 0.39; p < .01), fatigue (r = -0.46; p < .001), and also axillary temperature (r = -0.35; p < .001). Multiple linear regression analysis further indicated that in the RA group, time-of-day variation in postural balance was predicted collectively by that in pain and fatigue (30.7%) (R2 = 0.307; F = 11.53; p < .001). Our results first suggest that time-of-day significantly affects postural balance, axillary temperature, pain intensity, fatigue, and sleepiness in RA patients and second that the temporal variation observed in pain, fatigue, and somnolence are concomitant with that observed in postural balance.Abbreviations: RA: Rheumatoid arthritis; H&O questionnaire: Horne and Ostberg questionnaire; PSQI: Pittsburgh sleep quality index; HAQ: Health assessment questionnaire; SF-36: the short form-36; WOMAC: Western Ontario and McMaster Universities Osteoarthritis Index; CoP: The Center of foot Pressure; CoParea: The Center of foot Pressure area; VAS: The Visual Analogue Scale; KSS: Karolinska Sleepiness Scale.
Collapse
Affiliation(s)
- Fatma Bouchaala
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Rabeb Laatar
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Mariam Lahiani
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicolas Vuillerme
- University of Grenoble Alpes, AGEIS, Grenoble, France.,Institut Universitaire de France, Paris, France
| | - Amira Zouabi
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Rihab Borji
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Haithem Rebai
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Sonia Sahli
- Research Laboratory: Education, Motricité, Sport Et Santé, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| |
Collapse
|
12
|
Kamaraj A, Agarwal N, Seah KTM, Khan W. Understanding cost-utility analysis studies in the trauma and orthopaedic surgery literature. EFORT Open Rev 2021; 6:305-315. [PMID: 34150325 PMCID: PMC8183147 DOI: 10.1302/2058-5241.6.200115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Cost-utility analysis (CUA) studies are becoming increasingly important due to the need to reduce healthcare spending, especially in the field of trauma and orthopaedics. There is an increasing need for trauma and orthopaedic surgeons to understand these economic evaluations to ensure informed cost-effective decisions can be made to benefit the patient and funding body. This review discusses the fundamental principles required to understand CUA studies in the literature, including a discussion of the different methods employed to assess the health outcomes associated with different management options and the various approaches used to calculate the costs involved. Different types of model design may be used to conduct a CUA which can be broadly categorized into real-life clinical studies and computer-simulated modelling. We discuss the main types of study designs used within each category. We also cover the different types of sensitivity analysis used to quantify uncertainty in these studies and the commonly employed instruments used to assess the quality of CUAs. Finally, we discuss some of the important limitations of CUAs that need to be considered. This review outlines the main concepts required to understand the CUA literature and provides a basic framework for their future conduct.
Cite this article: EFORT Open Rev 2021;6:305-315. DOI: 10.1302/2058-5241.6.200115
Collapse
Affiliation(s)
- Achi Kamaraj
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Nikhil Agarwal
- Department of Surgery, University of Cambridge, Cambridge, UK
| | | | - Wasim Khan
- Department of Surgery, University of Cambridge, Cambridge, UK
| |
Collapse
|
13
|
Gueugnon M, Fournel I, Soilly AL, Diaz A, Baulot E, Bussière C, Casillas JM, Cherasse A, Conrozier T, Loeuille D, Maillefert JF, Mazalovic K, Timsit M, Wendling D, Ramon A, Binquet C, Morisset C, Ornetti P. Effectiveness, safety, and cost-utility of a knee brace in medial knee osteoarthritis: the ERGONOMIE randomized controlled trial. Osteoarthritis Cartilage 2021; 29:491-501. [PMID: 33524515 DOI: 10.1016/j.joca.2020.11.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 09/15/2020] [Accepted: 11/30/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This pragmatic, multicenter, open-label, randomized controlled trial (RCT) aimed to compare the effectiveness, safety, and cost-utility of a custom-made knee brace versus usual care over 1 year in medial knee osteoarthritis (OA). DESIGN 120 patients with medial knee OA (VAS pain at rest >40/100), classified as Kellgren-Lawrence grade II-IV, were randomized into two groups: ODRA plus usual care (ODRA group) and usual care alone (UCA group). The primary effectiveness outcome was the change in VAS pain between M0 and M12. Secondary outcomes included changes over 1 year in KOOS (function) and OAKHQOL (quality of life) scores. Drug consumption, compliance, safety of the knee brace, and cost-utility over 1 year were also assessed. RESULTS The ODRA group was associated with a higher improvement in: VAS pain (adjusted mean difference of -11.8; 95% CI: -21.1 to -2.5); all KOOS subscales (pain: +8.8; 95% CI: 1.4-16.2); other symptoms (+10.4; 95% CI: 2.7-18); function in activities of daily living (+9.2; 95% CI: 1.1-17.2); function in sports and leisure (+12.3; 95% CI: 4.3-20.3); quality of life (+9.9; 95% CI: 0.9-15.9), OAKHQOL subscales (pain: +14.8; 95% CI: 5.0-24.6); and physical activities (+8.2; 95% CI: 0.6-15.8), and with a significant decrease in analgesics consumption at M12 compared with the UCA group. Despite localized side-effects, observance was good at M12 (median: 5.3 h/day). The ODRA group had a more than 85% chance of being cost-effective for a willingness-to-pay threshold of €45 000 per QALY. CONCLUSIONS The ERGONOMIE RCT demonstrated significant clinical benefits of an unloader custom-made knee brace in terms of improvements in pain, function, and some aspects of quality of life over 1 year in medial knee OA, as well as its potential cost-utility from a societal perspective.
Collapse
Affiliation(s)
- M Gueugnon
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France.
| | - I Fournel
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France.
| | - A-L Soilly
- Department of Clinical Research, Clinical Research Unit-Methodological Support Network CHU Dijon-Bourgogne, F-21000, Dijon, France.
| | - A Diaz
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France.
| | - E Baulot
- Department of Orthopedic Surgery, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
| | - C Bussière
- Department of Orthopedic Surgery, Centre Orthopédique Medico-chirugical, Dracy-Le-Fort, France.
| | - J M Casillas
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport; Department of Physical Medicine and Rehabilitation, CHU Dijon Bourgogne, F-2100 Dijon, France.
| | - A Cherasse
- Department of Rheumatology, Hospital Center Mâcon, Mâcon, France.
| | - T Conrozier
- Department of Rheumatology, Hospital Nord Franche-Comté, Belfort, France.
| | - D Loeuille
- Department of Rheumatology, CHU Nancy, F-54500 Vandoeuvre-lès-Nancy, France INSERM, CIC-EC CIE6, Nancy, France University Hospital of Nancy, Epidemiology and Clinical Evaluation, F-54500 Vandoeuvre-lès-Nancy, France.
| | - J-F Maillefert
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
| | - K Mazalovic
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France; Department of General Medicine, Bourgogne Franche-Comté University, UFR des Sciences de Santé, Dijon, France.
| | - M Timsit
- Department of Physical Medicine and Rehabilitation, Clinique de Provence Bourbonne, F-13400 Aubagne, France.
| | - D Wendling
- Department of Rheumatology, CHU Besançon EA4266 Bourgogne Franche-Comté University, F-25030 Besançon, France.
| | - A Ramon
- Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France.
| | - C Binquet
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module EC, CHU Dijon-Bourgogne, Dijon, France.
| | - C Morisset
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France.
| | - P Ornetti
- INSERM, CIC 1432, Centre D'Investigation Clinique, Module Plurithématique, Plateforme D'Investigation Technologiques, Dijon, France CHU Dijon-Bourgogne, Dijon, France; Department of Rheumatology, CHU Dijon Bourgogne, F-21000 Dijon, France; INSERM UMR 1093-CAPS, Bourgogne Franche-Comté University, UFR des Sciences et Du Sport.
| |
Collapse
|
14
|
Fekete H, Guillemin F, Pallagi E, Fekete R, Lippai Z, Luterán F, Tóth I, Tóth K, Vallata A, Varjú C, Csóka I. Evaluation of osteoarthritis knee and hip quality of life (OAKHQoL): adaptation and validation of the questionnaire in the Hungarian population. Ther Adv Musculoskelet Dis 2021; 12:1759720X20959570. [PMID: 33414849 PMCID: PMC7750574 DOI: 10.1177/1759720x20959570] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 08/21/2020] [Indexed: 12/26/2022] Open
Abstract
Background: At least 17% of the population suffers from osteoarthritis (OA) in Hungary, according to the European Health Interview Survey. In Hungary, until now there was no OA-specific questionnaire available for the lower limb, in order to monitor the health-related quality of life (HRQoL). This gap gave the relevance of this research. The aim of the study was to perform the Hungarian cross-cultural adaptation and validation of the French-developed Osteoarthritis Knee and Hip Quality of Life (OAKHQoL) questionnaire. Methods: The five-step translation procedure of the original OAKHQoL was performed by the expert panel and the translators. The created Hungarian version (OAKHQoL-HUN) was tested in six different geographical areas of Hungary. The validity and the reliability of this adapted tool was analyzed by our research group. Results: A total of 99 patients completed the questionnaires (78 women and 21 men), with the average age of 66.6 years (standard deviation (SD) 12.1), living with OA for more than 10 years. Excellent internal consistency was observed in the following domains: physical activity (α = 0.93), mental health (α = 0.91) and pain (α = 0.89). Good correlation was determined between physical subscales (r = 0.615–0.676) and mental subscales (r = 0.633–0.643) compared to generic quality of life instruments (World Health Organization Quality of life – BREF questionnaire and EQ-5D-3L). Conclusion: The OAKHQoL-HUN is the first valid and reliable tool for measuring the Hungarian lower limb OA patients’ quality of life. Trial Registration: This study is registered (24950-3/2016/EKU) by the National Ethics Committee: the Hungarian Medical Research Council.
Collapse
Affiliation(s)
- Helga Fekete
- Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, Faculty of Pharmacy, Szeged, Hungary
| | | | - Edina Pallagi
- Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, Faculty of Pharmacy, Szeged, Hungary
| | - Róbert Fekete
- County Hospital, Kiskunfélegyháza Municipal Hospital and Polyclinic - Musculoskeletal Rehabilitation Unit, Kiskunfélegyháza, Hungary
| | - Zoltán Lippai
- Hospital - Musculoskeletal Rehabilitation Unit, Budapest, Hungary
| | - Ferenc Luterán
- Teaching Hospital Musculoskeletal Rehabilitation Unit, Győr, Hungary
| | - István Tóth
- II. Rákóczi Ferenc Hospital, Szikszó, Musculoskeletal Rehabilitation Unit, Szikszó, Hungary
| | - Kálmán Tóth
- Department of Orthopaedics, University of Szeged, Faculty of Medicine, Szeged, Hungary
| | - Amandine Vallata
- Centre d'investigation Clinique - Epidemiologie Clinique CIC 1433, Institute national de la santé et de la recherché médicale, rue du Morvan, Vandoeuvre - les-Nancy, France
| | - Cecília Varjú
- Department of Rheumatology and Immunology, University of Pécs, Medical School, Pécs, Hungary
| | - Ildiko Csóka
- Institute of Pharmaceutical Technology and Regulatory Affairs, University of Szeged, Faculty of Pharmacy, Eötvös u. 6., Szeged 6720, Hungary
| |
Collapse
|
15
|
Adib-Hajbaghery M, Jamali N, Soleimani A. The effect of curcumin ointment on the quality of life of older adults with knee osteoarthritis: A randomized placebo clinical trial. Nurs Midwifery Stud 2021. [DOI: 10.4103/nms.nms_62_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
16
|
Pain in women with knee and/or hip osteoarthritis is related to systemic inflammation and to adipose tissue dysfunction: Cross-sectional results of the KHOALA cohort. Semin Arthritis Rheum 2020; 51:129-136. [PMID: 33383288 DOI: 10.1016/j.semarthrit.2020.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 09/29/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Considering the role of metabolic diseases in osteoarthritis (OA), we investigated whether biomarkers of adipose tissue dysfunction could be associated with OA-related pain. DESIGN We cross-sectionally analyzed patients with knee and/or hip OA at inclusion in the KHOALA cohort. We used visual analogic scale (VAS) for pain, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) pain subscores. At inclusion, we measured ultra-sensitive CRP (usCRP), leptin and adiponectin for calculation of leptin:adiponectin ratio (LAR), a marker of adipose tissue dysfunction associated with central adiposity, high-molecular-weight adiponectin, visfatin and apolipoproteins. Univariate and multivariable analyses using stepwise linear regression models were performed to search for correlation between pain assessments and these biomarkers, with systematic adjustment on age. RESULTS In 596 women with hip and/or knee OA, multivariable analyses indicated that higher pain intensity was associated with higher LAR (VAS pain: β=0.49; p = 0.0001, OAKHQOL pain: β=-0.46; p = 0.0002, WOMAC pain: β=0.30; p = 0.001) in the whole group as well as in hip or knee OA patients considered separately. Pain intensity correlated also with usCRP level (VAS pain: β= 0.27; p = 0.02, OAKHQOL pain: β =-0.30; p = 0.01) and Kellgren-Lawrence score. In 267 men, no correlation between biomarkers and pain was found. CONCLUSION Serum LAR and usCRP level are associated with pain level, independently of radiographic structural severity in women with hip and/or knee OA, emphasizing the role of adipose tissue dysfunction and of meta-inflammation in pain experience in the female population.
Collapse
|
17
|
Bitar S, Omorou AY, Van Hoye A, Guillemin F, Rat AC. Five-year Evolution Patterns of Physical Activity and Sedentary Behavior in Patients with Lower-limb Osteoarthritis and Their Sociodemographic and Clinical Correlates. J Rheumatol 2020; 47:1807-1814. [PMID: 32173658 DOI: 10.3899/jrheum.190854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The present study aimed to identify trajectories of physical activity (PA) components (frequency, duration, intensity, and type) and screen-based sedentary behavior (SB) as well as baseline predictors of each trajectory in patients with hip and/or knee osteoarthritis (OA). METHODS We included 878 patients with a 5-year follow-up from the KHOALA cohort. PA and SB were measured by the Modifiable Activity Questionnaire. We used group-based trajectory analysis to identify the trajectories of PA components and screen-based SB, and multivariable logistic regression to determine predictors of the identified trajectories. RESULTS Two groups of trajectories were identified for each PA component and 3 for SB. High and decreasing PA duration was associated with female sex (OR 0.3, 95% CI 0.1-0.5) as was low and stable, more so than high and decreasing prevalence of weight-bearing activities (OR 0.6, 95% CI 0.4-0.9). Patients with impaired patient-reported outcome measures and obese patients often featured low versus high and decreasing prevalence of weight-bearing activities. Predictors of moderate and high versus low and slightly increasing screen-based SB trajectories were male sex, age < 60 years, single status (OR 1.5, 95% CI 1.1-2.1), obesity (OR 2.1, 95% CI 1.4-3.1), smoking (OR 2.0, 95% CI 1.1-3.7), and less physical jobs. Predictors of moderate and high versus low screen-based SB trajectories were all sociodemographic: male sex, age < 60 years, single status, obesity, smoking, and less physical jobs. CONCLUSION Sociodemographic and clinical predictors of trajectories vary between PA components; they are associated mainly with PA frequency and type. No clinical characteristics were associated with screen-based SB.
Collapse
Affiliation(s)
- Sarah Bitar
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy;
| | - Abdou Y Omorou
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy
| | | | - Francis Guillemin
- S. Bitar, MPH, A. Omorou, MD, PhD, F. Guillemin, PU-PH, Université de Lorraine, APEMAC, and CHRU-Nancy, INSERM, Université de Lorraine, CIC, Epidémiologie Clinique, Nancy
| | - Anne-Christine Rat
- A.C. Rat, MD, PhD, Université de Lorraine, APEMAC, Nancy, and Centre Hospitalier Universitaire Caen Normandie, Service de Rhumatologie Département, Caen, France
| |
Collapse
|
18
|
Validation of Pediatric Self-Report Patient-Reported Outcomes Measurement Information System (PROMIS) Measures in Different Stages of Legg-Calvé-Perthes Disease. J Pediatr Orthop 2020; 40:235-240. [PMID: 31318732 DOI: 10.1097/bpo.0000000000001423] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Patient-reported outcomes (PRO) assessing health-related quality of life (HRQoL) are important outcome measures, especially in Legg-Calvé-Perthes disease (LCPD) where symptoms (pain and limping), activity restrictions, and treatments vary depending on the stage of the disease. The purpose of this study was to investigate the validity of the Patient-reported Outcomes Measurement Information System (PROMIS) for measuring HRQoL of patients with LCPD in various stages of the disease. METHODS This is a multicenter validity study. Patients with LCPD between 4 and 18 years old were included and classified into modified Waldenström stages of disease: Early (1 or 2A), Late (2B or 3), or Healed (4). Seven PROMIS domains were collected, including Pain Interference, Fatigue, Mobility, Depression, Anger, Anxiety, and Peer Relationships. Convergent, discriminant, and known group validity was determined. RESULTS A total of 190 patients were included (mean age: 10.4±3.1 y). All 7 domains showed the worst scores in patients in the Early stage (known group validity). Within each domain, all domains positively correlated to each other (convergent validity). Patients who reported more anxiety, depression, and anger were associated with decreased mobility and increased fatigue and pain. Peer relationships had no to weak associations with other domains (discriminant validity). CONCLUSIONS PROMIS has construct validity in measuring the HRQoL of patients in different stages of LCPD, suggesting that PROMIS has potential to serve as a patient-reported outcome tool for this population. LEVEL OF EVIDENCE Diagnostic level III study.
Collapse
|
19
|
Postural Stability and Regulation before and after High Tibial Osteotomy and Rehabilitation. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10186517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Knee osteoarthrosis (OA) is a widespread orthopedic problem and a high tibial osteotomy (HTO) is a common treatment to minimize degeneration of the affected compartment. The primary aim of this study was to evaluate the postural regulation and stability among patients who underwent HTO and rehabilitation. This prospective study included 32 patients (55.3 ± 5.57 years) diagnosed with medial tibiofemoral OA. Each subject completed postural regulation and stability testing (Interactive Balance System), as well as pain intensity (visual analogue scale) and quality of life questionnaires (SF-36) prior to HTO (exam 1), and at six weeks (exam 2), twelve weeks (exam 3) and six months (exam 4) post HTO. For postural comparison, all patients were matched (sex, age, height) with asymptomatic subjects. Significant time effects (exam 1 vs. exam 4) were found for weight distribution index (WDI; ηp2 = 0.152), mediolateral weight distribution ηp2 = 0.163) and anterior–posterior weight distribution ηp2 = 0.131). The largest difference (exam 3: ηp2 = 0.251) and the most significant differences to the matched sample were calculated for the stability indicator (exam 1: ηp2 = 0.237; exam 2: ηp2 = 0.215; exam 3: ηp2 = 0.251; exam 4: ηp2 = 0.229). Pain intensity showed a significant reduction (ηp2 = 0.438) from exam 1 (50.7 ± 20.0 mm) to exam 4 (19.3 ± 16.0 mm). Physical pain was the quality of life parameter with the largest improvement between exams 1 and 4 (ηp2 = 0.560). HTO allows patients to improve their mediolateral weight distribution, whereas postural stability is consistently lower than in asymptomatic subjects. This surgery leads to marked improvements in quality of life and pain.
Collapse
|
20
|
Spa therapy with physical rehabilitation is an alternative to usual spa therapy protocol in symptomatic knee osteoarthritis. Sci Rep 2020; 10:11004. [PMID: 32620866 PMCID: PMC7334225 DOI: 10.1038/s41598-020-67436-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 05/27/2020] [Indexed: 11/08/2022] Open
Abstract
The objective of the study was to demonstrate the non-inferiority of low-frequency spa therapy combined with rehabilitation (Spa-rehab) versus standard spa therapy at 6 months for symptomatic knee osteoarthritis (KOA). A prospective, randomized, monocenter, non-inferiority trial with recruitment of community-based symptomatic KOA patients was performed. Standard spa therapy comprised standardized spa treatment, 6 days a week for 3 weeks, and Spa-rehab therapy comprised spa sessions, 3 days a week for 3 weeks, followed by a dedicated rehabilitation program, 3 days a week for 3 weeks. The primary endpoint was achieving at 6 months a minimal clinically important improvement (MCII) for pain on a visual analog scale and/or an MCII for function on the WOMAC index and no knee surgery (composite MCII). Secondary endpoints were composite MCII at 3 months and achieving a Patient Acceptable Symptom State (PASS) for pain and function at 3 and 6 months. Among 283 patients included, 145 were allocated to standard spa therapy and 138 to Spa-rehab therapy. We could not demonstrate the non-inferiority of Spa-rehab therapy for the primary endpoint: difference for responders − 0.08 [90% CI (− 0.18 to 0.02), p = 0.14]. However, the difference test between the groups was not significant (p = 0.18). Spa-rehab therapy was not inferior to standard spa therapy for the composite MCII at 3 months or the PASS at 3 and 6 months. Spa-rehab therapy can reasonably be proposed to patients with symptomatic KOA. This protocol may be more cost-effective than standard spa therapy and avoid absenteeism from work and accommodation costs for patients who live close to a centre.
Collapse
|
21
|
Teissier V, Leclercq R, Schiano-Lomoriello S, Nizard R, Portier H. Does eccentric-concentric resistance training improve early functional outcomes compared to concentric resistance training after total knee arthroplasty? Gait Posture 2020; 79:145-151. [PMID: 32408038 DOI: 10.1016/j.gaitpost.2020.04.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/17/2020] [Accepted: 04/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Total knee arthroplasty (TKA) is the preferred surgical treatment of end stage osteoarthritis of the knee. However, up to 20% of patients are dissatisfied after TKA. Moreover, kinesiophobia is negatively correlated with functional outcomes. RESEARCH QUESTION The aim of this study was to compare the effects of combined concentric-eccentric versus concentric program on muscular strength assessment and quality of life, after total knee arthroplasty in elderly people. METHOD A prospective study including 20 subjects (72.1 ± 6.3 years), following a rehabilitation program after TKA was performed. Subjects were randomized in combined eccentricconcentric (ECC-CON, n = 10) versus concentric (CN, n = 10) early rehabilitation protocols. There were no significant differences between groups with respect to demographic data. Data were collected before and after protocol: performance-based physical function (timed up and go test, 10-meter walk test, isokinetic assessment), Selfreported physical function and quality of life (Lequesne-ISK, WOMAC, OAKHQOL) and kinesiophobia assessment (TSK-CF). The Gaussian distribution for the whole population of this study was tested by a Kolmogorov-Smirnov test. Statistical analysis was performed using non-parametric Mann-Whitney U or Fisher's exact probability test, as appropriate. RESULTS AND CONCLUSION Performance-based physical function tests showed a significant improvement after early rehabilitation in the ECC-CON group for timed up and go (p = 0.0002) and 10-meter walk test (p = 0.001). Operated hamstring muscle peak torque was significantly improved in the ECC-CON group (p = 0.03). Self-reported physical function and quality of life tests were significantly better in the ECC-CON group for ISK (p = 0.03) and WOMAC (p = 0.04). Self-reported kinesiophobia significantly decreased after rehabilitation in both groups (p = 0.01) whilst there were no differences between groups. Early combined eccentric-concentric rehabilitation after TKA appears to be associated with improved outcomes compared to classic concentric rehabilitation protocols, on both physical function and quality of life. This information is new. Assessment and care of kinesiophobia should be considered in rehabilitation protocols standards.
Collapse
Affiliation(s)
- Victoria Teissier
- Université Paris, Laboratoire de Biologie Bioingénierie et Bioimagerie Ostéo-Articulaire (B3OA), UMR CNRS 7052, INSERM U1273, 10 Av de Verdun, 75010, Paris, France; Department of Orthopaedic Surgery, Hospital Cochin, APHP, Université Paris 5, Paris, France.
| | | | - Sandrine Schiano-Lomoriello
- Université Orléans, CIAMS, 45067, Orléans, France; CIAMS, Université Paris-Sud, Université Paris-Saclay, 91405, Orsay Cedex, France.
| | - Rémy Nizard
- Université Paris, Laboratoire de Biologie Bioingénierie et Bioimagerie Ostéo-Articulaire (B3OA), UMR CNRS 7052, INSERM U1273, 10 Av de Verdun, 75010, Paris, France; 6-AP-HP, Hôpital Lariboisière, Service de chirurgie orthopédique, F-75010, Paris, France.
| | - Hugues Portier
- Université Paris, Laboratoire de Biologie Bioingénierie et Bioimagerie Ostéo-Articulaire (B3OA), UMR CNRS 7052, INSERM U1273, 10 Av de Verdun, 75010, Paris, France; Université d'Orléans, COST, 45100, Orléans, France.
| |
Collapse
|
22
|
Wieczorek M, Rotonda C, Coste J, Pouchot J, Saraux A, Guillemin F, Rat AC. Trajectory analysis combining pain and physical function in individuals with knee and hip osteoarthritis: results from the French KHOALA cohort. Rheumatology (Oxford) 2020; 59:3488-3498. [DOI: 10.1093/rheumatology/keaa148] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 02/13/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The aims of this study were to identify homogeneous subgroups of knee and/or hip OA patients with distinct trajectories of the combination of pain and physical function (PF) over time and to determine the baseline factors associated with these trajectories.
Methods
We used data from the Knee and Hip Osteoarthritis Long-term Assessment (KHOALA) cohort, a French population-based cohort of 878 patients with symptomatic knee and/or hip OA. Pain and PF were measured annually over 5 years with the Medical Outcomes Study Short Form 36 questionnaire. First, trajectory models were estimated with varying numbers of groups for each of the outcomes separately then fitted into a multi-trajectory model. We used multinomial logistic regression to determine the baseline characteristics associated with each trajectory.
Results
Univariate four-class models were identified as most appropriate for pain and PF. Comparison of separate trajectories showed that 41% of patients included in the severe functional limitations trajectory did not belong to the more severe pain trajectory (Cramér’s V statistic = 0.45). Group-based multi-trajectory modelling revealed four distinct trajectories of pain and PF. On multivariate analyses, female sex, older age, high Kellgren grade, low physical activity intensity, low psychosocial distress score (high distress) and low vitality score were associated with the more severe symptoms trajectory.
Conclusion
Over 5 years, we identified four distinct trajectories combining pain and PF. Management of weight, fatigue and psychosocial distress and the practice of physical activity seem important to maintain function and limit pain in patients with lower-limb OA.
Collapse
Affiliation(s)
| | | | - Joël Coste
- Biostatistics and Epidemiology Unit, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu, Paris
| | - Jacques Pouchot
- Department of Internal Medicine, Assistance Publique-Hôpitaux de Paris, European Georges Pompidou Hospital, Paris
| | - Alain Saraux
- Rheumatology Department, Centre National de Référence des Maladies Auto-Immunes Rares (CERAINO), Cavale Blanche University Hospital, Brest
- UMR 1227, Lymphocytes B et Autoimmunité, Université de Brest, Inserm, CHU, Brest, LabEx IGO, Brest
| | - Francis Guillemin
- EA4360 Apemac, Université de Lorraine, Nancy
- ICIC-1433 Epidémiologie Clinique, CHRU Nancy, Université de Lorraine, Inserm, Nancy
| | - Anne-Christine Rat
- EA4360 Apemac, Université de Lorraine, Nancy
- Department of Rheumatology, CHU Caen, Caen, France
| |
Collapse
|
23
|
Jin X, Antony B, Wang X, Persson MS, McAlindon T, Arden NK, Srivastava S, Srivastava R, Van Middelkoop M, Bierma-Zeinstra SM, Zhang W, Cicuttini F, Ding C. Effect of vitamin D supplementation on pain and physical function in patients with knee osteoarthritis (OA): an OA Trial Bank protocol for a systematic review and individual patient data (IPD) meta-analysis. BMJ Open 2020; 10:e035302. [PMID: 32332006 PMCID: PMC7204938 DOI: 10.1136/bmjopen-2019-035302] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Observational data suggest that vitamin D deficiency is associated with the onset and progression of knee osteoarthritis (OA). However, randomised controlled trials (RCTs) to date investigating the efficacy of vitamin D supplementation in knee OA have reported conflicting results. Further research is needed to clarify the effects of vitamin D on patient-reported outcomes and determine whether there are patient subgroups who may benefit from the supplementation. The aim of this individual patient data (IPD) meta-analysis is to identify patient-level predictors of treatment response to vitamin D supplementation on pain and physical function. METHODS AND ANALYSIS A systematic literature search will be conducted for RCTs of vitamin D supplementation on knee OA. Authors of original RCTs will be contacted to obtain the IPD. The primary outcomes will include long-term (≥12 months) pain and physical function. Secondary outcomes will include medium-term (≥6 months and <12 months) and short-term (<6 months) pain and physical function, as well as patient global assessment, quality of life and adverse events. Potential treatment effect modifiers to be examined in the subgroup analyses include age, gender, body mass index, baseline knee pain severity and physical function, baseline vitamin D level, radiographic stage, presence of bone marrow lesions on MRI, presence of clinical signs of local inflammation and concomitant depressive symptoms. Both one-step and two-step modelling methods will be used to determine the possible modifiable effect of each subgroup of interest. ETHICS AND DISSEMINATION Research ethical or governance approval is exempt for this study as no new data are being collected. This study will be the first IPD meta-analysis to clarify the effect of vitamin D supplementation on clinical symptoms in different subgroups of patients with knee OA. The findings will be disseminated through peer-review publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42018107740.
Collapse
Affiliation(s)
- Xingzhong Jin
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Benny Antony
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Xia Wang
- Institute of Bone and Joint Research, The University of Sydney, Sydney, New South Wales, Australia
| | - Monica Sm Persson
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, United Kingdom
| | | | - Nigel K Arden
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Shouthampton, Southampton, United Kingdom
| | - Sudeepti Srivastava
- Department of Orthopaedic Surgery, King George's Medical University, Lucknow, India
| | - Rajeshwar Srivastava
- Department of Orthopaedic Surgery, King George's Medical University, Lucknow, India
| | - Marienke Van Middelkoop
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Sita Ma Bierma-Zeinstra
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Weiya Zhang
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, United Kingdom
| | - Flavia Cicuttini
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Changhai Ding
- Zhujiang Hospital, Southern Medical University, Guangzhou, China
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
24
|
Reliability of a specific questionnaire to evaluate quality of life in people with osteoarthritis. ACTA ACUST UNITED AC 2019; 17:279-283. [PMID: 31707093 DOI: 10.1016/j.reuma.2019.08.005] [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: 04/30/2019] [Revised: 07/28/2019] [Accepted: 08/07/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The aim of this study was to determine the reliability of The Osteoarthritis Knee and Hip Quality of Life questionnaire in a Columbian older adult population with knee and hip osteoarthritis. METHODS The methodological approach of this study was quantitative, with a cross-sectional design. Respondents completed the questionnaire with a period of 5 to 8 days between measurements. The psychometric properties of reproducibility, internal consistency and level of agreement of the questionnaire were determined using the intraclass correlation coefficient, Cronbach's alpha coefficient and Bland-Altman graphical analysis, respectively. RESULTS Sixty-two older adults with osteoarthritis of the knee and hip aged between 57 and 82 responded to the questionnaire. Almost perfect reproducibility (CCI=.89) was found for the domain of physical activity, and substantial reproducibility (CCI=.62-.77) for the domains of pain, mental health and activities. A very satisfactory internal consistency was also obtained for the domains of mental health and physical activity (alpha=.90-.94), while that for pain was adequate (alpha=.89). As soon as the level of agreement was established, the mean of the differences in the domains of physical activity, main and mental health was -7.0, -8.0 and -6.9 points, respectively. DISCUSSION AND CONCLUSIONS The Osteoarthritis Knee and Hip Quality of Life questionnaire showed good psychometric properties principally in the domains of physical activity, pain and mental health. This questionnaire can be used in the clinical setting, but requires adjustment to be used in research.
Collapse
|
25
|
Choojaturo S, Sindhu S, Utriyaprasit K, Viwatwongkasem C. Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study. BMC Health Serv Res 2019; 19:688. [PMID: 31604433 PMCID: PMC6788102 DOI: 10.1186/s12913-019-4441-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/20/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The main purpose of health service systems is to improve patients' quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. METHODS A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. RESULTS The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = -.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). CONCLUSIONS This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient's background, such as socioeconomic status, disease severity, and self-management skills.
Collapse
Affiliation(s)
- Siriwan Choojaturo
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand.,Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
| | - Siriorn Sindhu
- Mahidol University, Faculty of Nursing, 2 Wang Lang Road, Siriraj, Bangkoknoi, Bangkok, 10700, Thailand.
| | - Ketsarin Utriyaprasit
- Department of Surgical Nursing, Faculty of Nursing, Mahidol University, Bangkok, 10700, Thailand
| | - Chukiat Viwatwongkasem
- Department of Biostatistics, Faculty of Public Health, Mahidol University, Bangkok, 10400, Thailand
| |
Collapse
|
26
|
Pehlivan S, Karadakovan A. Effects of aromatherapy massage on pain, functional state, and quality of life in an elderly individual with knee osteoarthritis. Jpn J Nurs Sci 2019; 16:450-458. [DOI: 10.1111/jjns.12254] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 11/29/2018] [Accepted: 12/20/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Seda Pehlivan
- Health Science Faculty, Department of NursingBursa Uludag University Bursa Turkey
| | - Ayfer Karadakovan
- Nursing Faculty, Nursing of Internal MedicineEge University İzmir Turkey
| |
Collapse
|
27
|
Osteoarthritis knee hip quality of life questionnaire assessment in Egyptian primary knee osteoarthritis patients: Relation to clinical and radiographic parameters. THE EGYPTIAN RHEUMATOLOGIST 2019. [DOI: 10.1016/j.ejr.2018.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
28
|
Adaptation and Validation of the Malay Version of the Osteoarthritis Knee and Hip Quality of Life Questionnaire among Knee Osteoarthritis Patients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:4329751. [PMID: 29955601 PMCID: PMC6000845 DOI: 10.1155/2018/4329751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/16/2018] [Accepted: 02/13/2018] [Indexed: 11/18/2022]
Abstract
Objective To adapt and validate the Malay version of Osteoarthritis Knee and Hip Quality of Life (OAKHQOL) questionnaire. Design The OAKHQOL was adapted into Malay version using forward-backward translation methodology. It was then validated in a cross-sectional study of 191 patients with knee osteoarthritis (OA). Patients completed the OAKHQOL and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Confirmatory analysis, reliability analysis, and Pearson correlation test were performed. Results The new five-factor model of 28 items demonstrated an acceptable level of goodness of fit (comparative fit index = 0.915, Tucker-Lewis index = 0.905, incremental fit index = 0.916, chi-squared/degree of freedom = 1.953, and root mean square error of approximation = 0.071), signifying a fit model. The Cronbach's alpha value and the composite reliability of each construct ranged from 0.865 to 0.933 and 0.819 to 0.921, respectively. The Pearson correlation coefficient between the OAKHQOL and the WOMAC showed adequate criterion validity. Known groups validity showed statistical difference in body mass index in physical activity, mental health, and pain construct. The pain domain was statistically different between the age groups. Conclusion The Malay version OAKHQOL questionnaire is a valid and reliable instrument to assess health-related quality of life in knee OA patients.
Collapse
|
29
|
Wieczorek M, Rotonda C, Epstein J, Guillemin F, Rat AC. Can the e-OAKHQOL be an alternative to measure health-related quality of life in knee osteoarthritis? Qual Life Res 2018; 27:2731-2743. [PMID: 29948602 DOI: 10.1007/s11136-018-1914-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Abstract
OBJECTIVE To assess the validity of the e-OAKHQOL questionnaire and analyze whether the answers were affected by the form of administration (electronic vs. paper). METHODS Two samples of patients with knee osteoarthritis were constituted. The first was recruited by general practitioners. Patients could choose to respond to the electronic or paper version. The second included subjects who responded to the paper version and were matched with respondents to the electronic version in the first sample. The OAKHQOL questionnaire measures health-related quality of life in five dimensions (43 items): physical activity, mental health, pain, social functioning, and social support. Validity was assessed by the classical test theory (CTT) and a Rasch measurement model (partial credit model). RESULTS The electronic form was preferred by 471 (89.7%) patients: 345 were matched to respondents of the paper version. The percentage of missing responses was lower with the electronic than paper form (1.6 vs. 2.0%, p = .01). Rasch analysis revealed four items with underfitting. Internal consistency was excellent for physical activity (PSI = 0.96) and mental health (PSI = 0.93) but was slightly < 0.85 for the other dimensions. The top-down purification highlighted the significance of DIF by gender in the pain dimension and by form of questionnaire in the mental health dimension. CONCLUSION CTT and Rasch analysis demonstrated acceptable measurement properties for the five dimensions of the e-OAKHQOL, so it may be a valuable alternative to the paper form for measuring HRQoL.
Collapse
Affiliation(s)
- Maud Wieczorek
- EA4360 Apemac, University of Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France. .,CIC-1433 Epidémiologie Clinique, Inserm, Hôpitaux de Brabois, Allée du Morvan, 54500, Vandœuvre-lès-Nancy, France.
| | - Christine Rotonda
- EA4360 Apemac, University of Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.,CIC-1433 Epidémiologie Clinique, Inserm, Hôpitaux de Brabois, Allée du Morvan, 54500, Vandœuvre-lès-Nancy, France
| | - Jonathan Epstein
- EA4360 Apemac, University of Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.,CIC-1433 Epidémiologie Clinique, Inserm, Hôpitaux de Brabois, Allée du Morvan, 54500, Vandœuvre-lès-Nancy, France
| | - Francis Guillemin
- EA4360 Apemac, University of Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.,CIC-1433 Epidémiologie Clinique, Inserm, Hôpitaux de Brabois, Allée du Morvan, 54500, Vandœuvre-lès-Nancy, France
| | - Anne-Christine Rat
- EA4360 Apemac, University of Lorraine, 9 avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.,Department of Rheumatology, CHRU Nancy, Allée du Morvan, 54500, Vandoeuvre-lès-Nancy, France
| |
Collapse
|
30
|
Quality of life assessment in musculo-skeletal health. Aging Clin Exp Res 2018; 30:413-418. [PMID: 28664458 DOI: 10.1007/s40520-017-0794-8] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/23/2017] [Indexed: 12/18/2022]
Abstract
Musculoskeletal disorders affect morbidity, quality of life and mortality, and represent an increasing economic and societal burden in the context of population aging and increased life expectancy. Improvement of quality of life should be one of the priorities of any interventions to prevent and treat musculoskeletal disorders in the ageing population. Two main approaches, namely generic and disease-specific instruments, can be applied to measure health-related quality of life. Among the generic tools available in scientific literature, the short form 36 questionnaire (SF-36) and the Euroqol five item questionnaire (EQ-5D) are two of the most popular questionnaires used to quantify the health related quality of life in people with musculoskeletal disorders. However, because generic tools may not always be able to detect subtle effects of a specific condition on quality of life, a specific tool is highly valuable. Specific tools improve the ability to clinically characterize quality of life in subjects with a specific musculoskeletal disorder, as well as the capacity to assess changes over time in the QoL of these subjects. The recent development of specific tools should help to validate preventive and therapeutic interventions in this field.
Collapse
|
31
|
Detecting functional change in response to exercise in knee osteoarthritis: a comparison of two computerized adaptive tests. BMC Musculoskelet Disord 2018; 19:29. [PMID: 29361920 PMCID: PMC5782393 DOI: 10.1186/s12891-018-1942-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 01/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background The intent of this study was to examine and compare the ability to detect change of two patient reported outcome (PRO) instruments that use a computerized adaptive test (CAT) approach to measurement. The Patient Reported Outcomes Measurement Information System (PROMIS®) Physical Function scale is a generic PRO, while the Osteoarthritis Computerized Adaptive Test (OA-CAT) is an osteoarthritis-specific PRO. Methods This descriptive, longitudinal study was conducted in a community setting, involving individuals from the greater Boston area. Inclusion criteria: age > 50, self-reported doctor-diagnosed knee osteoarthritis (OA) and knee pain. The PROMIS® Physical Function CAT and OA-CAT Functional Difficulty scale were administered at baseline and at the conclusion of a 6-week exercise program. Effect sizes (ES) were calculated for both measures, and bootstrap methods were used to construct confidence intervals and to test for significant ES differences between the measures. Results The OA-CAT Functional Difficulty scale achieved an ES of 0.62 (0.43, 0.87) compared to the PROMIS® Physical Function CAT ES of 0.42 (0.24, 0.63). ES estimates for the two CAT measures were not statistically different. Conclusions The condition-specific OA-CAT and generic PROMIS® Physical Function CAT both demonstrated the ability to detect change in function. While the OA-CAT scale showed larger effect size, no statistically significant difference was found in the effect size estimates for the generic and condition-specific CATs. Both CATs have potential for use in arthritis research. Trial registration This trial is registered with ClinicalTrials.gov on 6/21/11 (Identifier NCT01394874)
Collapse
|
32
|
Gagnier JJ, Huang H, Mullins M, Marinac-Dabić D, Ghambaryan A, Eloff B, Mirza F, Bayona M. Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Hip Arthroplasty. JBJS Rev 2018; 6:e2. [DOI: 10.2106/jbjs.rvw.17.00038] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
33
|
Rodríguez-Grande EI, Osma-Rueda JL, Serrano-Villar Y, Ramírez C. Effects of pulsed therapeutic ultrasound on the treatment of people with knee osteoarthritis. J Phys Ther Sci 2017; 29:1637-1643. [PMID: 28932004 PMCID: PMC5599837 DOI: 10.1589/jpts.29.1637] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Accepted: 06/15/2017] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim was to evaluate the effect of therapeutic ultrasound on the pain, joint mobility, muscle strength, physical function, and quality of life of people with knee OA. [Subjects and Methods] One-site, one-arm, before-after study that included people with Grade II or III tibiofemoral osteoarthritis. Ten therapeutic ultrasound sessions (duty cycle=20%, ERA=10 cm2, BNR=6:1, SATP=2.2 W/cm2, SATA=0.44 W/cm2, frequency=1 MHz, time=4 minutes) were applied. Assessments of primary outcome variables: pain intensity and function, and secondary variables: joint mobility, muscle strength and quality of life, were performed at onset and end of therapy; an additional intermediate evaluation was included for the primary variables. [Results] Means of repeated measurements of pain intensity (pain at rest, pain on palpation and pain after functional activities) and function showed significant differences. There was a significant reduction in pain intensity at the end of functional activities as well as a significant increase in function and in quadriceps muscle strength. [Conclusion] Therapeutic ultrasound applied in accordance with the parameters used, could be recommended during the treatment of individuals with knee osteoarthritis, because it significantly decreased the intensity of pain after the 5th session, and this reduction was maintained until the end of the intervention.
Collapse
Affiliation(s)
- Eliana-Isabel Rodríguez-Grande
- Universidad del Rosario, Escuela de Medicina y Ciencias de la Salud, GI Ciencias de la Rehabilitación: Bogota, Cundinamarca, Colombia
| | - Jose-Luis Osma-Rueda
- Department of Surgery and Orthopedics, School of Medicine, Universidad Industrial de Santander, Colombia
| | | | - Carolina Ramírez
- School of Physiotherapy, Universidad Industrial de Santander, Colombia
| |
Collapse
|
34
|
Ruiz Iban M, Tejedor A, Gil Garay E, Revenga C, Hermosa J, Montfort J, Peña M, López Millán J, Montero Matamala A, Capa Grasa A, Navarro M, Gobbo M, Loza E. GEDOS-SECOT consensus on the care process of patients with knee osteoarthritis and arthoplasty. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017. [DOI: 10.1016/j.recote.2017.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
35
|
Ruiz Iban MA, Tejedor A, Gil Garay E, Revenga C, Hermosa JC, Montfort J, Peña MJ, López Millán JM, Montero Matamala A, Capa Grasa A, Navarro MJ, Gobbo M, Loza E. GEDOS-SECOT consensus on the care process of patients with knee osteoarthritis and arthoplasty. Rev Esp Cir Ortop Traumatol (Engl Ed) 2017; 61:296-312. [PMID: 28689784 DOI: 10.1016/j.recot.2017.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/21/2017] [Accepted: 03/27/2017] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To develop recommendations on the evaluation and management procedure in patients undergoing total knee replacement based on best evidence and the experience of a panel of experts. METHODS A multidisciplinary group of 12 experts was selected that defined the scope, users and the document parts. Three systematic reviews were performed in patients undergoing knee replacement: (i)efficacy and safety of fast-tracks; (ii)efficacy and safety of cognitive interventions in patients with catastrophic pain, and (iii) efficacy and safety of acute post-surgical pain management on post-surgical outcomes. A narrative review was conducted on the evaluation and management of pain sensitization, and about the efficacy and safety of pre-surgical physiotherapy. The experts generated the recommendations and explicative text. The level of agreement was evaluated in a multidisciplinary group of 85 experts with the Delphi technique. The level of evidence was established as well for each recommendation. RESULTS A total of 20 recommendations were produced. An agreement higher than 80% was reached in all of them. We found the highest agreement on the need for a full discharge report, on providing proper information about the process and on following available guidelines. CONCLUSIONS There is consensus among professionals involved in the management of patients undergoing total knee replacement, in that it is important to protocolize the replacement process, performing a proper, integrated and coordinated patient evaluation and follow-up, paying special attention to the surgical procedure and postoperative period.
Collapse
Affiliation(s)
- M A Ruiz Iban
- Servicio Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España
| | - A Tejedor
- Especialista en Medicina Familiar y Comunitaria, CS Las Ciudades, Getafe, Madrid, España
| | - E Gil Garay
- Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario La Paz, Madrid, España
| | - C Revenga
- Servicio de Traumatología y Cirugía Ortopédica, Hospital San Juan Grande, Jerez de la Frontera, Cádiz, España
| | - J C Hermosa
- Especialista en Medicina Familiar y Comunitaria, CS Las Ciudades, Getafe, Madrid, España
| | - J Montfort
- Servicio de Reumatología, Hospital del Mar, Barcelona, España
| | - M J Peña
- Responsable de Enfermería de Atención Primaria del sector II, Zaragoza, España
| | - J M López Millán
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitario Virgen Macarena, Sevilla, España
| | - A Montero Matamala
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Universitari Arnau de Vilanova, Lleida, España
| | - A Capa Grasa
- Servicio de Medicina Física y Rehabilitación Médica, Hospital Universitario La Paz, Madrid, España
| | - M J Navarro
- Servicio de Medicina Física y Rehabilitación Médica, Hospital Universitario Doctor Peset, Valencia, España
| | - M Gobbo
- Positivamente Centro de Psicología, Madrid, España
| | - E Loza
- Instituto de Salud Musculoesquelética, Madrid, España.
| |
Collapse
|
36
|
A Systematic Review of Measurement Properties of Patient-Reported Outcome Measures Used in Patients Undergoing Total Knee Arthroplasty. J Arthroplasty 2017; 32:1688-1697.e7. [PMID: 28162839 DOI: 10.1016/j.arth.2016.12.052] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/15/2016] [Accepted: 12/27/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND While clinical research on total knee arthroplasty (TKA) outcomes is prevalent in the literature, studies often have poor methodological and reporting quality. A high-quality patient-reported outcome instrument is reliable, valid, and responsive. Many studies evaluate these properties, but none have done so with a systematic and accepted method. The objectives of this study were to identify patient-reported outcome measures (PROMs) for TKA, and to critically appraise, compare, and summarize their psychometric properties using accepted methods. METHODS MEDLINE, EMBASE, SCOPUS, Web of Science, PsycINFO, and SPORTDiscus were systematically searched for articles with the following inclusion criteria: publication before December 2014, English language, non-generic PRO, and evaluation in the TKA population. Methodological quality and evidence of psychometric properties were assessed with the COnsensus-based standards for the selection of health Status Measurement INstruments (COSMIN) checklist and criteria for psychometric evidence proposed by the COSMIN group and Terwee et al. RESULTS One-hundred fifteen studies on 32 PROMs were included in this review. Only the Work, Osteoarthritis or joint-Replacement Questionnaire, the Oxford Knee Score, and the Western Ontario and McMaster Universities Arthritis Index had 4 or more properties with positive evidence. CONCLUSION Most TKA PROMs have limited evidence for their psychometric properties. Although not all the properties were studied, the Work, Osteoarthritis or joint-Replacement Questionnaire, with the highest overall ratings, could be a useful PROM for evaluating patients undergoing TKA. The methods and reporting of this literature can improve by following accepted guidelines.
Collapse
|
37
|
Validation of the Mini-OAKHQOL for use in patients with osteoarthritis in Spain. Clin Rheumatol 2017; 36:1855-1864. [PMID: 28353088 DOI: 10.1007/s10067-017-3611-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/08/2017] [Accepted: 03/19/2017] [Indexed: 10/19/2022]
Abstract
The Mini-Osteoarthritis Knee and Hip Quality of Life (Mini-OAKHQOL) questionnaire osteoarthritis is specific to individuals with knee or hip osteoarthritis. The objective of this study was to perform a validation of the Mini-OAKHQOL for use in Spain in terms of its psychometric properties of reliability, validity and responsiveness. Patients with osteoarthritis from the waiting list for a joint replacement completed the OAKHQOL, Short Form 36 Health Survey and Western Ontario and McMaster Universities Osteoarthritis Index. Reliability was assessed in terms of internal consistency and test-retest data, and convergent validity using Spearman's correlation coefficient. Structural validity was investigated by confirmatory factor analysis, and Rasch analysis was used to examine the unidimensionality of the scales. Responsiveness was assessed by calculating effect sizes. Confirmatory factor analysis confirmed the five-factor model, and the results of the Rasch analyses supported the unidimensionality assumption, with infit and outfit statistics. Cronbach's alpha ranged from 0.76 to 0.89 for all except the social dimensions. Statistically significant differences were observed between patients with different degrees of disease severity on all dimensions. There was convergent validity among dimensions expected to be correlated. The OAKHQOL questionnaire showed good responsiveness, with large changes for all dimensions apart from the two social dimensions, which had small effect sizes. Results of the study support the view that the Spanish version of the Mini-OAKHQOL questionnaire is a valid instrument to measure health-related quality of life in patients with osteoarthritis of the lower limb.
Collapse
|
38
|
Renaudin L, Guillemin F, Pouchot J, Rat AC. The presence of cardiovascular disease does not modify the weak impact obesity has on health-related quality of life in patients with hip osteoarthritis in the KHOALA cohort. Joint Bone Spine 2017; 85:233-238. [PMID: 28242173 DOI: 10.1016/j.jbspin.2017.02.006] [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: 09/02/2016] [Accepted: 02/01/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE In people with hip osteoarthritis (OA), the impact of obesity on health-related quality of life (HRQoL) remains unknown. Also whether cardiovascular conditions can modify the obesity-HRQoL relation has not been explored. We aimed to (1) study the cross-sectional relationship between body mass index (BMI) and HRQoL in symptomatic hip OA patients and determine whether cardiovascular comorbidity modifies this relationship and (2) examine the impact of BMI on the course of HRQoL over time. METHODS We used data from the first 3 years of follow-up from the KHOALA study, which recruited patients from 2007 to 2009. HRQoL was assessed by the SF-36 and OAKHQOL questionnaires at baseline and during follow-up. We determined BMI and presence of cardiovascular disease by the Groll score. Associated factors at baseline and predictors of HRQoL over time were evaluated by multiple linear regression. RESULTS For 222 hip OA patients included, mean (SD) BMI was 26.9 (4.4) kg/m2; 37 (17.1%) had at least one cardiovascular comorbidity. Increased BMI but not presence of cardiovascular comorbidity was associated with poor HRQoL. Increased BMI affected mainly physical and social HRQoL dimensions (up to -1.0 points, 95% CI [-1.6;-0.4]; P=0.002). The BMI-HRQoL relationship was not modified by the presence of cardiovascular disease. BMI was not associated with the course of HRQoL. CONCLUSION In patients with hip OA, BMI had an independent weak negative impact on HRQoL that was not modified by cardiovascular comorbidities. Neither of these factors affected HRQoL change during a 3-year follow-up.
Collapse
Affiliation(s)
- Laurie Renaudin
- INSERM, CIC-EC 1433, 54000 Nancy, France; Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France
| | - Francis Guillemin
- INSERM, CIC-EC 1433, 54000 Nancy, France; Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France
| | - Jacques Pouchot
- Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France; Assistance publique-Hôpitaux de Paris, hôpital européen Georges-Pompidou, Department of internal medicine, 75015 Paris, France
| | - Anne-Christine Rat
- INSERM, CIC-EC 1433, 54000 Nancy, France; Université de Lorraine, Paris Descartes University, EA 4360 Apemac, 54500 Nancy, France; CHRU Brabois, Rheumatology Department, 54500 Nancy, France.
| |
Collapse
|
39
|
Henry BM, Wrażeń W, Hynnekleiv L, Kłosiński M, Pękała PA, Kucharska E, Golec EB, Tomaszewski KA, Pąchalska M. Health-Related Quality-of-Life and Functional Outcomes in Short-Stem Versus Standard-Stem Total Hip Arthroplasty: An 18-Month Follow-Up Cohort Study. Med Sci Monit 2016; 22:4406-4414. [PMID: 27853130 PMCID: PMC5123780 DOI: 10.12659/msm.900610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Osteoarthritis (OA) progressively produces symptoms and disability that may significantly reduce health-related quality of life (HRQoL). Total hip arthroplasty (THA) is an important treatment for symptomatic OA. An alternative to standard-stem THA for younger patients is short-stem THA. The aim of this study was to investigate potential HRQoL and functional outcome differences between these patient groups to provide additional data that will be clinically useful in the decision making between the types of prosthesis. MATERIAL AND METHODS In an 18-month follow-up longitudinal cohort study, we conducted Harris Hip Score (HHS) evaluations and SF-36 questionnaires in a study group and a control group undergoing short-stem and standard-stem THA preoperatively and during follow-up at 1, 3, 6, 12, and 18 months. Effect size was calculated to estimate the size of changes in scores during follow-up between chosen time intervals. RESULTS A total of 168 patients were included in the study. The total HHS score was significantly increased postoperatively from 46.9 to 87.0 in the standard-stem group, and from 42.7 to 85.1 in the short-stem group. All SF-36 scores improved after THA in both groups. No HRQoL or functional differences were found in the use of either surgical option in the HHS or SF-36 score results (all p>0.05). CONCLUSIONS As there were no differences in HRQoL in the two groups, we strongly recommend considering short-stem THA, especially in younger patients, due to the benefit of future revision options and a minimally invasive approach.
Collapse
Affiliation(s)
| | - Waldemar Wrażeń
- Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital in Cracow, Cracow, Poland
| | - Leif Hynnekleiv
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Michał Kłosiński
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Przemysław A Pękała
- Department of Anatomy, Jagiellonian University Medical College, Cracow, Poland
| | - Ewa Kucharska
- Department of Gerontology, Geriatrics and Social Work, Ignatianum Academy, Cracow, Poland
| | - Edward B Golec
- Department of Orthopaedics and Trauma Surgery, 5th Military Clinical Hospital in Cracow, Cracow, Poland
| | | | - Maria Pąchalska
- Department of Neuropsychology, Andrzej Frycz-Modrzewski Cracow University, Cracow, Poland
| |
Collapse
|
40
|
Development and preliminary evaluation of the OsteoArthritis Questionnaire (OA-Quest): a psychometric study. Osteoarthritis Cartilage 2016; 24:1357-66. [PMID: 27038491 DOI: 10.1016/j.joca.2016.03.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 03/11/2016] [Accepted: 03/22/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE This study reports the development of the OsteoArthritis Questionnaire (OA-Quest) - a new measure designed to comprehensively capture the potentially modifiable burden of osteoarthritis. DESIGN Item development was guided by the a priori conceptual framework of the Personal Burden of Osteoarthritis (PBO) which captures 8 dimensions of osteoarthritis burden (Physical distress, Fatigue, Physical limitations, Psychosocial distress, Physical de-conditioning, Financial hardship, Sleep disturbances, Lost productivity). One hundred and twenty three candidate items were pretested in a clinical sample of 18 osteoarthritis patients. The measurement properties of the OA-Quest were assessed with exploratory factor analysis (EFA), Rasch modelling, and confirmatory factor analysis (CFA) in a community-based sample (n = 792). RESULTS EFA replicated 7 of the 8 PBO domains. An exception was PBO Fatigue domain, with items merging into the Physical distress subscale in the OA-Quest. Following item analysis, a 42-item 7-subscale questionnaire was constructed, measuring Physical distress (seven items, Cronbach's α = 0.93), Physical limitations (11 items, α = 0.95), Psychosocial distress (seven items, α = 0.93), Physical de-conditioning (four items, α = 0.87), Financial hardship (four items, α = 0.93), Sleep disturbances (five items, α = 0.96), and Lost productivity (four items α = 0.90). A highly restricted 7-factor CFA model had excellent fit with the data (χ(2)(113) = 316.36, P < 0.001; chi-square/degrees of freedom = 2.8; comparative fit index [CFI] = 0.97; root mean square error of approximation [RMSEA] = 0.07), supporting construct validity of the new measure. CONCLUSIONS The OA-Quest is a new measure of osteoarthritis burden that is founded on a comprehensive conceptual model. It has strong evidence of construct validity and provides reliable measurement across a broad range of osteoarthritis burden.
Collapse
|
41
|
Clerehan R, Guillemin F, Epstein J, Buchbinder R. Using the Evaluative Linguistic Framework for Questionnaires to Assess Comprehensibility of Self-Report Health Questionnaires. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2016; 19:335-342. [PMID: 27325325 DOI: 10.1016/j.jval.2016.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 01/06/2016] [Accepted: 01/17/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The Evaluative Linguistic Framework (ELF) was developed to judge the quality of health care texts for patients, based on systemic functional linguistic theory. This approach considers key variables such as context and structure, known to be important for communication. OBJECTIVE Our objective was to adapt the ELF to evaluate the quality of self-report questionnaires. METHODS We reviewed the Health Literacy Questionnaire using the ELF. On the basis of these data, we drafted the preliminary version of the Evaluative Linguistic Framework for Questionnaires (ELF-Q) and applied it to English- and French-language versions of two arthritis self-report questionnaires and to Spanish, Dutch, and Turkish versions of an arthritis questionnaire. RESULTS The developed ELF-Q was found to be effective for evaluating questionnaires in English and in four other languages. It contains nine items with new descriptions and assessment probes. These include overall organizational or generic structure of the questionnaire, metadiscourse (or text about the text), headings, rhetorical elements (function of each "move" or stage of the text in relation to the reader), the writer-reader relationship, technicality of vocabulary, lexical density (proportion of content words in the text), format, and overall judgment. We added assessment responses on a two- or three-point Likert scale to complement the assessment probes and make the intent and meaning of the probes fully explicit for the questionnaire developer or assessor. CONCLUSIONS The ELF-Q is a framework practical to use for the development or assessment of any type of self-report questionnaire. Its application can identify features of a self-report questionnaire that could be improved to optimize its comprehensibility.
Collapse
Affiliation(s)
- Rosemary Clerehan
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Francis Guillemin
- Faculty of Medicine, University of Lorraine, Vandoeuvre-les-Nancy, France
| | - Jonathan Epstein
- Faculty of Medicine, University of Lorraine, Vandoeuvre-les-Nancy, France
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| |
Collapse
|
42
|
Che H, Roux C, Etcheto A, Rothenbuhler A, Kamenicky P, Linglart A, Briot K. Impaired quality of life in adults with X-linked hypophosphatemia and skeletal symptoms. Eur J Endocrinol 2016; 174:325-33. [PMID: 26783348 DOI: 10.1530/eje-15-0661] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Adults with X-linked hypophosphatemia (XLH) may suffer from skeletal symptoms leading to functional disability. No data on their quality of life (QoL) have been reported so far. Our objectives were to evaluate the QoL and its determinants in XLH adults. PATIENTS AND METHODS We conducted a prospective study in XLH adults, who consulted for musculoskeletal symptoms between 2013 and 2014. We assessed their QoL using HAQ, RAPID3 and SF36, and analysed the variables associated with low QoL. We compared their QoL to that of patients affected with axial spondyloarthritis (ax-SpA) (paired on age and gender), a rheumatologic disorder with a known low QoL. RESULTS Fifty-two XLH adults (37 women (71.1%); mean age 41.8±13.3 years) were included; 44 (84.6%) patients had an altered QoL. Increased age and presence of structural lesions were significantly associated with worse QoL (HAQ, RAPID3) (P<0.05). Presence of enthesopathies was significantly associated with worse RAPID3 (OR=4.45 (1.09-18.29), P=0.038). Treatment with phosphate supplements and vitamin D in XLH adults were significantly associated with a better SF36-mental component score (OR=0.14 (0.03-0.57), P=0.007 and OR=0.26 (0.07-0.98), P=0.047 respectively). QoL was significantly worse in XLH than in ax-SpA adults (VAS pain, SF36-PCS, RAPID3) (P<0.05). CONCLUSION Our study showed i) QoL of XLH adults is altered and significantly worse than that of ax-SpA patients (VAS pain, SF36-PCS and RAPID3), ii) structural lesions and especially enthesopathies are associated with a worse QoL and iii) treatment using phosphate supplements and/or vitamin D is associated with a better mental health score.
Collapse
MESH Headings
- Adult
- Case-Control Studies
- Cohort Studies
- Familial Hypophosphatemic Rickets/diagnostic imaging
- Familial Hypophosphatemic Rickets/epidemiology
- Familial Hypophosphatemic Rickets/physiopathology
- Female
- Fractures, Bone/diagnostic imaging
- Fractures, Bone/epidemiology
- Fractures, Bone/physiopathology
- Genetic Diseases, X-Linked/diagnostic imaging
- Genetic Diseases, X-Linked/epidemiology
- Genetic Diseases, X-Linked/physiopathology
- Humans
- Male
- Middle Aged
- Osteoarthritis/diagnostic imaging
- Osteoarthritis/epidemiology
- Osteoarthritis/physiopathology
- Osteoarthritis, Hip/diagnostic imaging
- Osteoarthritis, Hip/epidemiology
- Osteoarthritis, Hip/physiopathology
- Osteoarthritis, Knee/diagnostic imaging
- Osteoarthritis, Knee/epidemiology
- Osteoarthritis, Knee/physiopathology
- Osteoarthritis, Spine/diagnostic imaging
- Osteoarthritis, Spine/epidemiology
- Osteoarthritis, Spine/physiopathology
- Prospective Studies
- Quality of Life
- Radiography
- Rheumatic Diseases/diagnostic imaging
- Rheumatic Diseases/epidemiology
- Spondylarthritis/diagnostic imaging
- Spondylarthritis/epidemiology
- Spondylarthritis/physiopathology
- Spondylarthropathies/diagnostic imaging
- Spondylarthropathies/epidemiology
- Spondylarthropathies/physiopathology
Collapse
Affiliation(s)
- Hélène Che
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Christian Roux
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Adrien Etcheto
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Anya Rothenbuhler
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Peter Kamenicky
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Agnès Linglart
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| | - Karine Briot
- Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France Department of RheumatologyFrench Reference Center for Genetic Bone Diseases, Cochin Hospital, Assistance Publique- Hôpitaux de Paris, 27 rue du Faubourg Saint Jacques, 75014 Paris, FranceINSERM U1153Paris, FranceParis-Descartes UniversityParis, FranceINSERM U1169Paris Sud University, Assistance Publique- Hôpitaux de Paris, French Reference Center for Rare Disorders of the Mineral Metabolism, Department of Endocrinology and Diabetology for Children, Bicêtre Hospital, 78 rue du Général Leclerc, 94270 Le Kremlin Bicêtre, France
| |
Collapse
|
43
|
Wiering B, de Boer D, Delnoij D. Patient involvement in the development of patient-reported outcome measures: a scoping review. Health Expect 2016; 20:11-23. [PMID: 26889874 PMCID: PMC5217930 DOI: 10.1111/hex.12442] [Citation(s) in RCA: 175] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 02/06/2023] Open
Abstract
Background Patient‐reported outcome measures (PROMs) measure patients’ perspectives on health outcomes and are increasingly used in health care. To capture the patient's perspective, it is essential that patients are involved in PROM development Objective This article reviews in what ways and to what extent patients are involved in PROM development and whether patient involvement has increased over time. Search strategy Literature was searched in PubMed, EMBASE, MEDLINE and the Cochrane Methodology Register. Inclusion criteria Studies were included if they described a new PROM development. Data extraction Basic information and information regarding patient involvement in development phases was recorded. Main results A total of 189 studies, describing the development of 193 PROMs, were included. Most PROMs were meant for chronic disease patients (n = 59) and measured quality of life (n = 28). In 25.9% of the PROM development studies, no patients were involved. Patients were mostly involved during item development (58.5%), closely followed by testing for comprehensibility (50.8%), while patient involvement in determining which outcome to measure was minimal (10.9%). Some patient involvement took place in the development of most PROMs, but in only 6.7% patients were involved in all aspects of the development. Patient involvement did not increase with time. Conclusions Although patient involvement in PROM development is essential to develop valid patient‐centred PROMs, patients are not always involved. When patients are involved, their level of involvement varies considerably. These variations suggest that further attention to building and/or disseminating consensus on requirements for patient involvement in PROM development is necessary.
Collapse
Affiliation(s)
- Bianca Wiering
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, Tilburg, The Netherlands
| | - Dolf de Boer
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Diana Delnoij
- Tranzo (Scientific Centre for Transformation in Care and Welfare), Tilburg University, Tilburg, The Netherlands
| |
Collapse
|
44
|
Wang W, He CR, Zheng W, Li J, Xu WD. Development of a valid simplified Chinese version of the Osteoarthritis of Knee and Hip Quality of Life (OAKHQOL) in patients with knee or hip osteoarthritis. J Eval Clin Pract 2016; 22:53-61. [PMID: 26239829 DOI: 10.1111/jep.12431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES As the first specific questionnaire for knee or hip osteoarthritis (OA) patients' condition assessment, the Osteoarthritis of Knee and Hip Quality of Life (OAKHQOL) questionnaire is widely used and its original version is French. Although it has already been translated into multiple languages, a Chinese version is still unpublished, despite the fact that China has the largest population of OA patients in the world. The objectives of our study were to adapt the OAKHQOL questionnaire into simplified Chinese and to assess its psychometric properties in Chinese patients with knee or hip OA. METHODS First, we developed the simplified Chinese version of OAKHQOL (SC-OAKHOQL) in a five-step procedure of translation and cross-cultural adaptation. Next, we calculated the Cronbach's alpha, intraclass correlation coefficient (ICC), Pearson's correlation coefficient (r), effect size (ES) and standardized response mean (SRM) to evaluate the reliability, validity and responsiveness of the SC-OAKHQOL, respectively. Unidimensionality of subscales was assessed by the principal component analysis (PCA) of residuals. RESULTS Overall, 144 knee or hip OA patients successfully completed all of the questionnaires. Excellent or good internal consistency (alpha = 0.826-0.964) was found in the SC-OAKHQOL, as well as excellent test-retest reliability (ICC = 0.888-0.944). Good correlations were also obtained among physical subscales (r = 0.646-0.934), as well as mental subscales (r = 0.786-0.874) in the SC-OAKHQOL and other questionnaires, on which excellent or good validity of the SC-OAKHQOL shall be based. With the exception of the social support subscale, all others contained excellent or good responsiveness (ES, SRM = 1.02-2.92). The unidimensionality of five subscales was respected according to the PCA of residuals. CONCLUSION The SC-OAKHQOL questionnaire is reliable, valid and responsive for the evaluation of Chinese osteoarthritis patients of the knee or hip, and it would be an effective instrument.
Collapse
Affiliation(s)
- Wei Wang
- Department of Orthopedics, Changhai Hospital, Shanghai, China
| | - Chong-Ru He
- Department of Orthopedics, Changhai Hospital, Shanghai, China
| | - Wei Zheng
- Department of Orthopedics, Changhai Hospital, Shanghai, China
| | - Jia Li
- Department of Orthopedics, Changhai Hospital, Shanghai, China
| | - Wei-Dong Xu
- Department of Orthopedics, Changhai Hospital, Shanghai, China
| |
Collapse
|
45
|
Bouyer B, Mazieres B, Guillemin F, Bouttier R, Fautrel B, Morvan J, Pouchot J, Rat AC, Roux CH, Verrouil E, Saraux A, Coste J. Association between hip morphology and prevalence, clinical severity and progression of hip osteoarthritis over 3 years: The knee and hip osteoarthritis long-term assessment cohort results. Joint Bone Spine 2016; 83:432-8. [PMID: 26832187 DOI: 10.1016/j.jbspin.2015.09.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 09/01/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the effects of variations in hip morphology on prevalence, clinical severity and progression of hip osteoarthritis. METHODS From 2007 to 2009, we conducted a study of 242 patients aged between 40 and 75 years with symptomatic lower limb osteoarthritis, as part of a population-based osteoarthritis cohort study in France. Standard radiographs of both hips were obtained at baseline and at three years. The progression of hip osteoarthritis was evaluated according to the radiological Kellgren-Lawrence score (KL) and clinical severity from the scores on a Visual Analogic Scale (VAS) for pain recorded yearly. Five measures were used to describe hip morphology: centre edge angle, acetabular index (AI), vertical centre anterior angle, acetabular depth and neck-shaft angle. RESULTS Of the 484 hips studied, 205 (42%) showed osteoarthritis at baseline and 16 (11 right and 5 left) underwent joint replacement during the follow-up. AI was the morphological measure most consistently and strongly associated with radiographic osteoarthritis at baseline (odds-ratio=1.05, 95% CI: 1.01-1.08 per degree of angle change), clinical severity (correlation coefficient with VAS during 3 years=0.15, P=0.004), radiological progression (odds-ratio=1.05, 95% CI: 1.00-1.10 per degree) and joint replacement (hazard ratio=1.18, 95% CI: 1.07-1.29 per degree). CONCLUSIONS Acetabular obliquity and especially AI is strongly, and likely causally, associated with the existence, severity and progression of hip osteoarthritis.
Collapse
Affiliation(s)
- Benjamin Bouyer
- EA 4360 Apemac, University Paris-Descartes, University of Lorraine, 75013 Paris, France; Biostatistics and Epidemiology Unit, Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du Parvis-Notre-Dame, 75004 Paris, France
| | - Bernard Mazieres
- Rheumatology centre, Purpan University Hospital, 31000 Toulouse, France
| | - Francis Guillemin
- Faculty of medicine, School of public health, CHU de Brabois, 54500 Vandœuvre-lès-Nancy, France; CIC-EC CIE6, Inserm, 54500 Vandœuvre-lès-Nancy, France; Rheumatology department, CHU de Brabois, 54500 Vandœuvre-lès-Nancy, France
| | - Ronan Bouttier
- Radiology department, Cavale-Blanche University Hospital, 29200 Brest, France
| | - Bruno Fautrel
- Rheumatology department, groupe hospitalier Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, 75013 Paris, France; GRC-08-EEMOIS, University Paris 6 Pierre-et-Marie-Curie, 75005 Paris, France
| | - Johanne Morvan
- Medicine department, Laennec hospital, 29000 Quimper, France; Rheumatology department, Cavale-Blanche University Hospital, 29200 Brest, France
| | - Jacques Pouchot
- EA 4360 Apemac, University Paris-Descartes, University of Lorraine, 75013 Paris, France; Department of internal medicine, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, 75015 Paris, France
| | - Anne-Christine Rat
- Faculty of medicine, School of public health, CHU de Brabois, 54500 Vandœuvre-lès-Nancy, France; CIC-EC CIE6, Inserm, 54500 Vandœuvre-lès-Nancy, France; Rheumatology department, CHU de Brabois, 54500 Vandœuvre-lès-Nancy, France
| | - Christian H Roux
- Rheumatology department, Academic Hospital l'Archet 1, 06200 Nice, France
| | - Evelyne Verrouil
- Rheumatology centre, Purpan University Hospital, 31000 Toulouse, France
| | - Alain Saraux
- EA 2216, University Bretagne-Occidentale, 29200 Brest, France; Faculty of Medicine, Paul-Sabatier University, 31000 Toulouse, France
| | - Joël Coste
- EA 4360 Apemac, University Paris-Descartes, University of Lorraine, 75013 Paris, France; Biostatistics and Epidemiology Unit, Hôtel-Dieu, Assistance publique-Hôpitaux de Paris, 1, place du Parvis-Notre-Dame, 75004 Paris, France.
| | | |
Collapse
|
46
|
Couraud G, Escalas C, Etcheto A, Rannou F, Poiraudeau S. French adaptation and validation of the Osteoarthritis Quality of Life scale. Ann Phys Rehabil Med 2015; 58:336-42. [PMID: 26596580 DOI: 10.1016/j.rehab.2015.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 09/06/2015] [Accepted: 09/27/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The Osteoarthritis Quality of Life scale (OAQoL) is an osteoarthritis-specific measure developed in the United Kingdom by a needs-based approach. This study describes the adaptation and validation of this English scale into French. METHODS The OAQoL was translated into French by a dual-panel technique followed by cognitive debriefing interviews. Internal consistency was assessed by the Cronbach α. Construct validity was tested by exploratory and confirmatory factor analyses and by convergent and divergent correlations with other patient-reported outcome measures by the Spearman rho (ρ). Reliability was explored by Spearman rho as well as the Bland and Altman method for the total score and Cohen's kappa for each item score. RESULTS Cognitive debriefing revealed the French OAQoL to be clear, relevant and comprehensive. The Cronbach α was 0.91. Exploratory factor analysis extracted 4 groups of items. After eliminating 4 items, confirmatory factor analysis of the remaining 18 items confirmed higher intra-factor than inter-factor correlations. The expected convergent and divergent correlations were observed. Test-retest reliability was good (ρ 0.93) and was confirmed by Bland and Altman analysis; most items (12/18) had kappa values from 0.61 to 0.80. CONCLUSION The French OAQoL is an easy-to-use 18-item questionnaire with good content and construct validity to assess the impact of osteoarthritis on quality of life for French-speaking patients.
Collapse
Affiliation(s)
- G Couraud
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
| | - C Escalas
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - A Etcheto
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - F Rannou
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France
| | - S Poiraudeau
- Inserm U1153, université Paris Descartes, hôpital Cochin, AP-HP, 75619 Paris, France.
| |
Collapse
|
47
|
The Mini-OAKHQOL for knee and hip osteoarthritis quality of life was obtained following recent shortening guidelines. J Clin Epidemiol 2015; 69:70-8. [PMID: 26111768 DOI: 10.1016/j.jclinepi.2015.06.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 05/22/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To develop a short form of the knee and hip osteoarthritis quality of life questionnaire, the Mini-OAKHQOL, preserving the conceptual model and, as far as possible, the content and the psychometric properties of the original instrument. STUDY DESIGN AND SETTING A two-step shortening procedure was used: (1) a consensus Delphi method, with a panel of patients and another of professionals independently asked to select items and (2) a nominal group, where patients, professionals, and methodologists reached consensus on the final selection of items, using information from the panels and from modern measurement and classical test theory analyses. The psychometric properties of the Mini-OAKHQOL were assessed in an independent population-based sample of 581 subjects with knee or hip osteoarthritis. RESULTS The two-step shortening procedure resulted in a 20-item questionnaire. Confirmatory factor analysis showed preservation of the original five-dimensional structure. Rasch analyses showed the unidimensionality and invariance by sex, age, and joint of the main dimensions. Convergent validity, reproducibility, and internal consistency were similar to or better than those of the original OAKHQOL. CONCLUSIONS The 20-item Mini-OAKHQOL has good psychometric properties and can be used for the measurement of quality of life in subjects with osteoarthritis of the lower limbs.
Collapse
|
48
|
Petkovic J, Epstein J, Buchbinder R, Welch V, Rader T, Lyddiatt A, Clerehan R, Christensen R, Boonen A, Goel N, Maxwell LJ, Toupin-April K, De Wit M, Barton J, Flurey C, Jull J, Barnabe C, Sreih AG, Campbell W, Pohl C, Duruöz MT, Singh JA, Tugwell PS, Guillemin F. Toward Ensuring Health Equity: Readability and Cultural Equivalence of OMERACT Patient-reported Outcome Measures. J Rheumatol 2015; 42:2448-59. [PMID: 26077410 DOI: 10.3899/jrheum.141168] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The goal of the Outcome Measures in Rheumatology (OMERACT) 12 (2014) equity working group was to determine whether and how comprehensibility of patient-reported outcome measures (PROM) should be assessed, to ensure suitability for people with low literacy and differing cultures. METHODS The English, Dutch, French, and Turkish Health Assessment Questionnaires and English and French Osteoarthritis Knee and Hip Quality of Life questionnaires were evaluated by applying 3 readability formulas: Flesch Reading Ease, Flesch-Kincaid grade level, and Simple Measure of Gobbledygook; and a new tool, the Evaluative Linguistic Framework for Questionnaires, developed to assess text quality of questionnaires. We also considered a study assessing cross-cultural adaptation with/without back-translation and/or expert committee. The results of this preconference work were presented to the equity working group participants to gain their perspectives on the importance of comprehensibility and cross-cultural adaptation for PROM. RESULTS Thirty-one OMERACT delegates attended the equity session. Twenty-six participants agreed that PROM should be assessed for comprehensibility and for use of suitable methods (4 abstained, 1 no). Twenty-two participants agreed that cultural equivalency of PROM should be assessed and suitable methods used (7 abstained, 2 no). Special interest group participants identified challenges with cross-cultural adaptation including resources required, and suggested patient involvement for improving translation and adaptation. CONCLUSION Future work will include consensus exercises on what methods are required to ensure PROM are appropriate for people with low literacy and different cultures.
Collapse
Affiliation(s)
- Jennifer Petkovic
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jonathan Epstein
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Rachelle Buchbinder
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Vivian Welch
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Tamara Rader
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Anne Lyddiatt
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Rosemary Clerehan
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Robin Christensen
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Annelies Boonen
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Niti Goel
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Lara J Maxwell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Karine Toupin-April
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Maarten De Wit
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jennifer Barton
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Caroline Flurey
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Janet Jull
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Cheryl Barnabe
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Antoine G Sreih
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Willemina Campbell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Christoph Pohl
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Mehmet Tuncay Duruöz
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Jasvinder A Singh
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Peter S Tugwell
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| | - Francis Guillemin
- From the Centre for Global Health, University of Ottawa, Ottawa, Ontario, Canada; University of Lorraine, EA 4360 Apemac, Nancy, France; Cabrini Institute and Monash University, Melbourne, Australia; Bruyère Research Institute, and the Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada; Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, Copenhagen University Hospitals, Bispebjerg and Frederiksberg, Denmark; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Quintiles Inc.; Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Children's Hospital of Eastern Ontario Research Institute, Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VU Medical Centre, Amsterdam, The Netherlands; University of California at San Francisco, San Francisco, California, USA; Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK; Departments of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine Berlin, Berlin, Germany; University of Marmara, Faculty of Medicine, Department of Physical and Rehabilitation Medicine, Rheumatology Clinics, Istanbul, Turkey; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Ottawa Hospital Research Institute, Ottawa; University Health Network (UHN)-Toronto Western Hospital, Toronto, Ontario
| |
Collapse
|
49
|
Moderators, mediators, and bidirectional relationships in the International Classification of Functioning, Disability and Health (ICF) framework: An empirical investigation using a longitudinal design and Structural Equation Modeling (SEM). Soc Sci Med 2015; 135:133-42. [DOI: 10.1016/j.socscimed.2015.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
50
|
SECOT-GEDOS consensus on pre-surgical pain management in knee and hip arthrosis. Rev Esp Cir Ortop Traumatol (Engl Ed) 2015. [DOI: 10.1016/j.recote.2015.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|