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Toomey CM, Bhardwaj A, Browne J, Dowling I, Grealis S, Hayes P, Higgins N, Maguire D, O'Hora J, Rector J, Wood-Thornsbury A, Kennedy N. Guideline-based exercise management for hip and knee osteoarthritis: a cross-sectional comparison of healthcare professional and patient beliefs in Ireland. BMJ Open 2024; 14:e080646. [PMID: 38969380 PMCID: PMC11227783 DOI: 10.1136/bmjopen-2023-080646] [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: 10/23/2023] [Accepted: 06/23/2024] [Indexed: 07/07/2024] Open
Abstract
OBJECTIVES To identify within-stakeholder agreement and between-stakeholder differences in beliefs regarding exercise for osteoarthritis among general practitioners (GPs), physiotherapists (PTs) and people with hip and knee osteoarthritis (PwOA). A secondary objective was to explore the association between referral patterns and beliefs of PwOA. DESIGN Cross-sectional. SETTING Online surveys administered to GPs, PTs and PwOA in Ireland via social media and healthcare networks. PARTICIPANTS 421 valid responses (n=161 GPs, n=163 PTs, n=97 PwOA). PRIMARY AND SECONDARY OUTCOME MEASURES Nine belief statements related to exercise effectiveness, safety and delivery were rated on a 5-point Likert scale and analysed for within-stakeholder consensus. χ2 tests assessed differences in agreement between groups. Multivariable linear regression models tested associations between beliefs in PwOA and referral to/attendance at physiotherapy. RESULTS Positive within-stakeholder consensus (>75% agreement) was reached for most statements (7/9 GPs, 6/9 PTs, 5/9 PwOA). However, beliefs of PwOA were significantly less positive compared with healthcare professionals for six statements. All stakeholders disagreed that exercise is effective regardless of the level of pain. Attendance at physiotherapy (49% of PwOA), rather than referral to physiotherapy from a GP only, was associated with positive exercise beliefs for PwOA (β=0.287 (95% CI 0.299 to 1.821)). CONCLUSIONS Beliefs about exercise therapy for osteoarthritis are predominantly positive across all stakeholders, although less positive in PwOA. PwOA are more likely to have positive beliefs if they have seen a PT for their osteoarthritis. Knowledge translation should highlight the effectiveness of exercise for all levels of pain and osteoarthritis disease.
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Affiliation(s)
- Clodagh M Toomey
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
- Participatory Health Research Unit, University of Limerick, Limerick, Ireland
| | - Avantika Bhardwaj
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Jacqui Browne
- Patient Author, IMPACT Steering Committee, Limerick, Ireland
| | - Ian Dowling
- Ian Dowling Physiotherapy Clinic, Limerick, Ireland
- Clinician Author, IMPACT Steering Committee, Limerick, Ireland
| | - Stacey Grealis
- Patient Author, IMPACT Steering Committee, Limerick, Ireland
- Centre of Arthritis Research, University College Dublin, Dublin, Ireland
| | - Peter Hayes
- Health Research Institute, University of Limerick, Limerick, Ireland
- Clinician Author, IMPACT Steering Committee, Limerick, Ireland
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Niall Higgins
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Darragh Maguire
- Clinician Author, IMPACT Steering Committee, Limerick, Ireland
- Department of Physiotherapy, National Orthopaedic Hospital Cappagh, Dublin, Ireland
| | - John O'Hora
- Clinician Author, IMPACT Steering Committee, Limerick, Ireland
- Community Healthcare West, Health Service Executive, Co. Roscommon, Ireland
| | - Joseph Rector
- School of Allied Health, University of Limerick, Limerick, Ireland
| | | | - Norelee Kennedy
- School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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Dubé MO, Dillon S, Gallagher K, Ryan J, McCreesh K. One and Done? The Effectiveness of a Single Session of Physiotherapy Compared With Multiple Sessions to Reduce Pain and Improve Function and Quality of Life in Patients With a Musculoskeletal Disorder: A Systematic Review With Meta-analyses. Arch Phys Med Rehabil 2024; 105:1171-1180. [PMID: 37805175 DOI: 10.1016/j.apmr.2023.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE To compare single and multiple physiotherapy sessions to improve pain, function, and quality of life (QoL) in patients with musculoskeletal disorders (MSKDs). DATA SOURCES AMED, Cinahl, SportsDiscus, Medline, Cochrane Register of Clinical Trials, Physiotherapy Evidence Database, and reference lists. STUDY SELECTION Randomized controlled trials (RCTs) comparing single and multiple physiotherapy sessions for MSKDs. DATA EXTRACTION Two reviewers extracted data and assessed risk of bias and certainty of evidence using Cochrane Risk of Bias tool 2.0 and Grading of Recommendation Assessment, Development, and Evaluation. DATA SYNTHESIS Six RCTs (n=2090) were included (conditions studied: osteoporotic vertebral fracture, neck, knee, and shoulder pain). Meta-analyses with low-certainty evidence showed a significant pain improvement at 6 months in favor of multiple sessions compared with single session interventions (3 RCTs; n=1035; standardized mean difference [SMD]: 0.29; 95% CI: 0.05 to 0.53; P=.02) but this significant difference in pain improvement was not observed at 3 months (4 RCTs; n=1312; SMD: 0.39; 95% CI: -0.11 to 0.89; P=.13) and at 12 months (4 RCTs; n=1266; SMD: -0.05; 95% CI: -0.49 to 0.39; P=.82). Meta-analyses with low-certainty evidence showed no significant differences in function at 3 (4 RCTs; n=1583; SMD: 0.05; 95% CI: -0.11 to 0.21; P=.56), 6 (4 RCTs; n=1538; SMD: 0.06; 95% CI: -0.12 to 0.23; P=.53) and 12 months (4 RCTs; n=1528; SMD: 0.08; 95% CI: -0.08 to 0.25; P=.30) and QoL at 3 (4 RCTs; n=1779; SMD: 0.08; 95% CI: -0.02 to 0.17; P=.12), 6 (3 RCTs; n=1206; SMD: 0.03; 95% CI: -0.08 to 0.14; P=.59), and 12 months (4 RCTs; n=1729; SMD: -0.03; 95% CI: -0.12 to 0.07; P=.58). CONCLUSIONS Low certainty meta-analyses found no clinically significant differences in pain, function, and QoL between single and multiple physiotherapy sessions for MSKD management for the conditions studied. Future research should compare the cost-effectiveness of those different models of care.
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Affiliation(s)
- Marc-Olivier Dubé
- Rehabilitation Department, Faculty of Medicine, Université Laval, Quebec, Canada; Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada.
| | - Sarah Dillon
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kevin Gallagher
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Jake Ryan
- School of Allied Health, University of Limerick, Limerick, Ireland
| | - Karen McCreesh
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
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Kung Y, Chien WC, Shen HH, Chen SL, Yu WL, Wang YC, Chen WS, Wu CH. Potential of thermoresponsive hydrogel as an alternative therapy for rat knee osteoarthritis. J Biomater Appl 2023; 38:707-718. [PMID: 37867223 DOI: 10.1177/08853282231208506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023]
Abstract
Osteoarthritis is a degenerative condition that is highly prevalent and primarily affects the joints. The knee is the most commonly affected site, impacting the lives of over 300 million individuals worldwide. This study presents a potential solution to address the unmet need for a minimally invasive technique in the treatment of osteoarthritis: a biocompatible, injectable, and thermoresponsive hydrogel. In comparison to commercially available products such as lyophilized platelets, dextrose, and triamcinolone, the thermoresponsive hydrogel exhibits significantly superior performance in dynamic behaviors, including print area, stability, and step cycle, when tested on rats with knee osteoarthritis. However, it demonstrates similar treatment efficacy to these products in static behaviors, as observed through histopathological and immunohistochemical analysis. Therefore, the thermoresponsive hydrogel holds promise as an effective alternative therapy for osteoarthritis. Moreover, by blending the hydrogel with drugs, controlled and sustained release can be achieved, thereby facilitating the long-term management of osteoarthritis symptoms.
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Affiliation(s)
- Yi Kung
- Department of Biomechatronic Engineering, National Chiayi University, Chiayi, Taiwan
| | - Wei-Chun Chien
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Hsin-Hsin Shen
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Sen-Lu Chen
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Wei-Lin Yu
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Yu-Chi Wang
- Biomedical Technology and Device Research Laboratories, Industrial Technology Research Institute, Hsinchu, Taiwan
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli, Taiwan
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan
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Costa D, Cruz EB, Lopes DG, da Silva CN, Henriques AR, Luis D, Branco J, Canhão H, Rodrigues AM. Prevalence of and factors associated with unmanageable pain levels in people with knee or hip osteoarthritis: a cross-sectional population-based study. BMC Musculoskelet Disord 2023; 24:60. [PMID: 36683031 PMCID: PMC9869512 DOI: 10.1186/s12891-022-06110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 12/21/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Pain due to knee and / or hip osteoarthritis (HKOA) is the most common symptom for seeking healthcare. Pain interferes on daily activities, social and occupational participation in people with HKOA. The goal of this study is to estimate the prevalence of unmanageable pain levels (UPL) among people with HKOA), characterize this population and identify factors associated with UPL, and compare therapeutic strategies used by people with UPL versus manageable pain levels (MPL). METHODS We analysed data from the EpiReumaPt study (n = 10,661), that included a representative sample of the Portuguese population. Among these, 1081 participants had a validated diagnosis of HKOA by a rheumatologist.. Sociodemographic, lifestyle and health-related data were collected in a structured interview. Pain intensity (NPRS) data were collected in a medical appointment. Painmedication (last month), physiotherapy and surgery were considered as therapies for pain management. UPL was defined as a mean pain intensity in the previous week of ≥5 points on 11-point numeric pain rating scale. The factors associated with UPL were analyzed with logistic regression (p < 0.05, 95%CI). The effect of unmanageable pain levels was assessed by the HOOS/KOOS activities of daily living and quality of life subscales. Symptoms of anxiety and depression were assessed by the Hospital Anxiety and Depression Scale (HADS). Analysis was completed with linear and logistic regression. All analysis were weighted. RESULTS The estimated prevalence of UPL among people with HKOA was 68.8%. UPL was associated with being female (odds ratio (OR) = 2.36, p < 0.001), being overweight (OR = 1.84, p = 0.035) or obese (OR = 2.26, p = 0.006), and having multimorbidity (OR = 2.08, p = 0.002). People with UPL reported worse performance in activities of daily living and lower quality of life (β = - 21.28, p < 0.001 and β = - 21.19, p < 0.001, respectively) than people with MPL. People with UPL consumed more NSAIDs (22.0%, p = 0.003), opioids (4.8%, p = 0.008), paracetamol (2.7%, p = 0.033), and overall analgesics (7.3%, p = 0.013) than people with MPL. A higher proportion of people with UPL underwent physiotherapy (17.5%, p = 0.002) than people with MPL. CONCLUSION Two-thirds of people with HKOA in Portugal have poor management of their pain levels. Clinical and lifestyle factors, that are highly presented in individuals with HKOA, are associated with unmanageable pain. Our results highlighting the need for further research and implementation of effective interventions to improve pain, function and quality of life in people with HKOA.
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Affiliation(s)
- Daniela Costa
- grid.10772.330000000121511713NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Eduardo B. Cruz
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.421114.30000 0001 2230 1638Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - David G. Lopes
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Catarina Nunes da Silva
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana Rita Henriques
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Diogo Luis
- grid.421114.30000 0001 2230 1638Physiotherapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Jaime Branco
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal ,grid.414462.10000 0001 1009 677XServiço de Reumatologia do Hospital Egas Moniz, Centro Hospital Lisboa Ocidental (CHLO), Lisbon, Portugal
| | - Helena Canhão
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Ana M. Rodrigues
- grid.10772.330000000121511713Comprehensive Health Research Centre (CHRC), Universidade Nova de Lisboa, Lisbon, Portugal ,grid.10772.330000000121511713EpiDoC Unit, NOVA Medical School (NMS), Universidade NOVA de Lisboa, Lisbon, Portugal ,Rheumatology Unit, Hospital dos Lusíadas, Lisbon, Portugal
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Liu CY, Tu JF, Lee MS, Qi LY, Yu FT, Yan SY, Li JL, Lin LL, Hao XW, Su XT, Yang JW, Wang LQ. Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis. BMJ Open 2022; 12:e052270. [PMID: 35017242 PMCID: PMC8753400 DOI: 10.1136/bmjopen-2021-052270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA. METHODS AND ANALYSIS Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched from the database inception to 1 September 2021. All randomised controlled trials related to acupuncture for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be pain intensity. Risk of bias will be assessed using the Cochrane Collaboration's tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology. ETHICS AND DISSEMINATION Ethics approval is not required because individual patient data are not included. This protocol was registered in the international Prospective Register of Systematic Reviews on 25 February 2021. The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal. The findings will also be disseminated through conference presentations. TRIAL REGISTRATION NUMBER CRD42021232177.
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Affiliation(s)
- Chuan-Yang Liu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jian-Feng Tu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Myeong Soo Lee
- KM Science Research division, Korea Institute of Oriental Medicine, Daejon, South Korea
| | - Ling-Yu Qi
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Fang-Ting Yu
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Shi-Yan Yan
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jin-Ling Li
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Lu-Lu Lin
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Wan Hao
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Xin-Tong Su
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Jing-Wen Yang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
| | - Li-Qiong Wang
- School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
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Costa D, Cruz EB, Rodrigues AM, Gonçalves-Bradley D, Gomes LA, Donato H, Nunes C. Models of care for patients with knee osteoarthritis in primary healthcare: a scoping review protocol. BMJ Open 2021; 11:e045358. [PMID: 34158296 PMCID: PMC8220471 DOI: 10.1136/bmjopen-2020-045358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Knee osteoarthritis (OA) is a prevalent condition with associated high disability and healthcare costs. Evidence of major gaps in the implementation of evidence-based interventions in people with knee OA led several healthcare systems to implement models of care (MoCs) in order to improve knowledge translation and guaranty their economic sustainability. Nevertheless, there are few studies that analyse the existing body of evidence of MoCs for patients with knee OA in primary healthcare settings. Therefore, we aim to identify MoCs developed for patients with knee OA implemented in primary healthcare and, analyse their core components and outcomes. This scoping review will create knowledge about the components and outcomes of these MoCs which, in the future, will facilitate their transferability to practice. METHODS AND ANALYSIS We will include studies that developed and implemented an MoC for people with knee OA in primary healthcare. We will use the PCC mnemonic, being 'Population'-people with Knee OA, 'Concept'-the MoCs and 'Context'-the primary healthcare setting. We will conduct the search on PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science Core Collection, as well as grey literature databases and relevant institutions and organisations websites, for articles published after 2000. Two independent reviewers will screen titles and abstracts followed by a full-text review to assess papers regarding their eligibility. We will evaluate the methodological quality of the included studies with the Mixed Methods Appraisal tool and apply a data abstraction form to describe and interpret the evidence. ETHICS AND DISSEMINATION As a secondary analysis, this scoping review does not require ethical approval. Findings will be published in peer-review journal, presented in scientific conferences and as a summary through primary healthcare units.
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Affiliation(s)
- Daniela Costa
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit - Epidemiology of Chronic Diseases Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Eduardo B Cruz
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
- Physical Therapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Ana M Rodrigues
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit - Epidemiology of Chronic Diseases Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
| | | | - Luís A Gomes
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
- EpiDoC Unit - Epidemiology of Chronic Diseases Unit, CEDOC, NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal
- Physical Therapy Department, School of Health, Polytechnic Institute of Setúbal, Setúbal, Portugal
| | - Helena Donato
- Documentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Carla Nunes
- NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal
- Comprehensive Health Research Center (CHRC), Universidade Nova de Lisboa, Lisboa, Portugal
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Hunter DJ, March L, Chew M. Osteoarthritis in 2020 and beyond: a Lancet Commission. Lancet 2020; 396:1711-1712. [PMID: 33159851 DOI: 10.1016/s0140-6736(20)32230-3] [Citation(s) in RCA: 328] [Impact Index Per Article: 82.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 12/20/2022]
Affiliation(s)
- David J Hunter
- Rheumatology Department, Royal North Shore Hospital, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney and Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia; Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
| | - Lyn March
- Rheumatology Department, Royal North Shore Hospital, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney and Institute of Bone and Joint Research, Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW 2065, Australia
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8
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Hunter DJ, Harris RE. Acupuncture and Knee Osteoarthritis: Does Dose Matter? Arthritis Rheumatol 2020; 73:371-373. [PMID: 33169542 DOI: 10.1002/art.41583] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 11/03/2020] [Indexed: 11/05/2022]
Affiliation(s)
- David J Hunter
- Royal North Shore Hospital, St. Leonards, New South Wales, Australia, and the Institute of Bone and Joint Research, Kolling Institute of Medical Research, and The University of Sydney, Sydney, New South Wales, Australia, and Zhujiang Hospital and Southern Medical University, Guangzhou, China
| | - Richard E Harris
- Chronic Pain and Fatigue Research Center, University of Michigan, Ann Arbor
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O’Brien DW, Bassett S, Clair VWS, Siegert RJ. Can the Pain Attitudes and Beliefs Scales be adapted for use in the context of osteoarthritis with general practitioners and physiotherapists? BMC Rheumatol 2020; 4:15. [PMID: 32309777 PMCID: PMC7147025 DOI: 10.1186/s41927-020-0116-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/17/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Conservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits. Clinicians' beliefs can affect the advice and education given to patients, in turn, this can influence the uptake of treatment. In New Zealand, most conservative OA management is prescribed by general practitioners (GPs; primary care physicians) and physiotherapists. Few questionnaires have been designed to measure GPs' and physiotherapists' osteoarthritis-related health, illness and treatment beliefs. This study aimed to identify if a questionnaire about low back pain beliefs, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), can be adapted to assess GP and physiotherapists' beliefs about osteoarthritis. METHODS This study used a cross-sectional observational design. Data were collected anonymously from GPs and physiotherapists using an online survey. The survey included a study-specific demographic and occupational characteristics questionnaire and the PABS-PT questionnaire adapted for osteoarthritis. All data were analysed using descriptive statistics, and the PABS-PT data underwent principal factor analysis. RESULTS In total, 295 clinicians (87 GPs, 208 physiotherapists) participated in this study. The principal factor analysis identified two factors or subscales (categorised as biomedical and behavioural), with a Cronbach's alpha of 0.84 and 0.44, respectively. CONCLUSIONS The biomedical subscale of the PABS-PT appears appropriate for adaptation for use in the context of osteoarthritis, but the low internal consistency of the behavioural subscale suggests this subscale is not currently suitable. Future research should consider the inclusion of additional items to the behavioural subscale to improve internal consistency or look to develop a new, osteoarthritis-specific questionnaire. TRIAL REGISTRATION This trial was part of the primary author's PhD, which began in 2012 and therefore this study was not registered.
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Affiliation(s)
- Daniel W. O’Brien
- Physiotherapy Department, School of Clinical Sciences, Auckland University of Technology, North Shore Campus, Akoranga Drive, Northcote, Auckland, 0627 New Zealand
| | - Sandra Bassett
- Physiotherapy Department, School of Clinical Sciences, Auckland University of Technology, North Shore Campus, Akoranga Drive, Northcote, Auckland, 0627 New Zealand
| | | | - Richard J. Siegert
- Psychology Department, Auckland University of Technology, Auckland, New Zealand
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Fu K, Makovey J, Metcalf B, Bennell K, Zhang Y, Asher R, Robbins S, Deveza L, Hunter DJ. Role of Hip Injury and Giving Way in Pain Exacerbation in Hip Osteoarthritis: An Internet‐Based Case–Crossover Study. Arthritis Care Res (Hoboken) 2019; 71:742-747. [DOI: 10.1002/acr.23708] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/17/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Kai Fu
- University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia
| | - Joanna Makovey
- University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia
| | - Ben Metcalf
- University of Melbourne Melbourne Victoria Australia
| | - Kim Bennell
- University of Melbourne Melbourne Victoria Australia
| | - Yuqing Zhang
- Massachusetts General Hospital and Harvard School of Medicine Boston Massachusetts
| | - Rebecca Asher
- University of Sydney Sydney New South Wales Australia
| | - Sarah Robbins
- University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia
| | - Leticia Deveza
- University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia
| | - David J. Hunter
- University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia
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Whiteford CM, Steinbeck L, Dommerholt J. On "Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain," Bier JD, Scholten-Peeters WGM, Staal JB, et al. Phys Ther. 2018;98:162-171. Phys Ther 2018; 98:819-820. [PMID: 29961845 DOI: 10.1093/ptj/pzy078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Colleen M Whiteford
- Appalachian Physical Therapy, Broadway, Virginia. Dr Whiteford is a board-certified clinical specialist in orthopaedic physical therapy and a certified myofascial trigger point therapist (pain specialist)
| | - Larry Steinbeck
- Advance Rehabilitation Services, Jasper, Georgia. Mr Steinbeck is a certified myofascial trigger point therapist (pain specialist)
| | - Jan Dommerholt
- Bethesda Physiocare LLC, Bethesda, Maryland. Dr Dommerholt is a diplomate of the Academy of Integrative Pain Management
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Lewis J, O’Sullivan P. Is it time to reframe how we care for people with non-traumatic musculoskeletal pain? Br J Sports Med 2018; 52:1543-1544. [DOI: 10.1136/bjsports-2018-099198] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2018] [Indexed: 12/31/2022]
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Hunter DJ. Osteoarthritis: time for us all to shift the needle. Rheumatology (Oxford) 2018; 57:iv1-iv2. [PMID: 29684220 DOI: 10.1093/rheumatology/key065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, NSW, Australia
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