1
|
Jormand H, Mohammadi N, Khani Jeihooni A, Afzali Harsini P. Self-care behaviors in older adults suffering from knee osteoarthritis: Application of theory of planned behavior. Front Public Health 2022; 10:958614. [PMID: 36408046 PMCID: PMC9672679 DOI: 10.3389/fpubh.2022.958614] [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: 05/31/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Background Osteoarthritis is one of the main reasons causing disablement. Educational intervention for self-care behaviors of patients suffering from knee osteoarthritis is important because its effect on quality of patient life decreases the economic burden of disorder on society and family. This study aimed to investigate the effect of educational intervention based on the theory of planned behavior (TPB) on promoting self-care behaviors in elderly patients suffering from knee osteoarthritis. Methods This quasi-experimental study was performed on 200 elderlies suffering from knee osteoarthritis in the rheumatology clinics of Shiraz, Iran, in 2019. The subjects were divided into two groups (100 experimental and 100 control). Before and after 4 months, both experimental and control groups filled a questionnaire. After administering a pre-test to both groups, only the experimental group was trained based on the TPB constructs on self-care behaviors in elderly people suffering from knee osteoarthritis in eight sessions by presenting educational films and images, power points, and group discussions for solving problems. Results The mean age of the experimental group was 67.25 ± 3.64, and the mean age of the control group was 66.12 ± 3.50. The average scores of attitudes, subjective norms, perceived behavioral control, intention, and behavior before the educational intervention did not have significant differences in experimental and control groups, however, 4 months after the educational intervention, the paired t-test indicated significant enhancement in every construct in the experimental group, but no significant changes in the control group. Conclusion According to the results, the educational intervention increased the self-care behaviors of patients suffering from knee osteoarthritis based on the theory of planned behavior. Therefore, the results of this study can be used in theory-based intervention strategies for self-care behaviors of patients suffering from knee osteoarthritis.
Collapse
Affiliation(s)
- Hanieh Jormand
- Autism Spectrum Disorders Research Center and Clinical Research Development Unit of Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasim Mohammadi
- Department of Public Health, School of Health, Fasa University of Medical Sciences, Fasa, Iran
| | - Ali Khani Jeihooni
- Nutrition Research Center, Department of Public Health, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran,*Correspondence: Ali Khani Jeihooni
| | - Pooyan Afzali Harsini
- Department of Public Health, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
2
|
Applying the Evidence for Exercise Prescription in Older Adults with Knee Osteoarthritis. CURRENT GERIATRICS REPORTS 2016. [DOI: 10.1007/s13670-016-0178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
3
|
Is physical activity, practiced as recommended for health benefit, a risk factor for osteoarthritis? Ann Phys Rehabil Med 2016; 59:196-206. [DOI: 10.1016/j.rehab.2016.02.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/04/2016] [Accepted: 02/28/2016] [Indexed: 01/19/2023]
|
4
|
Russell Esposito E, Aldridge Whitehead JM, Wilken JM. Sound limb loading in individuals with unilateral transfemoral amputation across a range of walking velocities. Clin Biomech (Bristol, Avon) 2015; 30:1049-55. [PMID: 26412015 DOI: 10.1016/j.clinbiomech.2015.09.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Individuals with unilateral transfemoral amputation demonstrate significantly increased rates of osteoarthritis in their sound knee. This increased risk is likely the result of altered knee mechanical loading and gait compensations resulting from limited function in the prosthetic limb. Altered knee loading as calculated using loading rates and peak external knee adduction moments and impulses have been associated with both the development and progression of knee osteoarthritis in other populations. The purpose of this study was to determine if young individuals with transfemoral amputation demonstrate biomechanical indicators of increased knee osteoarthritis risk. METHODS Fourteen young male Service Members with unilateral transfemoral amputation and 14 able-bodied service members underwent biomechanical gait analysis at three standardized walking velocities. A two-way ANOVA (group × speed) with unpaired comparisons with Bonferroni-Holm post-hoc corrections assessed statistical significance and effect sizes (d) were calculated. FINDINGS Normalized peak external knee adduction moments and impulses were 25.7% (P < 0.014, d > 0.994) and 27.1% (P < 0.012, d > 1.019) lower, respectively, in individuals with trans-femoral amputation than controls when averaged across speeds, and effect sizes were large. External knee flexor moments were not, however, different between groups and effect sizes were generally small (P > 0.380, d < 0.338). Maximal loading rates were significantly greater in individuals with amputation and effect sizes were large (P < 0.001, d > 1.644). INTERPRETATION Individuals with transfemoral amputation did not demonstrate biomechanical risk factors for high medial compartment knee joint loads, but the increased loading rates could place the sound knee at greater risk for cartilage or other tissue damage, even if not localized to the medial compartment.
Collapse
Affiliation(s)
- Elizabeth Russell Esposito
- Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, JBSA, Ft. Sam Houston, TX, USA 78234; DoD-VA Extremity Trauma and Amputation Center of Excellence (EACE), USA.
| | - Jennifer M Aldridge Whitehead
- Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, JBSA, Ft. Sam Houston, TX, USA 78234; DoD-VA Extremity Trauma and Amputation Center of Excellence (EACE), USA
| | - Jason M Wilken
- Center for the Intrepid, Department of Orthopaedics and Rehabilitation, Brooke Army Medical Center, JBSA, Ft. Sam Houston, TX, USA 78234; DoD-VA Extremity Trauma and Amputation Center of Excellence (EACE), USA
| |
Collapse
|
5
|
Goossens L, Vercruysse S, Cardon G, Haerens L, Witvrouw E, De Clercq D. Musculoskeletal injuries in physical education versus non-physical education teachers: a prospective study. J Sports Sci 2015; 34:1107-15. [PMID: 26419187 DOI: 10.1080/02640414.2015.1091491] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical education (PE) teachers have a physically demanding job, putting them at a considerable risk for musculoskeletal injuries. To structurally develop tailored injury prevention programmes for PE teachers, a clear understanding of the extent, characteristics and underlying factors of their musculoskeletal injuries compared to referents is necessary. Therefore, the current study prospectively followed 103 PE teachers and 58 non-PE teachers, who registered musculoskeletal injuries and time of exposure to sports participation during one school year. Pearson χ(2)-tests and independent samples t-tests determined significant differences between PE and non-PE teachers regarding demographics and variables possibly related to injury occurrence. PE teachers had 1.23 and non-PE teachers 0.78 injuries/teacher/school year. This difference was significantly different after adjustment for hours spent weekly on intracurricular teaching during the career and for injury history during the preceding six months (P = 0.009; OR = 0.511; 95% CI = 0.308-0.846). PE teachers' most affected body parts were the knee and the back. PE teachers had a more extensive injury history (P < 0.001), a higher work- (P < 0.001) and sport index (P < 0.001), practiced more sports (P < 0.002) and taught more extracurricular sports (P = 0.001). Future injury prevention programmes should take account for the great injury history and heavy physical load in PE teachers.
Collapse
Affiliation(s)
- Lennert Goossens
- a Department of Movement- and Sports Sciences , Ghent University , Ghent , Belgium
| | - Sien Vercruysse
- a Department of Movement- and Sports Sciences , Ghent University , Ghent , Belgium
| | - Greet Cardon
- a Department of Movement- and Sports Sciences , Ghent University , Ghent , Belgium
| | - Leen Haerens
- a Department of Movement- and Sports Sciences , Ghent University , Ghent , Belgium
| | - Erik Witvrouw
- b Department of Rehabilitation and Physiotherapy , Ghent University , Ghent , Belgium.,c Aspetar Orthopaedic and Sports Medicine Hospital , Doha , Qatar
| | - Dirk De Clercq
- a Department of Movement- and Sports Sciences , Ghent University , Ghent , Belgium
| |
Collapse
|
6
|
Iosifidis MI, Tsarouhas A, Fylaktou A. Lower limb clinical and radiographic osteoarthritis in former elite male athletes. Knee Surg Sports Traumatol Arthrosc 2015; 23:2528-35. [PMID: 24817165 DOI: 10.1007/s00167-014-3047-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Accepted: 04/27/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To investigate the prevalence of lower extremities clinical and radiographic OA in former elite male athletes and referents from the general population and to examine its association with the participants' demographic characteristics. METHODS Two hundred and eighteen former elite male athletes (soccer, volleyball, martial arts, track and field and basketball players, and skiers) and 181 male controls that reported no systematic athletic activity were examined by means of questionnaire, clinical and radiographic evaluation. Exclusion criteria were age younger than 40 years and a positive history of lower extremity surgery, bone or soft tissue trauma and inflammatory arthropathy. RESULTS Overall, the prevalence of clinical OA between former elite athletes (15.6 %) and controls (14.4 %) was similar (n.s.). The prevalence of radiographic OA was significantly higher (p = 0.03) in former elite athletes (36.6 %) compared with controls (23.9 %). All the participants with clinical OA who underwent radiographic examination also had radiographic OA. The prevalence of clinical and radiographic OA was similar (n.s.) between former athletes of different sports. Age, body mass index (BMI) and occupation variably predicted the prevalence of hip, knee and ankle OA in both study groups. CONCLUSIONS In the absence of major bone and soft tissue lower limb trauma during their athletic career, former elite athletes may not be at increased risk of developing clinical OA. Radiographic signs of OA present at a significantly higher incidence and possibly precede the clinical onset of OA. Age, BMI and occupation are identified as strong predictors of the development of OA in former elite athletes.
Collapse
Affiliation(s)
- Michael I Iosifidis
- 2nd Department of Orthopaedic Surgery, Papageorgiou General Hospital, 21 Filiaton and Ikarou Str, 55438, Thessaloníki, Greece,
| | | | | |
Collapse
|
7
|
Russell Esposito E, Wilken JM. Biomechanical risk factors for knee osteoarthritis when using passive and powered ankle-foot prostheses. Clin Biomech (Bristol, Avon) 2014; 29:1186-92. [PMID: 25440576 DOI: 10.1016/j.clinbiomech.2014.09.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Revised: 09/08/2014] [Accepted: 09/09/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Gait compensations following transtibial amputation negatively affect sound limb loading and increase the risk of knee osteoarthritis. Push-off assistance provided by new powered prostheses may decrease the demands on the sound limb. However, their effects in a young population in the early stages of prosthetic use are still unknown. The purpose of this study was to compare limb loading between 1. passive and powered ankle-foot prostheses, 2. sound and amputated limbs, and 3. individuals with amputations in the relatively early stages of prosthetic use and controls. METHODS Ten young, active individuals with unilateral transtibial amputation and 10 controls underwent biomechanical gait analysis at three speeds. The peak external knee flexor and adductor moments, adductor moment's angular impulse, peak vertical ground reaction force and loading rate were calculated. Repeated measures ANOVAs compared between limbs, prostheses, and groups. FINDINGS The powered prosthesis did not decrease the sound limb's peak adduction moment or its impulse, but did decrease the external flexor moment, peak vertical force and loading rate as speed increased. The powered prosthesis decreased the loading rate from controls. The sound limb did not display a significantly greater risk for knee osteoarthritis than the intact limb or than controls in either device. INTERPRETATION In the early stages of prosthetic use, young individuals with transtibial amputation display few biomechanical risk factors for knee osteoarthritis development. However, a powered ankle-foot prosthesis still offers some benefits and may be used prophylactically to mitigate potential increases of these variables with continued prosthetic use over time.
Collapse
Affiliation(s)
- Elizabeth Russell Esposito
- Center for the Intrepid, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence (EACE), USA.
| | - Jason M Wilken
- Center for the Intrepid, Brooke Army Medical Center, Ft. Sam Houston, TX 78234, USA; DoD-VA Extremity Trauma and Amputation Center of Excellence (EACE), USA
| |
Collapse
|
8
|
Castillo-Rodríguez A, Chinchilla-Minguet JL. Cardiovascular program to improve physical fitness in those over 60 years old - pilot study. Clin Interv Aging 2014; 9:1269-75. [PMID: 25143714 PMCID: PMC4137914 DOI: 10.2147/cia.s66190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background In Spain, more than 50% of 60-year-olds are obese. Obesity is a disease with serious cardiovascular risks. The mortality rate for cardiovascular disease in Spain is 31.1%. Objectives To improve aerobic fitness, strength, flexibility and balance, and body composition (BC) in persons over 60 years old. Materials and methods A clinical intervention study of 24 participants was carried out over a period of 3 months. Aerobic fitness was assessed using the Rockport 1-Mile Walk Test. Upper-body strength was evaluated with an ad hoc test. Flexibility and balance were evaluated using the Sit and Reach Test and the Stork Balance Stand Test, respectively. Anthropometric measurements were taken by bioelectrical impedance. Results After 3 months of training, aerobic fitness was improved, as demonstrated by improved test times (pretest 13.04 minutes, posttest 12.13 minutes; P<0.05). Body composition was also improved, but the results were not statistically significant (fat mass pretest 31.58%±5.65%, posttest 30.65%±6.31%; skeletal muscle mass pretest 43.99±9.53 kg, posttest 46.63±10.90 kg). Conclusion Our data show that in subjects over 60 years old, aerobic fitness was improved due to program intervention. However, these results should be treated with caution, because of the limited sample size and the brief time period of this pilot study. A more rigorous study would include a sample of at least 100 participants.
Collapse
|
9
|
Hubbard-Turner T, Guderian S, Turner MJ. Lifelong physical activity and knee osteoarthritis development in mice. Int J Rheum Dis 2014; 18:33-9. [DOI: 10.1111/1756-185x.12291] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- Tricia Hubbard-Turner
- Department of Kinesiology; The University of North Carolina at Charlotte; Charlotte North Carolina USA
- Department of Mechanical Engineering & Engineering Science; Center for Biomedical Engineering Systems; The University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - Sophie Guderian
- Department of Kinesiology; The University of North Carolina at Charlotte; Charlotte North Carolina USA
| | - Michael J. Turner
- Department of Kinesiology; The University of North Carolina at Charlotte; Charlotte North Carolina USA
| |
Collapse
|
10
|
Bennell K, Hinman RS, Wrigley TV, Creaby MW, Hodges P. Exercise and osteoarthritis: cause and effects. Compr Physiol 2013; 1:1943-2008. [PMID: 23733694 DOI: 10.1002/cphy.c100057] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Osteoarthritis (OA) is a common chronic joint condition predominantly affecting the knee, hip, and hand joints. Exercise plays a role in the development and treatment of OA but most of the literature in this area relates to knee OA. While studies indicate that exercise and physical activity have a generally positive effect on healthy cartilage metrics, depending upon the type of the activity and its intensity, the risk of OA development does appear to be moderately increased with sporting participation. In particular, joint injury associated with sports participation may be largely responsible for this increased risk of OA with sport. Various repetitive occupational tasks are also linked to greater likelihood of OA development. There are a number of physical impairments associated with OA including pain, muscle weakness and altered muscle function, reduced proprioception and postural control, joint instability, restricted range of motion, and lower aerobic fitness. These can result directly from the OA pathological process and/or indirectly as a result of factors such as pain, effusion, and reduced activity levels. These impairments and their underlying physiology are often targeted by exercise interventions and evidence generally shows that many of these can be modified by specific exercise. There is currently little clinical trial evidence to show that exercise can alter mechanical load and structural disease progression in those with established OA, although a number of impairments, that are amenable to change with exercise, appears to be associated with increased mechanical load and/or disease progression in longitudinal studies.
Collapse
Affiliation(s)
- Kim Bennell
- Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, University of Melbourne, Australia.
| | | | | | | | | |
Collapse
|
11
|
Teoh JC, Low JH, Lim YB, Shim VPW, Park J, Park SB, Park SJ, Lee T. Investigation of the biomechanical effect of variable stiffness shoe on external knee adduction moment in various dynamic exercises. J Foot Ankle Res 2013; 6:39. [PMID: 24044429 PMCID: PMC3848782 DOI: 10.1186/1757-1146-6-39] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 08/22/2013] [Indexed: 12/05/2022] Open
Abstract
Background The growing ageing population and high prevalence of knee osteoarthritis (OA) in athletes across nations have created a strong demand for improved non-invasive therapeutic alternatives for knee OA. The aim of this study is to investigate the effect of the variable stiffness shoe (VSS), a new non-invasive therapeutic approach, on external knee adduction moment (EKAM) in various dynamic exercises. EKAM is believed to have positive correlation with the progression and development of knee OA. Methods Thirty young participants (16 male and 14 female; age 22.6 ± 1.9 years) from National University of Singapore were enrolled in this study. The tested activities were walking, running, drop-landing, and lateral hopping. All the dynamic exercises were recorded simultaneously by the 8-camera VICON Motion Systems (Oxford Metric, UK) with a sampling rate of 100 Hz. Results The results showed that the EKAM was reduced in all the dynamic exercises with the use of VSS. The VSS produced significant reductions in the peak EKAM during walking (4.97%, p = 0.039), running (11.15%, p = 0.011), drop-landing (11.18%, p = 0.038) and lateral hopping (17.34%, p = 0.023) as compared to the control shoe. Conclusions The reduction of EKAM with the use of VSS in various dynamic exercises demonstrates its potential in delaying the onset and the progression of knee OA in early stage of knee OA patients.
Collapse
Affiliation(s)
- Jee Chin Teoh
- Department of Bioengineering, Faculty of Engineering, National University of Singapore, Block E3A #07-15, 7 Engineering Drive 1, Singapore 117574, Singapore.
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Felson DT, Niu J, Yang T, Torner J, Lewis CE, Aliabadi P, Sack B, Sharma L, Guermazi A, Goggins J, Nevitt MC. Physical activity, alignment and knee osteoarthritis: data from MOST and the OAI. Osteoarthritis Cartilage 2013; 21:789-95. [PMID: 23523851 PMCID: PMC3648587 DOI: 10.1016/j.joca.2013.03.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 02/27/2013] [Accepted: 03/01/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effect of physical activity on knee osteoarthritis (OA) development in persons without knee injury and according to knee alignment. DESIGN We combined data from Multicenter Osteoarthritis (MOST) and Osteoarthritis Initiative (OAI), studies of persons with or at high risk of OA. Subjects had long limb and repeated posteroanterior knee radiographs and completed the physical activity survey for the elderly (PASE). We studied persons without radiographic OA and excluded knees with major injury and without long limb films. We followed subjects 30 months (in MOST) and 48 months (in OAI) for one of two incident outcomes: (1) symptomatic tibiofemoral OA (radiographic OA and knee pain), or (2) tibiofemoral narrowing. 'Active' persons were those with PASE score in the highest quartile by gender. We examined risk of OA in active group using logistic regression adjusting for age, gender, body mass index (BMI), Western Ontario and McMaster Arthritis Index (WOMAC) pain score, Kellgren and Lawrence (KL) grade (0 or 1), and study of origin. We also analyzed knees from malaligned and neutrally aligned limbs. RESULTS The combined sample comprised 2,073 subjects (3,542 knees) with mean age 61 years. The cumulative incidence of symptomatic tibiofemoral OA was 1.12% in the active group vs 1.82% in the others (odds ratio (OR) among active group 0.6, 95% confidence interval (CI) 0.3, 1.3). Joint space narrowing occurred in 3.41% of knees in the active group vs 4.04% in the others (OR among active group 0.9 (95% CI 0.5, 1.5)). Results did not differ by alignment status. CONCLUSIONS Physical activity in the highest quartile did not affect the risk of developing OA.
Collapse
Affiliation(s)
- David T. Felson
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Jingbo Niu
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Tianzhong Yang
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - James Torner
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - C. Elizabeth Lewis
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Piran Aliabadi
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Burton Sack
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Leena Sharma
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Ali Guermazi
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Joyce Goggins
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - Michael C. Nevitt
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| | - for the MOST and OAI investigators
- Clinical Epidemiology Unit (DTF, JN, TY, BS, JG) and Radiology (AG) at Boston University School of Medicine, the Department of Epidemiology and Biostatistics at University of California, San Francisco (MCN), the Division of Preventive Medicine at University of Alabama, Birmingham (CEL), Division of Rheumatology at Northwestern University Feinberg School of Medicine (LS), the Department of Epidemiology at the University of Iowa (JT), the Department of Radiology at Brigham and Women’s Hospital in Boston (PA) and the Arthritis Research UK Epidemiology Unit, University of Manchester, UK (DTF)
| |
Collapse
|
13
|
Hovis KK, Stehling C, Souza RB, Haughom BD, Baum T, Nevitt M, McCulloch C, Lynch JA, Link TM. Physical activity is associated with magnetic resonance imaging-based knee cartilage T2 measurements in asymptomatic subjects with and those without osteoarthritis risk factors. ACTA ACUST UNITED AC 2011; 63:2248-56. [PMID: 21538328 DOI: 10.1002/art.30419] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To evaluate the association of exercise and knee-bending activities with magnetic resonance imaging (MRI)-based knee cartilage T2 relaxation times and morphologic abnormalities in asymptomatic subjects from the Osteoarthritis Initiative, with or without osteoarthritis (OA) risk factors. METHODS We studied 128 subjects with knee OA risk factors and 33 normal control subjects ages 45-55 years, with a body mass index of 18-27 kg/m(2) and no knee pain. Subjects were categorized according to exercise level, using the leisure activity component of the Physical Activity Scale for the Elderly, and by self-reported frequent knee-bending activities. Two radiologists graded the cartilage of the right knee on MR images, using the Whole-Organ MRI Score (WORMS). Cartilage was segmented, and compartment-specific T2 values were calculated. Differences between the exercise groups and knee-bending groups were determined using multiple linear and logistic regression models. RESULTS Among subjects with risk factors for knee OA, light exercisers had lower T2 values compared with sedentary and moderate/strenuous exercisers. When the sexes were analyzed separately, female moderate/strenuous exercisers had higher T2 values compared with sedentary individuals and light exercisers. Subjects without risk factors displayed no significant differences in T2 values according to exercise level. However, frequent knee-bending activities were associated with higher T2 values in both subjects with OA risk factors and those without OA risk factors and with more severe cartilage lesions in the group with risk factors. CONCLUSION In subjects at risk of knee OA, light exercise was associated with low T2 values, whereas moderate/strenuous exercise in women was associated with high T2 values. Higher T2 values and WORMS grades were also observed in frequent knee-benders, suggesting greater cartilage degeneration in these individuals.
Collapse
|
14
|
Wang Y, Simpson JA, Wluka AE, Teichtahl AJ, English DR, Giles GG, Graves S, Cicuttini FM. Is physical activity a risk factor for primary knee or hip replacement due to osteoarthritis? A prospective cohort study. J Rheumatol 2010; 38:350-7. [PMID: 20952471 DOI: 10.3899/jrheum.091138] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To estimate prospectively any association between measures of physical activity and the risk of either primary knee or hip replacement due to osteoarthritis (OA). METHODS Eligible subjects (n = 39,023) were selected from participants in a prospective cohort study recruited 1990-1994. Primary knee and hip replacement for OA during 2001-2005 was determined by linking the cohort records to the National Joint Replacement Registry. A total physical activity level was computed, incorporating both intensity and frequency for different forms of physical activity obtained by questionnaire at baseline attendance. RESULTS There was a dose-response relationship between total physical activity level and the risk of primary knee replacement [hazards ratio (HR) 1.04, 95% CI 1.01-1.07 for an increase of 1 level in total physical activity]. Although vigorous activity frequency was associated with an increased risk of primary knee replacement (HR 1.42, 95% CI 1.08-1.86) for 1-2 times/week and HR 1.24 (95% CI 0.90-1.71) for ≥ 3 times/week), the p for trend was marginal (continuous HR 1.08, 95% CI 1.00-1.16, p = 0.05). The frequency of less vigorous activity or walking was not associated with the risk of primary knee replacement, nor was any measure of physical activity associated with the risk of primary hip replacement. CONCLUSION Increasing levels of total physical activity are positively associated with the risk of primary knee but not hip replacement due to OA. Physical activity might affect the knee and hip joints differently depending on the preexisting health status and anatomy of the joint, as well as the sort of physical activity performed.
Collapse
Affiliation(s)
- Yuanyuan Wang
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Melbourne, VIC 3004, Australia
| | | | | | | | | | | | | | | |
Collapse
|
15
|
Stehling C, Lane NE, Nevitt MC, Lynch J, McCulloch CE, Link TM. Subjects with higher physical activity levels have more severe focal knee lesions diagnosed with 3T MRI: analysis of a non-symptomatic cohort of the osteoarthritis initiative. Osteoarthritis Cartilage 2010; 18:776-86. [PMID: 20202488 PMCID: PMC4839980 DOI: 10.1016/j.joca.2010.02.008] [Citation(s) in RCA: 103] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2009] [Revised: 02/01/2010] [Accepted: 02/06/2010] [Indexed: 02/02/2023]
Abstract
PURPOSE To study the prevalence of focal knee abnormalities using 3 Tesla (T) magnetic resonance (MR) studies in relation to physical activity levels in asymptomatic, middle-aged subjects from the osteoarthritis initiative (OAI). MATERIAL AND METHODS We analyzed baseline data from 236, 45-55 years old individuals (136 women, 100 men) without knee pain (based on Western Ontario and McMaster University scores) and a body mass index (BMI) of 19-27 kg/m(2). Physical activity levels were determined in all subjects using the Physical Activity Scale for the Elderly (PASE). MR imaging (MRI) at 3T was performed using coronal intermediate-weighted (IW) 2D fast spin-echo (FSE), sagittal 3D dual-echo in steady state (DESS) and 2D IW fat-suppressed (fs) FSE sequences of the right knee. All images were analyzed by two musculoskeletal radiologists identifying and grading cartilage, meniscal, ligamentous and other knee abnormalities using the whole-organ MR imaging score (WORMS) MRI OA scoring method. Statistical significances between subjects with different activity levels were determined using one-way analysis of variance (ANOVA), chi-square tests and a multi-variate regression model adjusted for gender, age, BMI, Kellgren-Lawrence (KL) score and osteoarthritis (OA) risk factors. RESULTS Meniscal lesions were found in 47% of the 236 subjects, cartilage lesions in 74.6%, bone marrow edema pattern (BMEP) in 40.3% and ligament lesions in 17%. Stratification of subjects by physical activity resulted in an increasing incidence of cartilage, meniscus and ligament abnormalities, BMEP and joint effusion according to activity levels (PASE). The severity grade of cartilage lesions was also associated with PASE levels and presence of other knee abnormalities was also significantly associated with cartilage defects. CONCLUSION Asymptomatic middle-aged individuals from the OAI incidence cohort had a high prevalence of knee abnormalities; more physically active individuals had significantly more and more severe knee abnormalities independently of gender, age, BMI, KL score and OA risk factors. These data therefore also suggest that subjects with higher physical activity levels may be at greater risk for cartilage, meniscus and ligament abnormalities, but the analysis of the longitudinal data will show whether these subjects will demonstrate accelerated progress.
Collapse
Affiliation(s)
- Christoph Stehling
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA,Department of Clinical Radiology, University of Muenster, Muenster, Germany
| | - Nancy E. Lane
- UC Davis Center for Healthy Aging, Sacramento, CA, USA
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - John Lynch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Charles E. McCulloch
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Thomas M. Link
- Musculoskeletal and Quantitative Imaging Group (MQIR), Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
16
|
Bizet I, Laurencelle L, Lemoyne J, Larouche R, Trudeau F. Career changes among physical educators: searching for new goals or escaping a heavy task load? RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2010; 81:224-232. [PMID: 20527307 DOI: 10.1080/02701367.2010.10599669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Physical educators experience several occupational constraints and a high risk of physical injury associated with a high attrition rate. Our investigation aimed at identifying the principal career reorientation factors among physical educators and reasons for their career changes. This research used semistructured interviews (n = 53) that were analyzed qualitatively and quantitatively. While younger teachers frequently invoked job precariousness, the more experienced teachers and those who made a transition toward other teaching functions put more emphasis on teaching problems, work conditions, and physical context. Those who transferred toward administrative duties insisted on their desire for a new challenge. Our study indicates that career reorientation is most often associated with job precariousness and the pursuit of new challenges, respectively, for younger and older physical educators.
Collapse
Affiliation(s)
- Ivan Bizet
- Department of Physical Activity Sciences, University of Quebec, Trois-Rivières, Canada
| | | | | | | | | |
Collapse
|
17
|
Klussmann A, Gebhardt H, Nübling M, Liebers F, Quirós Perea E, Cordier W, von Engelhardt LV, Schubert M, Dávid A, Bouillon B, Rieger MA. Individual and occupational risk factors for knee osteoarthritis: results of a case-control study in Germany. Arthritis Res Ther 2010; 12:R88. [PMID: 20470400 PMCID: PMC2911872 DOI: 10.1186/ar3015] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2009] [Revised: 01/29/2010] [Accepted: 05/14/2010] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION A number of occupational risk factors are discussed in relation to the development and progress of knee joint diseases (for example, working in a kneeling or squatting posture, lifting and carrying heavy weights). Besides the occupational factors, a number of individual risk factors are important. The distinction between work-related and other factors is crucial in assessing the risk and in deriving preventive measures in occupational health. METHODS In a case-control study, patients with and without symptomatic knee osteoarthritis (OA) were questioned by means of a standardised questionnaire complemented by a semi-standardised interview. Controls were matched and assigned to the cases by gender and age. Conditional logistic regression was used in analysing data. RESULTS In total, 739 cases and 571 controls were included in the study. In women and men, several individual and occupational predictors for knee OA could be described: obesity (odds ratio (OR) up to 17.65 in women and up to 12.56 in men); kneeling/squatting (women, OR 2.52 (>8,934 hours/life); men, 2.16 (574 to 12,244 hours/life), 2.47 (>12,244 hours/life)); genetic predisposition (women, OR 2.17; men, OR 2.37); and sports with a risk of unapparent trauma (women, OR 2.47 (>or=1,440 hours/life); men, 2.58 (>or=3,232 hours/life)). In women, malalignment of the knee (OR 11.54), pain in the knee already in childhood (OR 2.08), and the daily lifting and carrying of loads (>or=1,088 tons/life, OR 2.13) were related to an increased OR; sitting and smoking led to a reduced OR. CONCLUSIONS The results support a dose-response relationship between kneeling/squatting and symptomatic knee OA in men and, for the first time, in women. The results concerning general and occupational predictors for knee OA reflect the findings from the literature quite well. Yet occupational risks such as jumping or climbing stairs/ladders, as discussed in the literature, did not correlate with symptomatic knee OA in the present study. With regards to occupational health, prevention measures should focus on the reduction of kneeling activities and the lifting and carrying of loads as well as general risk factors, most notably the reduction of obesity. More intervention studies of the effectiveness of tools and working methods for reducing knee straining activities are needed.
Collapse
Affiliation(s)
- André Klussmann
- Institute of Occupational Health, Safety and Ergonomics (ASER) at the University of Wuppertal, Corneliusstraße 31, 42329 Wuppertal, Germany
| | - Hansjürgen Gebhardt
- Institute of Occupational Health, Safety and Ergonomics (ASER) at the University of Wuppertal, Corneliusstraße 31, 42329 Wuppertal, Germany
| | - Matthias Nübling
- Freiburg Research Centre for Occupational and Social Medicine (FFAS), Bertoldstraße 27, 79098 Freiburg, Germany
| | - Falk Liebers
- Federal Institute for Occupational Safety and Health, Noeldnerstraße 40-42, 10317 Berlin, Germany
| | - Emilio Quirós Perea
- Centre for Orthopaedics and Rheumatology, Clinic for General Orthopaedics, Sankt Josef Hospital, Bergstraße 6-12, 42105 Wuppertal, Germany
| | - Wolfgang Cordier
- Centre for Orthopaedics and Rheumatology, Clinic for General Orthopaedics, Sankt Josef Hospital, Bergstraße 6-12, 42105 Wuppertal, Germany
| | - Lars V von Engelhardt
- Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, HELIOS Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Markus Schubert
- Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, HELIOS Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Andreas Dávid
- Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, HELIOS Hospital Wuppertal, Heusnerstraße 40, 42283 Wuppertal, Germany
| | - Bertil Bouillon
- Department of Trauma and Orthopaedic Surgery, University of Witten/Herdecke, Hospital Cologne Merheim, Ostmerheimerstraße 200, 51109 Cologne, Germany
| | - Monika A Rieger
- Department of Occupational Health and Environmental Medicine, Institute of General Practice and Family Medicine, University of Witten/Herdecke, Alfred-Herrhausen-Straße 50, 58448 Witten, Germany
- Institute of Occupational and Social Medicine, University Hospital of Tuebingen, Wilhelmstraße 27, 72074 Tuebingen, Germany
| |
Collapse
|
18
|
Abstract
In industrialized countries worldwide, women are delaying childbearing for a variety of reasons, including pursuit of career, greater financial independence, improved and more accessible contraception and longer life expectancy. In terms of fertility and maternity, those aged > or = 35 years are considered to be of advanced maternal age and there are usually marked reductions in both the fecundity rate for spontaneous conceptions and the success rates with assisted conception. These decreases are thought to be due mainly to oocyte ageing, and the established success of oocyte donation from younger individuals to older recipients supports this contention. For those who achieve a pregnancy at an advanced maternal age there is a greater likelihood of aneuploidy (assuming conception with the woman's own oocytes), hypertensive and other medical disorders, birth by Caesarean section and maternal mortality. However, most of the complications associated with advanced maternal age are caused by age-related confounding variables, and older premenopausal women in good health should not require special attention. The data on perinatal mortality rates are encouraging and in the absence of congenital abnormalities perinatal mortality is probably not much increased, if at all, in older mothers. Pregnancy is now possible for postmenopausal women with the application of oocyte donation, but these individuals have a significantly higher likelihood of cardiovascular ageing and should be considered at increased risk of vascular complications during pregnancy.
Collapse
Affiliation(s)
- D Nugent
- Centre for Reproduction, Growth and Development, The General Infirmary at Leeds, Belmont Grove, Leeds LS2 9NS, UK
| | | |
Collapse
|
19
|
Stehling C, Liebl H, Krug R, Lane NE, Nevitt MC, Lynch J, McCulloch CE, Link TM. Patellar cartilage: T2 values and morphologic abnormalities at 3.0-T MR imaging in relation to physical activity in asymptomatic subjects from the osteoarthritis initiative. Radiology 2009; 254:509-20. [PMID: 20019141 DOI: 10.1148/radiol.09090596] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To study the interrelationship between patella cartilage T2 relaxation time, other knee abnormalities, and physical activity levels in asymptomatic subjects from the Osteoarthritis Initiative (OAI) incidence cohort. MATERIALS AND METHODS The study had institutional review board approval and was HIPAA compliant. One hundred twenty subjects from the OAI without knee pain (age, 45-55 years) and with risk factors for knee osteoarthritis (OA) were studied by using knee radiographs, 3.0-T knee magnetic resonance (MR) images (including intermediate-weighted fast spin-echo and T2 mapping sequences), and the Physical Activity Scale for the Elderly. MR images of the right knee were assessed by two musculoskeletal radiologists for the presence and grade of abnormalities. Segmentation of the patella cartilage was performed, and T2 maps were generated. Statistical significance was determined by using analysis of variance, chi(2) analysis, correlation coefficient tests, the Cohen kappa, and a multiple linear regression model. RESULTS Cartilage lesions were found in 95 (79.0%) of 120 knees, and meniscal lesions were found in 54 (45%) of 120 knees. A significant correlation between patella cartilage T2 values and the severity and grade of cartilage (P = .0025) and meniscus (P = .0067) lesions was demonstrated. Subjects with high activity levels had significantly higher prevalence and grade of abnormalities and higher T2 values (48.7 msec +/-4.35 vs 45.8 msec +/-3.93; P < .001) than did subjects with low activity levels. CONCLUSION Middle-aged asymptomatic individuals with risk factors for knee OA had a high prevalence of cartilage and meniscus knee lesions. Physically active individuals had more knee abnormalities and higher patellar T2 values. Additional studies will be needed to determine causality.
Collapse
Affiliation(s)
- Christoph Stehling
- Musculoskeletal and Quantitative Imaging Group, Department of Radiology, University of California San Francisco, 185 Berry St, Suite 350, San Francisco, CA 94107, USA.
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Goldberg CA, Chiarello CM. Lumbar Sagittal Plane Mobility and Lordosis in the Well Elderly as Related to Gender and Activity Level. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2009. [DOI: 10.1080/j148v19n04_02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
21
|
Abstract
Exercise remains an extremely popular leisure time activity in many countries throughout the western world. It is widely promoted in the lay press as having salutory benefits for weight control, disease management advantages for cardiovascular disease and diabetes, in addition to improving psychological well-being amongst an array of other benefits. In contrast, however, the lay press and community perception is also that exercise is potentially deleterious to one's joints. The purpose of this review is to consider what osteoarthritis (OA) is and provide an overview of the epidemiology of OA focusing on validated risk factors for its development. In particular the role of both exercise and occupational activity in OA will be described as well as the role of exercise to the joints' tissues (particularly cartilage) and the role of exercise in disease management. Despite the common misconception that exercise is deleterious to one's joints, in the absence of joint injury there is no evidence to support this notion. Rather it would appear that exercise has positive salutory benefits for joint tissues in addition to its other health benefits.
Collapse
|
22
|
Alford L. Unveiling the physical therapies. S Afr Fam Pract (2004) 2009. [DOI: 10.1080/20786204.2009.10873871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
23
|
Scher DL, Belmont PJ, Mountcastle S, Owens BD. The incidence of primary hip osteoarthritis in active duty US military servicemembers. ACTA ACUST UNITED AC 2009; 61:468-75. [DOI: 10.1002/art.24429] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
24
|
Verweij LM, van Schoor NM, Deeg DJH, Dekker J, Visser M. Physical activity and incident clinical knee osteoarthritis in older adults. ACTA ACUST UNITED AC 2009; 61:152-7. [DOI: 10.1002/art.24233] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
25
|
Urquhart DM, Soufan C, Teichtahl AJ, Wluka AE, Hanna F, Cicuttini FM. Factors that may mediate the relationship between physical activity and the risk for developing knee osteoarthritis. Arthritis Res Ther 2008; 10:203. [PMID: 18279536 PMCID: PMC2374461 DOI: 10.1186/ar2343] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Studies investigating the effect of physical activity on risk for developing osteoarthritis at weight-bearing joints have reported conflicting results. We examine evidence to suggest that this may be due to the existence of subgroups of individuals who differ in their response to physical activity, as well as methodological issues associated with the assessment of knee joint structure and physical activity. Recommendations for future studies of physical activity and the development of knee osteoarthritis are discussed.
Collapse
Affiliation(s)
- Donna M Urquhart
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
| | - Cathy Soufan
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
| | - Andrew J Teichtahl
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
- Baker Heart Research Institute, AMREP Centre, Commercial Road, Melbourne, 3004, Australia
| | - Fahad Hanna
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
| | - Flavia M Cicuttini
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne 3004, Australia
| |
Collapse
|
26
|
Urquhart DM, Wluka AE, Teichtahl AJ, Cicuttini FM. The effect of physical activity on the knee joint: is it good or bad? Br J Sports Med 2007; 41:546-7. [PMID: 17726198 PMCID: PMC2465407 DOI: 10.1136/bjsm.2007.037416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
27
|
Lemoyne J, Laurencelle L, Lirette M, Trudeau F. Occupational health problems and injuries among Quebec's physical educators. APPLIED ERGONOMICS 2007; 38:625-34. [PMID: 16989768 DOI: 10.1016/j.apergo.2006.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2005] [Revised: 04/21/2006] [Accepted: 06/11/2006] [Indexed: 05/11/2023]
Abstract
The purpose of this study was to describe the traumatology of teaching physical education (PE) and to document the causes and mechanisms of injuries in this occupation. Our sample was composed of 314 physical educators (PEs) teaching at three school levels (primary school, secondary school and college) who responded to a questionnaire survey. The results showed a 0.55 rate of recent lesion per teacher per year (0.65 for women and 0.51 for men). A total of 37.6% of subjects were affected by a lesion during the last year at work. Subjects with a higher weekly frequency of leisure physical activities or endurance activities (five times and more) were less affected by chronic lesions as well as those who frequently practiced aerobic physical activities. Prevalence of chronic injuries was higher in older teachers. Our results confirm that the rate of lesions in this group of workers is high, and that school level and respondent age may influence the rate of lesion and the characteristics of risk factors. In particular, the effect of ageing and teaching specialization on the incidence of occupational problems in PEs warrants further research. Given the relatively high rate of injuries among PE teachers, we suggest that it is necessary to further explore preventive strategies to reduce occupational risk in these workers. In particular, prophylactic physical activity outside of work may represent such a strategy since PEs more active outside their work have lower chronic injury prevalence. PEs gave long periods of standing the highest rating for movements or positions most likely to cause them occupational injuries. It can thus be suggested to find ways to reduce standing position sustained for long periods.
Collapse
Affiliation(s)
- Jean Lemoyne
- Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, 3351, boul. des Forges, C.P. 500, Trois-Rivières (Québec), Canada G9A 5H7
| | | | | | | |
Collapse
|
28
|
Abstract
Osteoarthritis of the hip and knee is a leading cause of functional disability and compromised quality of life in older patients and a significant public health issue. Emerging research shows sex and gender differences in osteoarthritis which, to date, may not be appreciated by the orthopedic community. This article discusses sex and gender differences in osteoarthritis with a focus on disease involving the hip and knee. Understanding what we know (and do not know) about sex and gender differences in this disorder is critical to improving quality of care for our patients.
Collapse
|
29
|
Hootman JM, Macera CA, Helmick CG, Blair SN. Influence of physical activity-related joint stress on the risk of self-reported hip/knee osteoarthritis: a new method to quantify physical activity. Prev Med 2003; 36:636-44. [PMID: 12689810 DOI: 10.1016/s0091-7435(03)00018-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The relationship between physical activity (PA) and the development of hip/knee osteoarthritis (OA) has not been clearly defined. The purpose of this study was to develop a method to quantify PA-related joint stress and to assess its influence on the risk of hip/knee OA. METHODS Participants in a large longitudinal study, without knee/hip OA (n = 5284), were asked about their PA participation in 1986. PA-related joint stress was calculated using information on the frequency, intensity, and duration of individual types of PA, and incorporated a quantification of joint stress. Self-reported, physician-diagnosed hip/knee OA was ascertained by survey in 1990, 1995, and 1999 (average length of follow-up: 12.8 years). METHODS The joint stress PA score was not associated with an increased risk of hip/knee OA. Also, among walkers and runners there was no association between the frequency, pace, or weekly training mileage and hip/knee OA. Older age, previous joint injury and surgery, and higher body mass index were confirmed as independent risk factors for hip/knee OA. CONCLUSIONS Participation in PA as an adult does not increase the risk of hip/knee OA and there does not seem to be a threshold of increasing risk with increased training among walkers and runners.
Collapse
Affiliation(s)
- Jennifer M Hootman
- Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA.
| | | | | | | |
Collapse
|
30
|
Abstract
There appears to be an increased risk of lower limb osteoarthritis in participants of repetitive, high impact sports, and this is strongly associated with joint injury. There seems to be little risk associated with recreational running. Assessment of risk for osteoarthritis should take into account the nature of the sport, intensity of training, presence of previous injury, body mass index, and occupation.
Collapse
Affiliation(s)
- P G Conaghan
- Department of Rheumatology, Leeds General Infirmary, UK.
| |
Collapse
|
31
|
Zheng F, Sandhu HS, Cammisa FP, Girardi FP, Khan SN. Predictors of functional outcome in elderly patients undergoing posterior lumbar spine surgery. JOURNAL OF SPINAL DISORDERS 2001; 14:518-21. [PMID: 11723404 DOI: 10.1097/00002517-200112000-00011] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To ascertain the predictors of functional outcome in elderly patients undergoing posterior lumbar spinal decompression and fusion, a modified low back outcome score questionnaire survey in 83 elderly patients (49 men, 34 women) was carried out at our hospital. The average follow-up was 35.8 months (range: 22-57 months). The outcomes were as follows: excellent to good, 83%; fair, 7%; and poor, 10%. Multiple regression analysis revealed that significant predictors of unfavorable outcome included coexistence of other bone and joint degenerative disorders (p < 0.001) and history of heart disease (p < 0.01). Patients who had undergone previous lumbar surgery had significantly lower modified low back outcome score than those without previous lumbar spine surgery (p < 0.05). The modified low back outcome score questionnaire system is a reliable method in elderly patients.
Collapse
Affiliation(s)
- F Zheng
- Spine Service, Hospital for Special Surgery, New York, New York 10021, USA
| | | | | | | | | |
Collapse
|
32
|
Sutton AJ, Muir KR, Mockett S, Fentem P. A case-control study to investigate the relation between low and moderate levels of physical activity and osteoarthritis of the knee using data collected as part of the Allied Dunbar National Fitness Survey. Ann Rheum Dis 2001; 60:756-64. [PMID: 11454639 PMCID: PMC1753811 DOI: 10.1136/ard.60.8.756] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Physical activity is being recommended as an intervention for seemingly almost universal improvements to health. A potential concern with this recommendation for increased exercise is that some believe increased levels of activity may lead to increased incidence of osteoarthritis of the knee (knee OA), as a result of accelerated "wear and tear" of the major joints. OBJECTIVE To investigate the hypothesis that the occurrence of knee OA may be related to the duration of participation in some forms of sport and active recreation. METHODS The relation between habitual exercise, reported by a cross section of people surveyed in England, and self reported knee OA was investigated. Data were derived from the Allied Dunbar National Fitness Survey (1990-91). A matched retrospective case-control design was used and a new exposure classification system which categorised different grades of activities for different time periods for each subject's lifetime participation in regular physical activities was developed. Additional data on knee injuries sustained and bodily composition were also included in a multivariate analysis. RESULTS From 4316 people originally interviewed, 216 eligible cases (66 men, 150 women) were identified (mean age 57.1). Each case was matched to four controls. When habitual sport/exercise participation were examined during a subject's life, only exposure to regular long walks and being physically active between the ages of 20 and 24 suggested any association with developing knee OA later in life. The only strong association found was a greatly increased risk of knee OA having previously sustained a knee injury (p<0.01, odds ratio 8.0 (95% confidence interval 2.0 to 32.0)). CONCLUSIONS There was little evidence to suggest that increased levels of regular physical activity throughout life lead to an increased risk of knee OA later in life. Previous knee injury was associated with an increased risk of knee OA. Additionally, most injuries were caused through participation in physical activities. Hence, when deciding on participation in activities, it is worth taking the likelihood of joint injury into consideration, as the chance of injury is greater in some activities than others.
Collapse
Affiliation(s)
- A J Sutton
- Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, UK.
| | | | | | | |
Collapse
|
33
|
Caspi D, Flusser G, Farber I, Ribak J, Leibovitz A, Habot B, Yaron M, Segal R. Clinical, radiologic, demographic, and occupational aspects of hand osteoarthritis in the elderly. Semin Arthritis Rheum 2001; 30:321-31. [PMID: 11303305 DOI: 10.1053/sarh.2001.19957] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Osteoarthritis (OA) of the hand is common in elderly patients. The aim of this study was to characterize OA frequency, severity, and distribution and to trace interrelationships between these findings and the demographic, occupational, and medical data from elderly Jewish nonrheumatologic patients. METHODS Study participants were 253 consecutive patients admitted to a geriatric center for a variety of nonrheumatic medical conditions. Excluded patients were those with rheumatoid arthritis; neurologic, orthopedic, or other conditions that would interfere with symmetric hand function; and mental or medical states that would interfere with history taking and radiographic studies. Patient occupations were graded as workload degree (on a scale of 1 to 3) and as the total occupational score (workload degree multiplied by the duration of each job). Clinical findings of Heberden nodes, Bouchard nodes, and malignment, graded on a scale of 0 to 3, were summed as the clinical OA score. Hand radiographs were independently read (modified Altman method), grading 5 parameters in each joint on a scale of 0 to 3, summed as a radiologic OA score. Statistical analyses included the Student t test, chi(2) test, ANOVA, Pearson correlation, and partial correlation coefficients. RESULTS Among 253 elderly patients (171 women, 82 men; mean age, 79 years) OA was frequent (occurring in about 80% of patients), involving most severely the second and third distal interphalangeal, right first interphalangeal, and both first carpometacarpal joints. The prevalence of OA was similar in women and men, with higher scores in women, and reached significance only in the distal interphalangeal joints. Metacarpophalangeal joints were more involved in men. Age had a clear influence on OA scores. Ethnicity affected OA severity, with Ashkenazi Jews having significantly higher scores than Sepharadi Jews. Dominant hands had significantly higher global OA scores as well as isolated joint scores (except for the first carpometacarpal joint). Occupational load, housekeeping tasks, and the number of children did not influence the total or specific joint OA scores. Associated conditions such as obesity, diabetes, hypothyroidism, and chondro calcinosis were not associated with more pronounced OA. CONCLUSIONS Hand OA was prevalent in our elderly cohort, and its severity was influenced by inherent traits such as age, female gender, ethnicity, and handedness. In contrast, acquired factors such as workload, number of children, and associated diseases did not appear to influence OA expression.
Collapse
Affiliation(s)
- D Caspi
- Departments of Rheumatology and Radiology, Tel Aviv (Souraski) Medical Center, Tel Aviv, Israel.
| | | | | | | | | | | | | | | |
Collapse
|
34
|
Segal R, Avrahami E, Lebdinski E, Habut B, Leibovitz A, Gil I, Yaron M, Caspi D. The impact of hemiparalysis on the expression of osteoarthritis. ARTHRITIS AND RHEUMATISM 1998; 41:2249-56. [PMID: 9870882 DOI: 10.1002/1529-0131(199812)41:12<2249::aid-art21>3.0.co;2-o] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Primary generalized osteoarthritis (OA), the most prevalent joint disease, is usually symmetric. Sporadic case reports mention decreased OA manifestations in limbs in which there are neurologic deficits, but no systematic research has been published. The aim of the present study was to examine these observations in a planned and controlled survey in a group of patients with OA. METHODS Seventy-five geriatric patients with a history of stroke and hemiparalysis were studied clinically and radiographically (hand radiographs; graded according to a modified Altman method) for the presence and the degree of OA in the hands. Detailed clinical and radiologic scores were calculated for each hand. Demographic, occupational, and neurologic data were collected. Patients with other joint or neurologic conditions were excluded. A group of 55 elderly patients without stroke were similarly studied (controls). Scores in the paralyzed hand were compared with those in the nonparalyzed hand in the stroke patients and subgroups (by Student's paired t-test and Wilcoxon test). Scores in the dominant hands were compared with those in the nondominant hands in stroke patients and control subjects (by Student's paired t-test and Mann-Whitney test). Correlation between the degree of neurologic damage and OA asymmetry (Pearson's correlation coefficient) was also sought. RESULTS Paralyzed hands showed significantly fewer OA changes than nonparalyzed hands, both clinically and radiologically. This trend, accentuated in patients with more severe paralysis, disappeared in those with mild residual paresis. Asymmetry of OA was more pronounced in patients with flaccid, compared with spastic, paralysis. The degree of paralysis and loss of muscle strength correlated with the degree of OA asymmetry. Women had significantly higher OA scores than men. In the control group, dominant hands had higher OA scores, but this finding was concealed among hemiparalyzed patients. Lifetime gross occupational load and present grip strength did not correlate with the degree of OA. CONCLUSION In elderly patients, hemiparalysis reduces ipsilateral hand expression of OA, while OA is accentuated (or increased) in the dominant hand of patients without paralysis. This first systematic study confirms the findings of previous case reports and lends support to the role of biomechanical factors in the development of OA.
Collapse
Affiliation(s)
- R Segal
- Shmuel Harofe Geriatric Medical Center, Beer Yaacov, Israel
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Abstract
Participation in sports has evolved as a cause of osteoarthritis (OA), especially in hip and knee joints. OA often occurs at a relatively early age in adult life, in certain sports (soccer, rugby, racket sports and other track and field sports) and under certain conditions (high level of practice). We review preclinical considerations and published epidemiological studies. Joint overuse even without notable trauma is likely the main mechanism of OA both in these sports and in certain occupational activities (relative risk ranges from 1.5 to more than 5 depending chiefly on the category of sport and on the level and duration of practice). Irregular or sudden impacts, heavy load application on the dominant weight-bearing lower limb and the pre-existing state of the joint including dysplasia, dystrophy or previous trauma are risk factors for OA. However, recreational sport activities at a reasonable level are not likely to be harmful for most individuals, in most sport activities.
Collapse
Affiliation(s)
- M G Lequesne
- Rheumatology Department, Leopold Bellan Hospital, Paris, France
| | | | | |
Collapse
|
36
|
Vuori I. Exercise and physical health: musculoskeletal health and functional capabilities. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 1995; 66:276-285. [PMID: 8775582 DOI: 10.1080/02701367.1995.10607912] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
An adequately functioning musculoskeletal system is a key factor for functional capacity, independence, and good quality of life. Impaired functional capacity and degenerative diseases of the musculoskeletal organs are one of the most prevalent and increasing sources of morbidity and suffering. Physical activity positively influences most structural components of the musculoskeletal system that are related to functional capabilities and the risk of degenerative diseases. Physical activity also has the potential to postpone or prevent prevalent musculoskeletal disorders, such as mechanical low back pain, neck and shoulder pain, and osteoporosis and related fractures. Exercise can contribute to the rehabilitation of musculoskeletal disorders and recovery from orthopedic surgery. A substantial part of the age-related decline in functional capabilities is not due to aging per se but to decreased and insufficient physical activity. Physical activity has great potential to favorably influence both the normal and pathological structures, functions, and processes. Musculoskeletal benefits of physical activity can be attained by people of all ages and with various diseases. This potential is substantial because many benefits are gained by activity which is moderate in amount and intensity. Scientific evidence is sufficient to recommend regular lifelong physical activity as part of a healthy lifestyle for everyone in order to enhance musculoskeletal health and functions for individual and population levels. However, several important issues regarding the effects, effectiveness, feasibility, and safety of exercise to improve various aspects of musculoskeletal health and functional capabilities need further research.
Collapse
Affiliation(s)
- I Vuori
- Urho Kaleva Kekkonen Institute for Health Promotion Research, Tampere, Finland.
| |
Collapse
|