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Horn CG, Jensen K, Hartvigsen J, Wekre LL, Skou ST, Folkestad L. Evaluation of the Nordic Musculoskeletal Questionnaire for Measuring Prevalence and the Consequence of Pain in a Danish Adult OI Population: A Pilot Study. Calcif Tissue Int 2024:10.1007/s00223-024-01262-9. [PMID: 39066925 DOI: 10.1007/s00223-024-01262-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
Pain is a challenge in persons with OI and causes much concern in the Osteogenesis Imperfecta (OI) population. We aim to evaluate the usability of the Nordic Musculoskeletal Questionnaire (NMQ) to identify painful sites in adults with OI and to describe the occurrence of musculoskeletal (MSK) pain and its impact on their work and daily activities. This cross-sectional pilot study uses the OI-NMQ to study MSK pain prevalence in nine separate anatomical regions (neck, upper back, lower back, shoulder, elbow, hand/wrist, hip, knee, and ankle/foot) and its impact on regular work and daily activities in adults with OI. The questionnaire was distributed among participants of the 2023 annual meeting of The Danish OI Society. The response rate was 68%, and all participants considered the OI-NMQ helpful in assessing the presence of pain and its consequences. The analysis included 27 adults with OI type I, III, or IV above 18 years. Among all 27 participants, MSK pain was present in 15-56% of the 9 sites within the last 7 days and 33-89% of the nine anatomical regions during the last 12 months. In 7-48% of all the participants, their regular work and daily activities had been affected by the presence of MSK pain. The OI-NMQ was feasible in assessing MSK pain among adults with OI and displayed a high prevalence of MSK pain with a moderate impact on their regular work and daily activities in this OI population. A larger and repeated measurement of MSK pain in adults with OI is needed to confirm these results.
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Affiliation(s)
- Camilla Gehling Horn
- Faculty of Health Sciences, Medicine, University of Southern Denmark, Odense, Denmark
| | - Karsten Jensen
- The Danish Osteogenesis Imperfecta Society, Tarm, Denmark
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
| | - Lena Lande Wekre
- TRS National Resource Center of Rare Disorders, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
| | - Søren T Skou
- Department of Sports Science and Clinical Biomechanics, Center for Muscle and Joint Health, University of Southern Denmark, Odense, Denmark
- The Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Slagelse, Denmark
| | - Lars Folkestad
- Bone and Mineral Unit, Department of Endocrinology, Odense University Hospital, Odense, Denmark.
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
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Naili JE, Åström E, Löwing J, Reimeringer M, Löwing K. The impact of foot orthoses on gait in children with Osteogenesis Imperfecta type I, III and IV - a cross-sectional study. BMC Musculoskelet Disord 2024; 25:560. [PMID: 39026247 PMCID: PMC11256494 DOI: 10.1186/s12891-024-07672-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 07/08/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND For children with Osteogenesis Imperfecta (OI), a rare genetic bone disease, walking can be difficult to carry out due to a combination of bone fragility and deformity, muscle weakness, joint hypermobility, and pain. Bisphosphonate treatment has facilitated more children being able to walk, but for many, foot and ankle hypermobility is a limiting factor. Current evidence on foot orthoses in children with OI is sparse. This study aimed to evaluate gait characteristics in children with OI walking barefoot as compared to walking with foot orthoses. METHODS Twenty-three children with OI and hypermobility (mean age 8.3 ± 3.0 years) were included in this cross-sectional study. Children conducted three-dimensional gait analysis barefoot, and with foot orthoses and appropriate foot wear (stable yet light-weight), respectively. Walking speed, step length, lower limb kinematics and kinetics were collected. Differences in gait characteristics between test conditions were evaluated using paired sample t-tests. RESULTS When walking with foot orthoses, the external foot progression angle was reduced, peak ankle dorsiflexion angle increased, and peak plantarflexion moment increased as compared to barefoot. No difference was found in walking speed between test conditions, however, children with OI walked with longer steps with foot orthoses as compared to barefoot. CONCLUSION The observed gait alterations suggest that foot orthoses, aiming to support the foot and ankle joint, contributed to reduced overall foot rotation as measured by external foot progression, increased peak plantarflexion moment, and increased step length. In a wider perspective, the ability to walk provides the opportunity to be physically active, and thereby increase skeletal loading and prevent fractures, thus, foot orthoses may be an important treatment option to consider in children with OI. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Josefine E Naili
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska Vägen 37 A, QA 02:07, 171 76, Stockholm, Sweden.
- Motion Analysis Lab, Karolinska University Hospital, Stockholm, Sweden.
| | - Eva Åström
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska Vägen 37 A, QA 02:07, 171 76, Stockholm, Sweden
- Department of Neuropediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Josefin Löwing
- Department of Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Gävlegatan 55, NB0:01, 171 76, Stockholm, Sweden
| | - Mikael Reimeringer
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska Vägen 37 A, QA 02:07, 171 76, Stockholm, Sweden
| | - Kristina Löwing
- Department of Women's and Children's Health, Karolinska Institutet, Karolinska Vägen 37 A, QA 02:07, 171 76, Stockholm, Sweden
- Department of Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Gävlegatan 55, NB0:01, 171 76, Stockholm, Sweden
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Wang X, Li Y, Zhong Y, Wang M, Liu X, Han W, Chen H, Ji J. Home care needs assessment among caregivers of children and adolescents with osteogenesis imperfecta: a cross-sectional study. BMC PRIMARY CARE 2024; 25:119. [PMID: 38641795 PMCID: PMC11027538 DOI: 10.1186/s12875-024-02367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
BACKGROUND Children and adolescents with complex medical issues need home care services; however, few studies have provided insight into the unmet home care needs of the families of patients with osteogenesis imperfecta (OI). In this study, we aimed to assess the home care needs of caregivers of children and adolescents with OI and the associated factors. METHODS A self-administered questionnaire was administered online to 142 caregivers of patients with OI aged 3-17 years between May and October 2022 from 25 provinces in China. The questionnaire comprised 15 questions on demographic variables and 14 questions on home care needs. Chi-square analysis was used to compare group differences for categorical variables. Multivariate binary logistic regression analysis was conducted to examine predictors of caregivers' home care needs. RESULTS The study findings indicated that 81.5% of caregivers had high home care needs. The three leading types of home care needs were helping the child carry out physical fitness recovery exercises at home (72.5%), understanding precautions regarding treatment drugs (72.5%), and relieving the child's pain (70.4%). OI patients' poor self-care ability (adjusted odds ratio = 5.9, 95% confidence interval = 1.8-19.0) was related to caregivers' high level of home care needs. CONCLUSIONS The findings of this study suggest that future scientific research and nursing guidance should focus on OI patients' physical training, medication management, pain relief, fracture prevention, and treatment. In addition, caregivers of patients with poor self-care ability should receive special attention in the development of interventions. This study can help with addressing the unmet home care needs of caregivers of children and adolescents with OI. It is vital to develop a personalized intervention plan based on patients' self-care ability.
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Affiliation(s)
- Xinyi Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.6699 Qingdao Road, Huaiyin District, Jinan, Shandong Province, 250117, China
- Department of Pediatric Orthopaedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University& Shandong Academy of Medical Sciences, No.324 Five Weft Seven Road, Huaiyin District, Jinan, Shandong Province, 250021, China
| | - Yuqing Li
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.619 Changcheng Road, Daiyue District, Taian, Shandong Province, 271016, China
| | - Yaping Zhong
- Academic Nursing Unit, Peter MacCallum Cancer Centre, No.305 Grattan Street, Melbourne, VIC, 3000, Australia
| | - Min Wang
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.6699 Qingdao Road, Huaiyin District, Jinan, Shandong Province, 250117, China
| | - Xuehua Liu
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.6699 Qingdao Road, Huaiyin District, Jinan, Shandong Province, 250117, China
| | - Wenxuan Han
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, No.6699 Qingdao Road, Huaiyin District, Jinan, Shandong Province, 250117, China
| | - Huifang Chen
- School of Nursing, Guangzhou Medical University, No.195 Dongfengxi Road, Guangzhou, Guangdong, 510182, China
| | - Ji Ji
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University& Shandong Academy of Medical Sciences, No.324 Five Weft Seven Road, Huaiyin District, Jinan, Shandong Province, 250021, China.
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Westerheim I, Hart T, van Welzenis T, Wekre LL, Semler O, Raggio C, Bober MB, Rapoport M, Prince S, Rauch F. The IMPACT survey: a mixed methods study to understand the experience of children, adolescents and adults with osteogenesis imperfecta and their caregivers. Orphanet J Rare Dis 2024; 19:128. [PMID: 38515144 PMCID: PMC10956293 DOI: 10.1186/s13023-024-03126-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/03/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is a rare, heritable connective tissue disorder associated with a variety of symptoms, that affect individuals' quality of life (QoL) and can be associated with increased healthcare resource use. While some aspects of OI are well studied, others remain poorly understood. Therefore, the IMPACT survey aimed to elucidate the humanistic, clinical and economic burden of OI on individuals with OI, their families, caregivers and wider society. METHODS We developed an international mixed methods online survey in eight languages (fielded July-September 2021), aimed at adults (aged ≥ 18 years) or adolescents (aged ≥ 12-17 years) with OI, caregivers (with or without OI) of individuals with OI and other close relatives. All respondents provided data on themselves; caregivers additionally provided data on individuals in their care by proxy. Data were cleaned, coded, and analysed using the pandas Python software package and Excel. RESULTS IMPACT collected 2208 eligible questionnaires (covering 2988 individuals of whom 2312 had OI) including 1290 non-caregiver adults with OI, 92 adolescents with OI, 150 caregiver adults with OI, 560 caregivers for individuals with OI, 116 close relatives and 780 proxy care-recipients with OI. Most individuals with OI (direct or proxy) described their OI as moderate (41-52% across populations) and reported OI type 1 (33-38%). Pain (72-82%) was the most reported clinical condition experienced in the past 12 months and was also most frequently rated as severely or moderately impactful. Further, among adults, 67% reported fatigue, 47% scoliosis, and 46% sleep disturbance; in adolescents, fatigue affected 65%, scoliosis and other bone problems 60%, and mental health problems 46%; in children, fractures were common in 67%, fatigue in 47%, and dental problems in 46%. CONCLUSION IMPACT has generated an extensive dataset on the experience of individuals with OI, their caregivers and relatives. We found that, irrespective of age, individuals with OI experience numerous and evolving symptoms that affect their QoL; however, pain and fatigue are consistently present. Upcoming analyses will provide further insights into the economic impact, healthcare journey and caregiver wellbeing, aiming to contribute to improved treatment and care for the OI community.
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Affiliation(s)
| | - Tracy Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | - Lena Lande Wekre
- TRS National Resource Center for Rare Disorders, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
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Bukhari KA, Khan IA, Ishaq S, Iqbal MO, Alqahtani AM, Alqahtani T, Menaa F. Formulation and Evaluation of Diclofenac Potassium Gel in Sports Injuries with and without Phonophoresis. Gels 2022; 8:612. [PMID: 36286113 PMCID: PMC9601609 DOI: 10.3390/gels8100612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 09/15/2022] [Accepted: 09/20/2022] [Indexed: 08/30/2023] Open
Abstract
Background: Pain remains a global public heath priority. Phonophoresis, also known as sonophoresis or ultrasonophoresis, is when an ultrasound is used to maximize the effects of a topical drug. Purpose: The objective of this study was to test, in patients injured in sports or accidents (N = 200), the efficacy of diclofenac potassium (DK) 6%, 4%, and 2% formulated gels with and without phonophoresis in comparison with market available standard diclofenac sodium (DS or DN) gel. Methods: The patients were enrolled after informed consent. By using the lottery method, 100 patients were randomly segregated into five groups without phonophoresis and repeated similarly with phonophoresis at a frequency of 0.8 MHz, an intensity of about 1.5 W/cm2, and at continuous mode (2:1). Group-1 was treated with 6% DK gel, group-2 was treated with 4% DK gel, group-3 was treated with 2% DK gel, group-4 was treated with 4% DS gel and group-5 was given control gel three to four times a week for 4 weeks. The patients were screened by using NPRS and WOMAC scales. They were assessed on the baseline, 4th session, 8th session, 12th session, and 16th session. Results: Significant dose-dependently relief was observed in NPRS (Numeric Pain Rating Scale) and the WOMAC (Western Ontario McMaster Osteo-Arthritis) index for pain in disability and stiffness for each group treated with DK gel compared to DS gel. Phonophoresis increased these benefits significantly when used after topical application of DK gel or DS gel, and the dose-dependent effects of DK gel plus phonophoresis were stronger than the dose-dependent effects of DS gel plus phonophoresis. The faster and profounder relief was due to phonophoresis, which allows more penetration of the DK gel into the skin as compared to the direct application of DK gel in acute, uncomplicated soft tissue injury, such as plantar fasciitis, bursitis stress injuries, and tendinitis. In addition, DK gel with phonophoresis was well tolerated. Thus, in this personalized clinical setting, according to the degree of inflammation or injured-induced pain, disability, and stiffness, DK gel 6% with phonophoresis appeared more effective and thus more recommendable than DS gel 6% alone or DS gel 6% combined to phonophoresis.
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Affiliation(s)
- Komal Ammar Bukhari
- Ali-Ul-Murtaza, Department of Rehabilitation Sciences, Muhammad Institute of Medical and Allied Sciences, Multan 60000, Pakistan
| | - Imran Ahmad Khan
- Ali-Ul-Murtaza, Department of Rehabilitation Sciences, Muhammad Institute of Medical and Allied Sciences, Multan 60000, Pakistan
- Department of Pharmacology and Physiology, MNS University of Agriculture, Multan 60000, Pakistan
| | - Shahid Ishaq
- Department of Rehabilitation, Bakhtawar Amin Medical and Dental College, Multan 60000, Pakistan
| | - Muhammad Omer Iqbal
- Shandong Provincial Key Laboratory of Glycoscience and Glycoengineering, School of Medicine and Pharmacy, Ocean University of China, Qingdao 266100, China
- Royal Institute of Medical Sciences (RIMS), Multan 60000, Pakistan
| | - Ali M. Alqahtani
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Taha Alqahtani
- Department of Pharmacology, College of Pharmacy, King Khalid University, Abha 62529, Saudi Arabia
| | - Farid Menaa
- Departments of Internal Medicine and Nanomedicine, California Innovations Corporation, San Diego, CA 92037, USA
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