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Jones DL, Eicher JL, Fang W, Hootman JM. Effectiveness and Implementation of an Enhance®Fitness Physical Activity Intervention Specifically in Adults with Arthritis: A RE-AIM Evaluation. Gerontologist 2023:gnad157. [PMID: 38051008 DOI: 10.1093/geront/gnad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES This study evaluated the effectiveness of the evidence-based, Enhance®Fitness (EF) physical activity (PA) intervention in improving arthritis symptoms, physical and mental function, and PA in adults with arthritis. RESEARCH DESIGN AND METHODS This was a community-based, randomized, controlled effectiveness trial that switched to a non-randomized controlled trial. Participants were sedentary/low-active adults, aged ≥ 18 years, with self-reported physician-diagnosed arthritis, who were assigned to an immediate (IG) or delayed group (DG) (12-week, wait-list control group). Classes were held thrice weekly for 12 weeks at 17 community sites in four urban and five rural West Virginia counties. Data were collected at baseline, 12 weeks, and 24 weeks. The RE-AIM Framework evaluated EF's: 1) reach (enrollment); 2) effectiveness (outcomes); 3) adoption (proportion of sites/instructors that delivered EF); 4) implementation (attendance, fidelity, adverse events, satisfaction); and 5) maintenance (EF continuation). Outcomes were analyzed using linear mixed-effects regression. RESULTS There were 323 adults with a mean age of 68.3 years (range 27-95). Reach was 74%; site and instructor adoption rates were 100% and 55%, respectively; attendance (1.8 sessions per week) and fidelity were good; injury rate was low (3.8%); participants were highly satisfied and experienced improvements in arthritis symptoms and physical function; and 27% of instructors and 18% of sites continued EF. DISCUSSION AND IMPLICATIONS Enhance®Fitness was safe and effective in improving arthritis symptoms and physical function in sedentary/low-active adults with arthritis, across the adult age spectrum, under real-world conditions, in both urban and rural communities.
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Affiliation(s)
- Dina L Jones
- Department of Orthopaedics and Division of Physical Therapy, West Virginia University, Morgantown, West Virginia, USA
| | - Jennifer L Eicher
- Department of Orthopaedics, West Virginia University, Morgantown, West Virginia, USA
| | - Wei Fang
- West Virginia Clinical and Translational Science Institute, Erma Byrd Biomedical Research Center, West Virginia University, Morgantown, West Virginia, USA
| | - Jennifer M Hootman
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Santo L, Schappert SM, Hootman JM, Helmick CG. Trends in Office Visits During Which Opioids Were Prescribed for Adults With Arthritis in the US, 2006-2015. Arthritis Care Res (Hoboken) 2020; 73:1430-1435. [PMID: 32937030 DOI: 10.1002/acr.24447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/08/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To analyze trends for visits to office-based physicians at which opioids were prescribed among adults with arthritis in the US, from 2006 to 2015. METHODS We analyzed nationally representative data on patient visits to office-based physicians from 2006 to 2015 from the National Ambulatory Medical Care Survey (NAMCS). Visit percentages for first- and any-listed diagnosis of arthritis by age groups and sex were reported. Time points were grouped into 2-year intervals to increase the reliability of estimates. Annual percentage point change and 95% confidence intervals (95% CIs) were reported from linear regression models. RESULTS From 2006 to 2015, the percentage of visits to office-based physicians by adults with a first-listed diagnosis of arthritis increased from 4.1% (95% CI 3.5%, 4.7%) in 2006-2007 to 5.1% (95% CI 3.9%, 6.6%) in 2014-2015 (P = 0.033). Among these visits, the percentage of visits with opioids prescribed increased from 16.5% (95% CI 13.1%, 20.5%) in 2006-2007 to 25.6% (95% CI 17.9%, 34.6%) in 2014-2015 (P = 0.017). The percentage of visits with any-listed diagnosis of arthritis increased from 6.6% (95% CI 5.9%, 7.4%) in 2006-2007 to 8.4% (95% CI 7.0%, 10.0%) in 2014-2015 (P = 0.001). Among these visits, the percentage of visits with opioids prescribed increased from 17.4% (95% CI 14.6%, 20.4%) in 2006-2007 to 25.0% (95% CI 19.7%, 30.8%) in 2014-2015 (P = 0.004). CONCLUSION From 2006 to 2015, the percentage of visits to office-based physicians by adults with arthritis increased and the percentage of opioids prescribed at these visits also increased. NAMCS data will allow continued monitoring of these trends after the implementation of the 2016 Centers for Disease Control and Prevention Guideline for prescribing opioids for chronic pain.
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Affiliation(s)
- Loredana Santo
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Susan M Schappert
- National Center for Health Statistics, US Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Jennifer M Hootman
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Charles G Helmick
- National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, Georgia
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Murphy LB, Cisternas MG, Theis KA, Brady TJ, Bohm MK, Guglielmo D, Hootman JM, Barbour KE, Boring MA, Helmick CG. All-Cause Opioid Prescriptions Dispensed: The Outsized Role of Adults With Arthritis. Am J Prev Med 2020; 59:355-366. [PMID: 32763134 DOI: 10.1016/j.amepre.2020.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Limited estimates of prescribed opioid use among adults with arthritis exist. All-cause (i.e., for any condition) prescribed opioid dispensed (referred to as opioid prescription in the remainder of this abstract) in the past 12 months among U.S. adults aged ≥18 years (n=35,427) were studied, focusing on adults with arthritis (n=12,875). METHODS In 2018-2019, estimates were generated using Medical Expenditure Panel Survey data: (1) 2015 prevalence of 1 or more opioid prescriptions to U.S. adults overall and by arthritis status and (2) in 2014-2015, among adults with arthritis, multivariable-adjusted associations between 1 or more opioid prescriptions and sociodemographic characteristics, health status, and healthcare utilization characteristics. RESULTS In 2015, the age-standardized prevalence of 1 or more opioid prescriptions among adults with arthritis (29.6%) was almost double of that for all adults (15.4%). Adults with arthritis represented more than half of all adults (55.3%) with at least 1 opioid prescription; among those with 1 or more prescriptions, 43.2% adults had 4 or more prescriptions. The strongest multivariable-adjusted associations with 1 or more opioid prescriptions were ambulatory care visits (1-4: prevalence ratios=1.9-2.0, 5-8: prevalence ratios=2.5-2.7, 9 or more: prevalence ratios=3.4-3.7) and emergency room visits (1: prevalence ratios=1.6, 2-3: prevalence ratios=1.9-2.0, 4 or more: prevalence ratios=2.4); Ref for both: no visits. CONCLUSIONS Adults with arthritis are a high-need target group for improving pain management, representing more than half of all U.S. adults with 1 or more opioid prescriptions. The association with ambulatory care visits suggests that providers have routine opportunities to discuss comprehensive and integrative pain management strategies, including low-cost evidence-based self-management approaches (e.g., physical activity, self-management education programs, cognitive behavioral therapy). Those with multiple opioid prescriptions may need extra support if transitioning to nonopioid and nonpharmacologic pain management strategies.
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Affiliation(s)
- Louise B Murphy
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | | | - Kristina A Theis
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Teresa J Brady
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Clarity Consulting and Communications, Atlanta, Georgia
| | - Michele K Bohm
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana Guglielmo
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jennifer M Hootman
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kamil E Barbour
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Charles G Helmick
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Guglielmo D, Murphy LB, Boring MA, Theis KA, Helmick CG, Hootman JM, Odom EL, Carlson SA, Liu Y, Lu H, Croft JB. State-Specific Severe Joint Pain and Physical Inactivity Among Adults with Arthritis - United States, 2017. MMWR Morb Mortal Wkly Rep 2019; 68:381-387. [PMID: 31048678 PMCID: PMC6541316 DOI: 10.15585/mmwr.mm6817a2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Dunlop DD, Song J, Hootman JM, Nevitt MC, Semanik PA, Lee J, Sharma L, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Chang RW. One Hour a Week: Moving to Prevent Disability in Adults With Lower Extremity Joint Symptoms. Am J Prev Med 2019; 56:664-672. [PMID: 30902564 PMCID: PMC6475497 DOI: 10.1016/j.amepre.2018.12.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Physical activity guidelines recommend minimum thresholds. This study sought to identify evidence-based thresholds to maintain disability-free status over 4years among adults with lower extremity joint symptoms. METHODS Prospective multisite Osteoarthritis Initiative accelerometer monitoring cohort data from September 2008 through December 2014 were analyzed. Adults (n=1,564) aged ≥49years at elevated disability risk because of lower extremity joint symptoms were analyzed for biennial assessments of disability-free status from gait speed ≥1meter/second (mobility disability-free) and self-report of no limitations in activities of daily living (activities of daily living disability-free). Classification tree analyses conducted in 2017-2018 identified optimal thresholds across candidate activity intensities (sedentary, light, moderate-vigorous, total light and moderate-vigorous activity, and moderate-vigorous accrued in bouts lasting ≥10 minutes). RESULTS Minimal thresholds of 56 and 55 moderate-vigorous minutes/week best predicted disability-free status over 4years from mobility and activities of daily living disabilities, respectively, across the candidate measures. Thresholds were consistent across sex, BMI, age, and knee osteoarthritis presence. Mobility disability onset was one eighth as frequent (3% vs 24%, RR=0.14, 95% CI=0.09, 0.20) and activities of daily living disability onset was almost half (12% vs 23%, RR=0.55, 95% CI=0.44, 0.70) among people above versus below the minimum threshold. CONCLUSIONS Attaining an evidence-based threshold of approximately 1-hour moderate-vigorous activity/week significantly increased the likelihood of maintaining disability-free status over 4years. This minimum threshold tied to maintaining independent living abilities has value as an intermediate goal to motivate adults to take action towards the many health benefits of a physically active lifestyle.
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Affiliation(s)
- Dorothy D Dunlop
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.
| | - Jing Song
- Institute of Public Health and Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Jennifer M Hootman
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Pamela A Semanik
- Department of Adult Health and Gerontological Nursing, Rush University, College of Nursing, Chicago, Illinois
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Leena Sharma
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Charles B Eaton
- Department of Family Medicine, Brown University, Alpert Medical School, Pawtucket, Rhode Island; Department of Epidemiology, Brown University, Alpert Medical School, Pawtucket, Rhode Island
| | - Marc C Hochberg
- Department of Medicine, University of Maryland, School of Medicine, Baltimore, Maryland; Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore, Maryland
| | - Rebecca D Jackson
- Department of Internal Medicine, The Ohio State University, Columbus, Ohio
| | - C Kent Kwoh
- Department of Medicine, University of Arizona, College of Medicine, Tucson, Arizona; Department of Medical Imaging, University of Arizona, College of Medicine, Tucson, Arizona
| | - Rowland W Chang
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois; Department of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
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Murphy LB, Sacks JJ, Helmick CG, Brady TJ, Barbour KE, Hootman JM, Boring MA, Moss S, Guglielmo D, Theis KA. Arthritis Prevalence: Which Case Definition Should Be Used for Surveillance? Comment on the Article by Jafarzadeh and Felson. Arthritis Rheumatol 2019; 71:172-175. [PMID: 30251477 PMCID: PMC10506797 DOI: 10.1002/art.40733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Dana Guglielmo
- Centers for Disease Control and Prevention, Atlanta, GA
- Oak Ridge Institute for Science and Education, Oak Ridge, TN
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Silverstein RP, VanderVos M, Welch H, Long A, Kaboré CD, Hootman JM. Self-Directed Walk With Ease Workplace Wellness Program - Montana, 2015-2017. MMWR Morb Mortal Wkly Rep 2018; 67:1295-1299. [PMID: 30462629 PMCID: PMC6289078 DOI: 10.15585/mmwr.mm6746a3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Qin J, Barbour KE, Nevitt MC, Helmick CG, Hootman JM, Murphy LB, Cauley JA, Dunlop DD. Objectively Measured Physical Activity and Risk of Knee Osteoarthritis. Med Sci Sports Exerc 2018; 50:277-283. [PMID: 28976494 DOI: 10.1249/mss.0000000000001433] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to examine the association between objectively measured physical activity and risk of developing incident knee osteoarthritis (OA) in a community-based cohort of middle-age and older adults. METHODS We used data from the Osteoarthritis Initiative, an ongoing prospective cohort study of adults 45 to 83 yr of age at initial enrollment with elevated risk of symptomatic knee OA. Moderate-vigorous physical activity (MVPA) was measured by a uniaxial accelerometer for seven continuous days in two data collection cycles and was categorized as inactive (<10 min·wk), low activity (10-<150 min·wk), and active (≥150 min·wk). Incident knee OA based on radiographic and symptomatic OA and joint space narrowing were analyzed as outcomes over 4 yr of follow-up. Participants free of the outcome of interest in both knees at study baseline were included (sample sizes ranged from 694 to 1331 for different outcomes). We estimated hazard ratio (HR) with 95% confidence intervals (CI). RESULTS In multivariate analyses, active MVPA participation was not significantly associated with risk of incident radiographic knee OA (HR = 1.52, 95% CI = 0.68-3.40), symptomatic knee OA (HR = 1.17, 95% CI = 0.44-3.09), or joint space narrowing (HR = 0.87, 95% CI = 0.37-2.06) when compared with inactive MVPA participation. Similar results were found for participants with low activity MVPA. CONCLUSION MVPA was not associated with the risk of developing incident knee OA or joint space narrowing over 4 yr of follow-up among Osteoarthritis Initiative participants who are at increased risk of knee OA.
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Affiliation(s)
- Jin Qin
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA.,Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Kamil E Barbour
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Michael C Nevitt
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Charles G Helmick
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jennifer M Hootman
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Louise B Murphy
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Jane A Cauley
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
| | - Dorothy D Dunlop
- Arthritis Program, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, GA
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Sandoval-Rosario M, Nayeri BM, Rascon A, Boring M, Aseret-Manygoats T, Helmick CG, Murphy LB, Hootman JM, Imperatore G, Barbour KE. Prevalence of Arthritis Among Adults with Prediabetes and Arthritis-Specific Barriers to Important Interventions for Prediabetes - United States, 2009-2016. MMWR Morb Mortal Wkly Rep 2018; 67:1238-1241. [PMID: 30408017 PMCID: PMC6223955 DOI: 10.15585/mmwr.mm6744a4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Hootman JM, Theis KA, Barbour KE, Paul P, Carlson SA. Leisure Time and Transportation Walking Among Adults With and Without Arthritis in the United States, 2010. Arthritis Care Res (Hoboken) 2018; 71:178-188. [PMID: 30346654 DOI: 10.1002/acr.23790] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 10/15/2018] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Walking is a joint-friendly activity for adults with arthritis. The aim of this study was to estimate, among adults with arthritis, the prevalence of leisure and transportation walking overall (by arthritis status and by sociodemographic and health characteristics), the number of total minutes walking per week in each domain, and the distributions of walking bout length (i.e., short periods of activity) in minutes. METHODS Data were obtained from the 2010 National Health Interview Survey. Prevalence estimates (percentages and 95% confidence intervals [95% CIs]) of leisure and transportation walking in the past 7 days and walking bout times were calculated (in minutes), as were multivariable Poisson regression models, which account for the complex sample design. RESULTS Prevalence of leisure walking was 45.9% (95% CI 44.2-47.6) for adults with arthritis versus 51.9% (95% CI 50.9-52.9) for those without. Transportation walking prevalence was 23.0% (95% CI 21.7-24.4) for adults with arthritis versus 32.0% (95% CI 31.0-33.0) for those without. The total time of leisure walking per week did not differ in adults with arthritis compared to those without (77.3 versus 78.3 minutes, respectively; P = 0.62), while total time of transportation walking did differ (49.8 versus 58.1 minutes, respectively; P = 0.03). The most common walking bout length differed between leisure (26-40 minutes) and transportation (10-15 minutes) walking, but not by arthritis status. In separate adjusted multivariable models, obesity was consistently negatively associated with both walking outcomes, and being physically active was positively associated with both; lower extremity joint pain was not associated. CONCLUSION By adding short bouts, leisure and transportation walking could be adopted by large proportions of adults with arthritis. Existing evidence-based programs can help increase physical activity.
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Affiliation(s)
| | | | - Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Prabasaj Paul
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Susan A Carlson
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Guglielmo D, Hootman JM, Boring MA, Murphy LB, Theis KA, Croft JB, Barbour KE, Katz PP, Helmick CG. Symptoms of Anxiety and Depression Among Adults with Arthritis - United States, 2015-2017. MMWR Morb Mortal Wkly Rep 2018; 67:1081-1087. [PMID: 30286053 PMCID: PMC6171892 DOI: 10.15585/mmwr.mm6739a2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
An estimated 54.4 million (22.7%) U.S. adults have doctor-diagnosed arthritis (1). A report in 2012 found that, among adults aged ≥45 years with arthritis, approximately one third reported having anxiety or depression, with anxiety more common than depression (2). Studies examining mental health conditions in adults with arthritis have focused largely on depression, arthritis subtypes, and middle-aged and older adults, or have not been nationally representative (3). To address these knowledge gaps, CDC analyzed 2015-2017 National Health Interview Survey (NHIS) data* to estimate the national prevalence of clinically relevant symptoms of anxiety and depression among adults aged ≥18 years with arthritis. Among adults with arthritis, age-standardized prevalences of symptoms of anxiety and depression were 22.5% and 12.1%, respectively, compared with 10.7% and 4.7% among adults without arthritis. Successful treatment approaches to address anxiety and depression among adults with arthritis are multifaceted and include screenings, referrals to mental health professionals, and evidence-based strategies such as regular physical activity and participation in self-management education to improve mental health.
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Kucera KL, Lipscomb HJ, Roos KG, Dement JM, Hootman JM. Work-Related Injury and Management Strategies Among Certified Athletic Trainers. J Athl Train 2018; 53:606-618. [PMID: 29897279 DOI: 10.4085/1062-6050-232-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Health care workers have high rates of musculoskeletal injuries, but many of these injuries go unreported to workers' compensation and national surveillance systems. Little is known regarding the work-related injuries of certified athletic trainers (ATs). OBJECTIVE To determine the 12-month incidence and prevalence of work-related injuries and describe injury-reporting and -management strategies. DESIGN Cross-sectional study. SETTING Population-based online survey. PATIENTS OR OTHER PARTICIPANTS Of the 29 051 ATs currently certified by the Board of Certification, Inc, who "opted in" to research studies, we randomly selected 10 000. Of these, 1826 (18.3%) ATs currently working in the clinical setting were eligible and participated in the baseline survey. MAIN OUTCOME MEASURE(S) An online survey was e-mailed in May of 2012. We assessed self-reported work-related injuries in the previous 12 months and management strategies including medical care, work limitations or modifications, and time off work. Statistics (frequencies and percentages) were calculated to describe injury rates per 200 000 work hours, injury prevalence, injury characteristics, and injury-reporting and -management strategies. RESULTS A total of 247 ATs reported 419 work-related injuries during the previous 12 months, for an incidence rate of 21.6 per 200 000 hours (95% confidence interval = 19.6, 23.7) and injury prevalence of 13.5% (95% confidence interval = 12.0%, 15.1%). The low back (26%), hand/fingers (9%), and knee (9%) were frequently affected body sites. Injuries were most often caused by bodily motion/overexertion/repetition (52%), contact with objects/equipment/persons (24%), or slips/trips/falls (15%). More than half of injured ATs (55.5%) sought medical care, 25% missed work, and most (77%) did not file a workers' compensation claim for their injury. Half of injured ATs were limited at work (n = 125), and 89% modified or changed their athletic training work as a result of the injury. CONCLUSIONS More than half of AT work-related injuries required medical care or work limitations and were not reported for workers' compensation. Understanding how ATs care for and manage their work-related injuries is important given that few take time off work.
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Affiliation(s)
- Kristen L Kucera
- Department of Exercise and Sport Science and ‡Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill.,Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC
| | - Hester J Lipscomb
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC
| | - Karen G Roos
- Department of Exercise and Sport Science and ‡Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill
| | - John M Dement
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC
| | - Jennifer M Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Guglielmo D, Hootman JM, Murphy LB, Boring MA, Theis KA, Belay B, Barbour KE, Cisternas MG, Helmick CG. Health Care Provider Counseling for Weight Loss Among Adults with Arthritis and Overweight or Obesity - United States, 2002-2014. MMWR Morb Mortal Wkly Rep 2018; 67:485-490. [PMID: 29723172 PMCID: PMC5933870 DOI: 10.15585/mmwr.mm6717a2] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Barbour KE, Moss S, Croft JB, Helmick CG, Theis KA, Brady TJ, Murphy LB, Hootman JM, Greenlund KJ, Lu H, Wang Y. Geographic Variations in Arthritis Prevalence, Health-Related Characteristics, and Management - United States, 2015. MMWR Surveill Summ 2018; 67:1-28. [PMID: 29543787 PMCID: PMC5857191 DOI: 10.15585/mmwr.ss6704a1] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Problem/Condition Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity. Reporting Period 2015. Description of System The Behavioral Risk Factor Surveillance System is an annual, random-digit–dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method. Results In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%–33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%–42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%–19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%–61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%–53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain, and arthritis-attributable social participation restriction; ≥14 physically unhealthy days during the past 30 days; ≥14 mentally unhealthy days during the past 30 days; obesity; and leisure-time physical inactivity) and the lowest percentage of leisure-time walking. Interpretation The prevalence, health-related characteristics, and management of arthritis varied substantially across states. The modeled prevalence of arthritis varied considerably by county. Public Health Action The findings highlight notable geographic variability in prevalence, health-related characteristics, and management of arthritis. Targeted use of evidence-based interventions that focus on physical activity and self-management education can reduce pain and improve function and quality of life for adults with arthritis and thus might reduce these geographic disparities.
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Affiliation(s)
- Kamil E Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | | | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Charles G Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Kristina A Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Teresa J Brady
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Louise B Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Jennifer M Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Kurt J Greenlund
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Hua Lu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
| | - Yan Wang
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia
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Hootman JM, Murphy LB, Omura JD, Brady TJ, Boring M, Barbour KE, Helmick CG. Health Care Provider Counseling for Physical Activity or Exercise Among Adults with Arthritis - United States, 2002 and 2014. MMWR Morb Mortal Wkly Rep 2018; 66:1398-1401. [PMID: 29300722 PMCID: PMC5758301 DOI: 10.15585/mmwr.mm665152a2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Arthritis affects an estimated 54 million U.S. adults and, as a common comorbidity, can contribute arthritis-specific limitations or barriers to physical activity or exercise for persons with diabetes, heart disease, and obesity (1). The American College of Rheumatology's osteoarthritis management guidelines recommend exercise as a first-line, nonpharmacologic strategy to manage arthritis symptoms (2), and a Healthy People 2020 objective is to increase health care provider counseling for physical activity or exercise among adults with arthritis.* To determine the prevalence and percentage change from 2002 to 2014 in receipt of health care provider counseling for physical activity or exercise (counseling for exercise) among adults with arthritis, CDC analyzed 2002 and 2014 National Health Interview Survey (NHIS) data. From 2002 to 2014, the age-adjusted prevalence of reporting health care provider counseling for exercise among adults with arthritis increased 17.6%, from 51.9% (95% confidence interval [CI] = 49.9%-53.8%) to 61.0% (CI = 58.6%-63.4%) (p<0.001). The age-adjusted prevalence of reporting health care provider counseling for exercise among persons with arthritis who described themselves as inactive increased 20.1%, from 47.2% (CI = 44.0%-50.4%) in 2002 to 56.7% (CI = 52.3%-61.0%) in 2014 (p = 0.001). Prevalence of counseling for exercise has increased significantly since 2002; however, approximately 40% of adults with arthritis are still not receiving counseling for exercise. Improving health care provider training and expertise in exercise counseling and incorporating prompts into electronic medical records are potential strategies to facilitate counseling for exercise that can help adults manage their arthritis and comorbid conditions.
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Golightly YM, Allen KD, Ambrose KR, Stiller JL, Evenson KR, Voisin C, Hootman JM, Callahan LF. Physical Activity as a Vital Sign: A Systematic Review. Prev Chronic Dis 2017; 14:E123. [PMID: 29191260 PMCID: PMC5716811 DOI: 10.5888/pcd14.170030] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Physical activity (PA) is strongly endorsed for managing chronic conditions, and a vital sign tool (indicator of general physical condition) could alert providers of inadequate PA to prompt counseling or referral. This systematic review examined the use, definitions, psychometric properties, and outcomes of brief PA instruments as vital sign measures, with attention primarily to studies focused on arthritis. Methods Electronic databases were searched for English-language literature from 1985 through 2016 using the terms PA, exercise, vital sign, exercise referral scheme, and exercise counseling. Of the 838 articles identified for title and abstract review, 9 articles qualified for full text review and data extraction. Results Five brief PA measures were identified: Exercise Vital Sign (EVS), Physical Activity Vital Sign (PAVS), Speedy Nutrition and Physical Activity Assessment (SNAP), General Practice Physical Activity Questionnaire (GPPAQ), and Stanford Brief Activity Survey (SBAS). Studies focusing on arthritis were not found. Over 1.5 years of using EVS in a large hospital system, improvements occurred in relative weight loss among overweight patients and reduction in glycosylated hemoglobin among diabetic patients. On PAVS, moderate physical activity of 5 or more days per week versus fewer than 5 days per week was associated with a lower body mass index (−2.90 kg/m2). Compared with accelerometer-defined physical activity, EVS was weakly correlated (r = 0.27), had low sensitivity (27%–59%), and high specificity (74%–89%); SNAP showed weak agreement (κ = 0.12); GPPAQ had moderate sensitivity (46%) and specificity (50%), and SBAS was weakly correlated (r = 0.10–0.28), had poor to moderate sensitivity (18%–67%), and had moderate specificity (58%–79%). Conclusion Few studies have examined a brief physical activity tool as a vital sign measure. Initial investigations suggest the promise of these simple and quick assessment tools, and research is needed to test the effects of their use on chronic disease outcomes.
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Affiliation(s)
- Yvonne M Golightly
- University of North Carolina at Chapel Hill, Thurston Arthritis Research Center, 3300 Thurston Bldg, CB 7280, Chapel Hill, NC 27599-7280. .,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelli D Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Health Services Research & Development, VA Medical Center, Durham, North Carolina.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kirsten R Ambrose
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jamie L Stiller
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Christiane Voisin
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer M Hootman
- Arthritis Program, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leigh F Callahan
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Departments of Social Medicine and Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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17
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Barbour KE, Murphy LB, Helmick CG, Hootman JM, Renner JB, Jordan JM. Bone Mineral Density and the Risk of Hip and Knee Osteoarthritis: The Johnston County Osteoarthritis Project. Arthritis Care Res (Hoboken) 2017; 69:1863-1870. [PMID: 28129489 DOI: 10.1002/acr.23211] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/24/2017] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To address knowledge gaps regarding the relationship between bone mineral density (BMD) and incident hip or knee osteoarthritis (OA); specifically, lack of information regarding hip OA or symptomatic outcomes. METHODS Using data (n = 1,474) from the Johnston County Osteoarthritis Project's first (1999-2004) and second (2005-2010) followup of participants ages ≥45 years, we examined the association between total hip BMD and both hip and knee OA. Total hip BMD was measured using dual x-ray absorptiometry, and participants were classified into sex-specific quartiles (low, intermediate low, intermediate high, and high). Radiographic OA (ROA) was defined as development of Kellgren/Lawrence grade ≥2. Symptomatic ROA (sROA) was defined as onset of both ROA and symptoms. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS Median followup time was 6.5 years (range 4.0-10.2 years). In multivariate models, and compared with participants with low BMD, those with intermediate high and high BMD were less likely to develop hip sROA (HR 0.52 [95% CI 0.31-0.86] and 0.56 [95% CI 0.31-0.86], respectively; P = 0.024 for trend); high BMD was not associated (HR 0.69 [95% CI 0.45-1.06]) with risk of hip ROA. Compared with participants with low BMD, those with intermediate low and intermediate high total hip BMD were more likely to develop knee sROA (HR 2.15 [95% CI 1.40-3.30] and 1.65 [95% CI 1.02-2.67], respectively; P = 0.325 for trend); similar associations were seen with knee ROA. CONCLUSION Our findings suggest that higher BMD may reduce the risk of hip sROA, while intermediate levels may increase the risk of both knee sROA and ROA.
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Affiliation(s)
- Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Louise B Murphy
- Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Hootman JM, Helmick CG. Reply. Arthritis Rheumatol 2017; 69:1702-1703. [PMID: 28482140 PMCID: PMC6110612 DOI: 10.1002/art.40143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/02/2017] [Indexed: 11/07/2022]
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Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated Projected Prevalence of Self-Reported Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation Among US Adults, 2015-2040. Arthritis Rheumatol 2017; 68:1582-7. [PMID: 27015600 DOI: 10.1002/art.39692] [Citation(s) in RCA: 317] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 03/17/2016] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To update the projected prevalence of arthritis and arthritis-attributable activity limitations among US adults, using a newer baseline for estimates. METHODS Baseline prevalence data were obtained from the 2010-2012 National Health Interview Survey. Arthritis was defined as an answer of "yes" to the question "Have you ever been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus or fibromyalgia?" Arthritis-attributable activity limitation was defined as an answer of "yes" to the question "Are you limited in any way in any of your usual activities because of arthritis or joint symptoms?" The baseline prevalence of arthritis and arthritis-attributable activity limitation was stratified according to age and sex and was statistically weighted to account for the complex survey design. The projected prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation was calculated by multiplying the age- and sex-stratified population estimates projected for 2015-2040 (in 5-year intervals; provided by the US Census Bureau) by the baseline estimates. Age- and sex-specific prevalences were summed to provide the total prevalence estimates for each year. RESULTS In 2010-2012, 52.5 million adults in the US (22.7% of all adults) had doctor-diagnosed arthritis, and 22.7 million (9.8%) had arthritis-attributable activity limitation. By 2040, the number of US adults with doctor-diagnosed arthritis is projected to increase 49% to 78.4 million (25.9% of all adults), and the number of adults with arthritis-attributable activity limitation will increase 52% to 34.6 million (11.4% of all adults). CONCLUSION Updated projections suggest that arthritis and arthritis-attributable activity limitation will remain large and growing problems for clinical and public health systems, which must plan and create policies and resources to address these future needs.
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20
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Boring MA, Hootman JM, Liu Y, Theis KA, Murphy LB, Barbour KE, Helmick CG, Brady TJ, Croft JB. Prevalence of Arthritis and Arthritis-Attributable Activity Limitation by Urban-Rural County Classification - United States, 2015. MMWR Morb Mortal Wkly Rep 2017; 66:527-532. [PMID: 28542117 PMCID: PMC5657875 DOI: 10.15585/mmwr.mm6620a2] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rural populations in the United States have well documented health disparities, including higher prevalences of chronic health conditions (1,2). Doctor-diagnosed arthritis is one of the most prevalent health conditions (22.7%) in the United States, affecting approximately 54.4 million adults (3). The impact of arthritis is considerable: an estimated 23.7 million adults have arthritis-attributable activity limitation (AAAL). The age-standardized prevalence of AAAL increased nearly 20% from 2002 to 2015 (3). Arthritis prevalence varies widely by state (range = 19%-36%) and county (range = 16%-39%) (4). Despite what is known about arthritis prevalence at the national, state, and county levels and the substantial impact of arthritis, little is known about the prevalence of arthritis and AAAL across urban-rural areas overall and among selected subgroups. To estimate the prevalence of arthritis and AAAL by urban-rural categories CDC analyzed data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS). The unadjusted prevalence of arthritis in the most rural areas was 31.8% (95% confidence intervals [CI] = 31.0%-32.5%) and in the most urban, was 20.5% (95% CI = 20.1%-21.0%). The unadjusted AAAL prevalence among adults with arthritis was 55.3% in the most rural areas and 49.7% in the most urban. Approximately 1 in 3 adults in the most rural areas have arthritis and over half of these adults have AAAL. Wider use of evidence-based interventions including physical activity and self-management education in rural areas might help reduce the impact of arthritis and AAAL.
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Affiliation(s)
- Michael A Boring
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jennifer M Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Yong Liu
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Kristina A Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Louise B Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Kamil E Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Charles G Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Terry J Brady
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Janet B Croft
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Barbour KE, Helmick CG, Boring M, Qin J, Pan L, Hootman JM. Obesity Trends Among US Adults With Doctor-Diagnosed Arthritis 2009-2014. Arthritis Care Res (Hoboken) 2017; 69:376-383. [PMID: 27332971 PMCID: PMC10445492 DOI: 10.1002/acr.22958] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 05/20/2016] [Accepted: 06/07/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Arthritis and obesity are common co-occurring conditions that can increase disability and the risk of adverse outcomes (e.g., total knee replacement). METHODS We estimated recent obesity trends among adults with arthritis from 2009 to 2014, overall and by various sociodemographic and health characteristics using data from National Health Interview Survey, an ongoing, nationally representative, in-person household self-reported survey of the noninstitutionalized civilian US. A secondary aim was to examine the distribution of body mass index categories among adults with and without arthritis. RESULTS Obesity prevalence did not change significantly over time among middle-aged and younger adults with doctor-diagnosed arthritis either overall (P = 0.925 for both groups) or by demographic and health characteristics. Among older adults with doctor-diagnosed arthritis, the unadjusted obesity prevalence was 29.4% in 2009 and 34.3% in 2014; after adjusting for all demographic and health characteristics, there was a significant relative increase in obesity prevalence (15% [95% confidence interval 6-25]) and over time (P = 0.001). The age-standardized prevalence of obesity and the obesity subclasses I, II, and III among adults with doctor-diagnosed arthritis (compared with adults without doctor-diagnosed arthritis) was 40.3% versus 26.3%, 20.1% versus 16.4%, 10.4% versus 6.2%, and 9.8% versus 3.6%, respectively (P < 0.001 for all 4 comparisons). CONCLUSION Obesity increased significantly over time among older adults with arthritis and remains high when compared with adults without arthritis. A greater dissemination of interventions focused on physical activity and diet are needed in order to reduce adverse outcomes associated with obesity and arthritis.
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Affiliation(s)
- Kamil E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Michael Boring
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jin Qin
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Liping Pan
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Kucera KL, Roos KG, Hootman JM, Lipscomb HJ, Dement JM, Silverstein BA. Work-related illness and injury claims among nationally certified athletic trainers reported to Washington and California from 2001 to 2011. Am J Ind Med 2016; 59:1156-1168. [PMID: 27779316 PMCID: PMC5749227 DOI: 10.1002/ajim.22648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2016] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the work-related injury and illnesses experienced by certified athletic trainers (AT). METHODS The incidence and characteristics of injury/illness claims filed in two workers' compensation systems were described from 2001 to 2011. Yearly populations at risk were estimated from National Athletic Trainers' Association membership statistics. Incidence rate ratios (IRR) were reported by job setting. RESULTS Claims were predominantly for traumatic injuries and disorders (82.7%: 45.7% sprains/strains, 12.0% open wounds, 6.5% bruises) and at these body sites (back 17.2%, fingers 12.3%, and knee 9.6%) and over half were caused by body motion and overexertion (51.5%). Compared with school settings, clinic/hospital settings had modestly higher claim rates (IRR = 1.29, 95% CI: 1.06-1.52) while other settings (e.g., professional or youth sport, nursing home) had lower claim rates (IRR = 0.63, 95% CI: 0.44-0.70). CONCLUSIONS These first known estimates of work-related injuries/illnesses among a growing healthcare profession help identify occupational tasks and settings imposing injury risk for ATs. Am. J. Ind. Med. 59:1156-1168, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Kristen L. Kucera
- Division of Occupational & Environmental Medicine, Duke University, Durham, North Carolina
- Department of Exercise & Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Karen G. Roos
- Department of Epidemiology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer M. Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Hester J. Lipscomb
- Division of Occupational & Environmental Medicine, Duke University, Durham, North Carolina
| | - John M. Dement
- Division of Occupational & Environmental Medicine, Duke University, Durham, North Carolina
| | - Barbara A. Silverstein
- Safety and Health Assessment and Research for Prevention (SHARP) Program, State of Washington Department of Labor & Industries, Olympia, Washington
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Hootman JM, Helmick CG. Reply. Arthritis Rheumatol 2016; 68:3044-3045. [DOI: 10.1002/art.39838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 08/04/2016] [Indexed: 11/12/2022]
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Abstract
OBJECTIVE To introduce athletic trainers to the benefits of using a population-based approach to injury and illness prevention and to explore opportunities for partnering with public health professionals on these initiatives. BACKGROUND Athletic trainers play leading roles in individual injury and illness prevention but are less familiar with policy development, evaluation, and implementation from a population-level standpoint. The Athletic Training and Public Health Summit was convened to understand, explore, and develop the intersection of athletic training and public health. CONCLUSIONS To further the integration of athletic training within the public health arena, athletic trainers must expand their professional focus beyond the individual to the population level.
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Barbour KE, Lui LY, Nevitt MC, Murphy LB, Helmick CG, Theis KA, Hochberg MC, Lane NE, Hootman JM, Cauley JA. Hip Osteoarthritis and the Risk of All-Cause and Disease-Specific Mortality in Older Women: A Population-Based Cohort Study. Arthritis Rheumatol 2015; 67:1798-805. [PMID: 25778744 DOI: 10.1002/art.39113] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 03/10/2015] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To determine the risk of all-cause and disease-specific mortality among older women with hip osteoarthritis (OA) and to identify mediators in the causal pathway. METHODS Data were from the Study of Osteoporotic Fractures, a US population-based cohort study of 9,704 white women age ≥65 years. The analytic sample included women with hip radiographs at baseline (n = 7,889) and year 8 (n = 5,749). Mortality was confirmed through October 2013 by death certificates and hospital discharge summaries. Radiographic hip OA (RHOA) was defined as a Croft grade of ≥2 in at least 1 hip (definite joint space narrowing or osteophytes plus 1 other radiographic feature). RESULTS The mean ± SD followup time was 16.1 ± 6.2 years. The baseline and year 8 prevalence of RHOA were 8.0% and 11.0%, respectively. The cumulative incidence (proportion of deaths during the study period) was 67.7% for all-cause mortality, 26.3% for cardiovascular disease (CVD) mortality, 11.7% for cancer mortality, 1.9% for gastrointestinal disease mortality, and 27.8% for all other mortality causes. RHOA was associated with an increased risk of all-cause mortality (hazard ratio 1.14 [95% confidence interval 1.05-1.24]) and CVD mortality (hazard ratio 1.24 [95% confidence interval 1.09-1.41]) adjusted for age, body mass index, education, smoking, health status, diabetes, and stroke. These associations were partially explained by the mediating variable of physical function. CONCLUSION RHOA was associated with an increased risk of all-cause and CVD mortality among older white women followed up for 16 years. Dissemination of evidence-based physical activity and self-management interventions for hip OA in community and clinical settings can improve physical function and might also contribute to lower mortality.
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Affiliation(s)
| | - Li-Yung Lui
- California Pacific Medical Center, San Francisco
| | | | | | | | | | | | - Nancy E Lane
- University of California at Davis School of Medicine, Sacramento
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Harris KP, Driban JB, Sitler MR, Cattano NM, Balasubramanian E, Hootman JM. Tibiofemoral Osteoarthritis After Surgical or Nonsurgical Treatment of Anterior Cruciate Ligament Rupture: A Systematic Review. J Athl Train 2015; 52:507-517. [PMID: 25562459 DOI: 10.4085/1062-6050-49.3.89] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To determine if surgical or nonsurgical treatment of anterior cruciate ligament rupture affects the prevalence of posttraumatic tibiofemoral osteoarthritis (OA). DATA SOURCES Studies published between 1983 and April 2012 were identified via EBSCOhost and OVID. Reference lists were then screened in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. STUDY SELECTION Studies were included if (a) treatment outcomes focused on a direct comparison of surgical versus nonsurgical treatment of anterior cruciate ligament rupture, (b) the prevalence of tibiofemoral OA was reported, and (c) they were written in English. Studies were excluded if (a) the included patients were treated with cast immobilization after surgery, (b) the mean follow-up was less than 10 years, or (c) the patients underwent anterior cruciate ligament revision surgery. DATA EXTRACTION Two independent investigators reviewed the included articles using the Newcastle-Ottawa Scale. Frequency of OA, surgical procedure, nonsurgical treatments, and participant characteristics were extracted and summarized. We calculated prevalence (%) and 95% confidence intervals for treatment groups for each individual study and overall. We developed 2 × 2 contingency tables to assess the association between treatment groups (exposed had surgery, referent was nonsurgical treatment) and the prevalence of OA. DATA SYNTHESIS Four retrospective studies were identified (140 surgical patients, 240 nonsurgical patients). The mean Newcastle-Ottawa Scale score was 5 (range = 4-6 [of 10] points). Average length of follow-up was 11.8 years (range = 10-14 years). The prevalence of OA for surgically treated patients ranged from 32.6% to 51.2% (overall = 41.4%, 95% confidence interval = 35.0%, 48.1%) and for nonsurgical patients ranged from 24.5% to 42.3% (overall = 30.9%, 95% confidence interval = 24.4%, 38.3%). CONCLUSIONS Although OA prevalence was higher in the surgical treatment group at a mean follow-up of 11.8 years, no definitive evidence supports surgical or nonsurgical treatment after anterior cruciate ligament injury to prevent posttraumatic OA. Current studies have been limited by small sample sizes, low methodologic quality, and a lack of data regarding confounding factors.
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Affiliation(s)
- Kyle P Harris
- Department of Health, Physical Education and Nursing, Bucks County Community College, Newtown, PA
| | | | - Michael R Sitler
- Department of Health, Physical Education and Nursing, Bucks County Community College, Newtown, PA
| | - Nicole M Cattano
- Department of Sports Medicine, West Chester University of Pennsylvania
| | | | - 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
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Kelley GA, Kelley KS, Hootman JM. Effects of exercise on depression in adults with arthritis: a systematic review with meta-analysis of randomized controlled trials. Arthritis Res Ther 2015; 17:21. [PMID: 25645739 PMCID: PMC4467075 DOI: 10.1186/s13075-015-0533-5] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 01/19/2015] [Indexed: 02/12/2023] Open
Abstract
INTRODUCTION Previous randomized controlled trials have led to conflicting findings regarding the effects of exercise on depressive symptoms in adults with arthritis and other rheumatic conditions (AORC). The purpose of this study was to use the meta-analytic approach to resolve these discrepancies. METHODS The inclusion criteria were: (1) randomized controlled trials, (2) exercise (aerobic, strength training, or both) ≥4 weeks, (3) comparative control group, (4) adults with osteoarthritis, rheumatoid arthritis, fibromyalgia or systemic lupus erythematosus, (5) published studies in any language since January 1, 1981 and (6) depressive symptoms assessed. Studies were located by searching 10 electronic databases, cross-referencing, hand searching and expert review. Dual-selection of studies and data abstraction was performed. Hedge's standardized mean difference effect size (g) was calculated for each result and pooled using random-effects models, an approach that accounts for heterogeneity. Non-overlapping 95% confidence intervals (CI) were considered statistically significant. Heterogeneity based on fixed-effect models was estimated using Q and I (2) with alpha values ≤0.10 for Q considered statistically significant. RESULTS Of the 500 citations reviewed, 2,449 participants (1,470 exercise, 979 control) nested within 29 studies were included. Length of training, reported as mean ± standard deviation (±SD) was 19 ± 16 weeks, frequency 4 ± 2 times per week and duration 34 ± 17 minutes per session. Overall, statistically significant exercise minus control group reductions were found for depressive symptoms (g = -0.42, 95% CI, -0.58, -0.26, Q = 126.9, P <0.0001, I(2) = 73.2%). The number needed-to-treat was 7 (95% CI, 6 to 11) with an estimated 3.1 million (95% CI, 2.0 to 3.7) United States adults not currently meeting physical activity guidelines improving their depressive symptoms if they began and maintained a regular exercise program. Using Cohen's U3 Index, the percentile reduction was 16.4% (95% CI, 10.4% to 21.9%). All studies were considered to be at high risk of bias with respect to blinding of participants and personnel to group assignment. CONCLUSIONS Exercise is associated with reductions in depressive symptoms among selected adults with AORC. A need exists for additional, well-designed and reported studies on this topic.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, Robert C. Byrd Health Sciences Center, School of Public Health, West Virginia University, Morgantown, WV, 26506-9190, USA.
| | - Kristi S Kelley
- Department of Biostatistics, Robert C. Byrd Health Sciences Center, School of Public Health, West Virginia University, Morgantown, WV, 26506-9190, USA.
| | - Jennifer M Hootman
- Division of Population Health MS F-78, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention Atlanta, Atlanta, GA, 30341, USA.
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Driban JB, Hootman JM, Sitler MR, Harris KP, Cattano NM. Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review. J Athl Train 2015; 52:497-506. [PMID: 25574790 DOI: 10.4085/1062-6050-50.2.08] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Information regarding the relative risks of developing knee osteoarthritis (OA) as a result of sport participation is critical for shaping public health messages and for informing knee-OA prevention strategies. The purpose of this systematic review was to investigate the association between participation in specific sports and knee OA. DATA SOURCES We completed a systematic literature search in September 2012 using 6 bibliographic databases (PubMed; Ovid MEDLINE; Journals@Ovid; American College of Physicians Journal Club; Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Review, Database of Abstracts of Reviews of Effects; and Ovid HealthStar), manual searches (4 journals), and reference lists (56 articles). STUDY SELECTION Studies were included if they met the following 4 criteria: (1) an aim was to investigate an association between sport participation and knee OA; (2) the outcome measure was radiographic knee OA, clinical knee OA, total knee replacement, self-reported diagnosis of knee OA, or placement on a waiting list for a total knee replacement; (3) the study design was case control or cohort; and (4) the study was written in English. Articles were excluded if the study population had an underlying condition other than knee OA. DATA EXTRACTION One investigator extracted data (eg, group descriptions, knee OA prevalence, source of nonexposed controls). DATA SYNTHESIS The overall knee-OA prevalence in sport participants (n = 3759) was 7.7%, compared with 7.3% among nonexposed controls (referent group n = 4730, odds ratio [OR] = 1.1). Specific sports with a significantly higher prevalence of knee OA were soccer (OR = 3.5), elite-level long-distance running (OR = 3.3), competitive weight lifting (OR = 6.9), and wrestling (OR = 3.8). Elite-sport (soccer or orienteering) and nonelite-sport (soccer or American football) participants without a history of knee injury had a greater prevalence of knee OA than nonexposed participants. CONCLUSIONS Participants in soccer (elite and nonelite), elite-level long-distance running, competitive weight lifting, and wrestling had an increased prevalence of knee OA and should be targeted for risk-reduction strategies.
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Affiliation(s)
| | | | | | - Kyle P Harris
- Department of Health, Physical Education and Nursing, Bucks County Community College, Newton, PA
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Harris K, Driban JB, Sitler MR, Cattano NM, Hootman JM. Five-year clinical outcomes of a randomized trial of anterior cruciate ligament treatment strategies: an evidence-based practice paper. J Athl Train 2015; 50:110-2. [PMID: 25322347 PMCID: PMC4299728 DOI: 10.4085/1062-6050-49.3.53] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
REFERENCE/CITATION Frobell RB, Roos HP, Roos EM, Roemer FW, Ranstam J, Lohmander LS. Treatment for acute anterior cruciate ligament tear: five year outcome of randomised trial. BMJ. 2013;346:F232. CLINICAL QUESTION Does early anterior cruciate ligament (ACL) reconstruction with rehabilitation lead to better patient-reported outcomes and a lower incidence of osteoarthritis at 5 years postinjury compared with delayed ACL reconstruction with rehabilitation? STUDY SELECTION This randomized controlled trial with extended follow-up at 5 years postrandomization was conducted in 2 Swedish orthopaedic departments. DATA EXTRACTION The authors studied a total of 121 moderately active adults (age = 18-35 years) with an acute ACL rupture in a knee with no other history of trauma. Excluded were patients with a collateral ligament rupture, full-thickness cartilage defect, or extensive meniscal fixation. One patient assigned to the early ACL-reconstruction group did not attend the 5-year follow-up visit. Patients were randomly assigned to (1) an early ACL reconstruction plus structured rehabilitation group (n = 62, surgery within 10 weeks of injury) or (2) optional-delayed ACL reconstruction plus structured rehabilitation group (n = 59). The primary outcome measure was change in the average of 4 out of 5 subscales of the Knee Injury and Osteoarthritis Outcome Score (KOOS). The authors also assessed crude KOOS (combined 4 subscales), KOOS subscale scores, general physical and mental health (Short-Form 36), activity level (Tegner Activity Scale), mechanical knee stability (Lachman and pivot shift tests), meniscal surgery status, and presence of knee osteoarthritis on radiographs. MAIN RESULTS Among patients randomized to the optional-delayed ACL-reconstruction group, 30 (51%) opted for an ACL reconstruction. The treatment groups had comparable 5-year patient-reported outcomes and changes in patient-reported outcomes (eg, knee pain, knee symptoms, activities of daily living, sport and recreational levels, knee-related quality of life, general physical health, and general mental health). Patients in the optional-delayed ACL-reconstruction group had greater mechanical knee instability than patients who received early ACL reconstruction; however, this was primarily among the patients opting for conservative management alone. In the overall sample, 61 knees (51%) required meniscal surgery over 5 years, regardless of treatment group. At 5 years, radiographs were available for 113 patients (93%). Overall, 29 patients (26%) had knee osteoarthritis at 5 years. Specifically, 13 patients (12%) developed tibiofemoral radiographic osteoarthritis (9 patients [16%] in the early ACL-reconstruction group, 4 [7%] in the optional-delayed ACL-reconstruction group) and 22 (19%) developed patellofemoral osteoarthritis (14 patients [24%] in the early ACL-reconstruction group, 8 [15%] in the optional-delayed ACL-reconstruction group). Patients with patellar tendon grafts (n = 40) had a greater incidence of ipsilateral patellofemoral osteoarthritis than patients with hamstrings tendon grafts (n = 51), but the 2 groups had similar incidences of ipsilateral tibiofemoral osteoarthritis. Six knees (5%) had both tibiofemoral and patellofemoral osteoarthritis. CONCLUSIONS Early ACL reconstruction plus rehabilitation did not provide better results at 5 years compared with optional-delayed ACL reconstruction plus rehabilitation. Furthermore, the authors found no radiographic differences among patients with early ACL reconstruction, delayed ACL reconstruction, or no ACL reconstruction (rehabilitation alone).
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Affiliation(s)
- Kyle Harris
- Department of Health, Physical Education and Nursing, Bucks County Community College, Newtown, PA
| | | | - Michael R. Sitler
- Biokinetics Research Laboratory, Athletic Training Division, Department of Kinesiology, Temple University, Philadelphia, PA
| | | | - 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
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Murphy LB, Helmick CG, Allen KD, Theis KA, Baker NA, Murray GR, Qin J, Hootman JM, Brady TJ, Barbour KE. Arthritis among veterans - United States, 2011-2013. MMWR Morb Mortal Wkly Rep 2014; 63:999-1003. [PMID: 25375071 PMCID: PMC5779484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Arthritis is among the most common chronic conditions among veterans and is more prevalent among veterans than nonveterans. Contemporary population-based estimates of arthritis prevalence among veterans are needed because previous population-based studies predate the Persian Gulf War, were small, or studied men only despite the fact that women comprise an increasing proportion of military personnel and typically have a higher prevalence of arthritis than men. To address this knowledge gap, CDC analyzed combined 2011, 2012, and 2013 Behavioral Risk Factor Surveillance System (BRFSS) data among all adults aged ≥18 years, by veteran status, to estimate the total and sex-specific prevalence of doctor-diagnosed arthritis overall and by sociodemographic categories, and the state-specific prevalence (overall and sex-specific) of doctor-diagnosed arthritis. This report summarizes the results of these analyses, which found that one in four veterans reported that they had arthritis (25.6%) and that prevalence was higher among veterans than nonveterans across most sociodemographic categories, including sex (prevalence among male and female veterans was 25.0% and 31.3%, respectively). State-specific, age-standardized arthritis prevalence among veterans ranged from 18.8% in Hawaii to 32.7% in West Virginia. Veterans comprise a large and important target group for reducing the growing burden of arthritis. Those interested in veterans' health can help to improve the quality of life of veterans by ensuring that they have access to affordable, evidence-based, physical activity and self-management education classes that reduce the adverse effects of arthritis (e.g., pain and depression) and its common comorbidities (e.g., heart disease and diabetes).
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Affiliation(s)
- Louise B. Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC,Corresponding author: Louise B. Murphy, , 770-488-5464
| | - Charles G. Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Kelli D. Allen
- Health Services Research and Development Service, U.S. Department of Veterans Affairs Medical Center, Durham, North Carolina, and Thurston Arthritis Research Center, University of North Carolina at Chapel Hill
| | - Kristina A. Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Nancy A. Baker
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Glen R. Murray
- Geographic Information Systems Laboratory, University of West Georgia
| | - Jin Qin
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jennifer M. Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Teresa J. Brady
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Kamil E. Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Barbour KE, Stevens JA, Helmick CG, Luo YH, Murphy LB, Hootman JM, Theis K, Anderson LA, Baker NA, Sugerman DE. Falls and fall injuries among adults with arthritis--United States, 2012. MMWR Morb Mortal Wkly Rep 2014; 63:379-83. [PMID: 24785984 PMCID: PMC4584889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Falls are the leading cause of injury-related morbidity and mortality among older adults, with more than one in three older adults falling each year, resulting in direct medical costs of nearly $30 billion. Some of the major consequences of falls among older adults are hip fractures, brain injuries, decline in functional abilities, and reductions in social and physical activities. Although the burden of falls among older adults is well-documented, research suggests that falls and fall injuries are also common among middle-aged adults. One risk factor for falling is poor neuromuscular function (i.e., gait speed and balance), which is common among persons with arthritis. In the United States, the prevalence of arthritis is highest among middle-aged adults (aged 45-64 years) (30.2%) and older adults (aged ≥65 years) (49.7%), and these populations account for 52% of U.S. adults. Moreover, arthritis is the most common cause of disability. To examine the prevalence of falls among middle-aged and older adults with arthritis in different states/territories, CDC analyzed data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) to assess the state-specific prevalence of having fallen and having experienced a fall injury in the past 12 months among adults aged ≥45 years with and without doctor-diagnosed arthritis. This report summarizes the results of that analysis, which found that for all 50 states and the District of Columbia (DC), the prevalence of any fall (one or more), two or more falls, and fall injuries in the past 12 months was significantly higher among adults with arthritis compared with those without arthritis. The prevalence of falls and fall injuries is high among adults with arthritis but can be addressed through greater dissemination of arthritis management and fall prevention programs in clinical and community practice.
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Affiliation(s)
- Kamil E. Barbour
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC,Corresponding author: Kamil E. Barbour, , 770-488-5145
| | - Judy A. Stevens
- Division of Unintentional Injury Prevention; National Center for Injury Prevention and Control, CDC
| | - Charles G. Helmick
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Yao-Hua Luo
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Louise B. Murphy
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Jennifer M. Hootman
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Kristina Theis
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Lynda A. Anderson
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Nancy A. Baker
- Department of Occupational Therapy, University of Pittsburgh
| | - David E. Sugerman
- Division of Unintentional Injury Prevention; National Center for Injury Prevention and Control, CDC
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Barbour KE, Hootman JM, Helmick CG, Murphy LB, Theis KA, Schwartz TA, Kalsbeek WD, Renner JB, Jordan JM. Meeting physical activity guidelines and the risk of incident knee osteoarthritis: a population-based prospective cohort study. Arthritis Care Res (Hoboken) 2014; 66:139-46. [PMID: 23983187 DOI: 10.1002/acr.22120] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 07/15/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Knee osteoarthritis (OA) is a leading cause of disability and joint pain. Although other risk factors of knee OA have been identified, how physical activity affects incident knee OA remains unclear. METHODS Using data from the first (1999-2004) and second (2005-2010) followup periods of the Johnston County Osteoarthritis Project study, we tested the association between meeting physical activity guidelines and incident knee outcomes among 1,522 adults ages ≥45 years. The median followup time was 6.5 years (range 4.0-10.2 years). Physical activity at baseline (moderate-equivalent physical activity minutes/week) was calculated using the Minnesota Leisure Time Physical Activity questionnaire. Incident knee radiographic OA (ROA) was defined as the development of Kellgren/Lawrence grade ≥2 in a knee at followup. Incident knee symptomatic ROA (sROA) was defined as the development of ROA and symptoms in at least 1 knee at followup. Weibull regression modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for interval-censored data. RESULTS In multivariable models, meeting the 2008 Department of Health and Human Services (HHS) physical activity guidelines (≥150 minutes/week) was not significantly associated with ROA (HR 1.20 [95% CI 0.92-1.56]) or sROA (HR 1.24 [95% CI 0.87-1.76]). Adults in the highest level (≥300 minutes/week) of physical activity had a higher risk of knee ROA and sROA compared with inactive (0 to <10 minutes/week) participants; however, these associations were not statistically significant (HR 1.62 [95% CI 0.97-2.68] and HR 1.42 [95% CI 0.76-2.65], respectively). CONCLUSION Meeting the HHS physical activity guidelines was not associated with incident knee ROA or sROA in a cohort of middle-aged and older adults.
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Affiliation(s)
- K E Barbour
- Centers for Disease Control and Prevention, Atlanta, Georgia
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Theis KA, Helmick CG, Hootman JM, Barbour KE. Physical activity among adults with arthritis. Prev Chronic Dis 2014; 11:E23. [PMID: 24556249 PMCID: PMC3938955 DOI: 10.5888/pcd11.140025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Kristina A Theis
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Charles G Helmick
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Jennifer M Hootman
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
| | - Kamil E Barbour
- Arthritis Program, Centers for Disease Control and Prevention, 4770 Buford Hwy, Chamblee, GA 30341
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Barbour KE, Helmick CG, Theis KA, Murphy LB, Hootman JM, Brady TJ. Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation--United States, 2010-2012. MMWR Morb Mortal Wkly Rep 2013; 62:869-73. [PMID: 24196662 PMCID: PMC4585589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Arthritis is the most common cause of disability among U.S. adults and is particularly common among persons with multiple chronic conditions. In 2003, arthritis in the United States resulted in an estimated $128 billion in medical-care costs and lost earnings. To update previous U.S. estimates of the prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation (AAAL), CDC analyzed 2010-2012 data from the National Health Interview Survey (NHIS). This report summarizes the results of that analysis, which found that 52.5 million (22.7%) of adults aged ≥18 years had self-reported doctor-diagnosed arthritis, and 22.7 million (9.8%, or 43.2% of those with arthritis) reported AAAL, matching and exceeding previous projected increases, respectively. Among persons with heart disease, diabetes, and obesity, the prevalences of doctor-diagnosed arthritis were 49.0%, 47.3%, and 31.2%, respectively; the prevalences of AAAL among persons with these specific conditions were 26.8%, 25.7%, and 15.2%, respectively. Greater use of evidence-based interventions, such as chronic disease self-management education and physical activity interventions that have been proven to reduce pain and improve quality-of-life among adults with chronic diseases might help reduce the personal and societal burden of arthritis.
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Theis KA, Murphy L, Hootman JM, Wilkie R. Social participation restriction among US adults with arthritis: a population-based study using the International Classification of Functioning, Disability and Health. Arthritis Care Res (Hoboken) 2013; 65:1059-69. [PMID: 23401463 PMCID: PMC4466902 DOI: 10.1002/acr.21977] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Accepted: 01/29/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To examine arthritis impact among US adults with self-reported doctor-diagnosed arthritis using the International Classification of Functioning, Disability and Health (ICF) framework (including the impairments, activity limitations, environmental, and personal factors domains and social participation restriction [SPR] as the outcome) overall and among those with and without SPR, and to identify the correlates of SPR. METHODS Cross-sectional 2009 National Health Interview Survey data were analyzed to examine the distribution of the ICF domain components. Unadjusted and multivariable-adjusted prevalence ratios (PRs) and 95% confidence intervals (95% CIs) were estimated to identify the correlates of SPR. Analyses using SAS, version 9.2 survey procedures accounted for the complex sample design. RESULTS SPR prevalence was 11% of adults with arthritis (5.7 million). After initial multivariable adjustment by ICF domain, serious psychological distress (impairments domain; PR 2.5 [95% CI 2.0-3.2]), ≥5 medical office visits (environmental domain; PR 3.4 [95% CI 2.5-4.4]), and physical inactivity (personal domain; PR 4.8 [95% CI 3.6-6.4]) were most strongly associated with SPR. A combined measure (key limitations [walking, standing, or carrying]; PR 31.2 [95% CI 22.3-43.5]) represented the activity limitations domain. After final multivariable adjustment incorporating all ICF domains simultaneously, the strongest associations with SPR were key limitations (PR 24.3 [95% CI 16.8-35.1]), ≥9 hours of sleep (PR 1.6 [95% CI 1.3-2.0]), and income-to-poverty ratio <2.00 and severe joint pain (PR 1.4 [95% CI 1.2-1.6] for both). CONCLUSION SPR affects 1 of 9 adults with arthritis. This study is the first to use the ICF framework in a population-based sample to identify specific functional activities, pain, sleep, and other areas as priorities for intervention to reduce negative arthritis impacts on disability, including SPR. Increased use of existing clinical and public health interventions is warranted.
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Affiliation(s)
- K A Theis
- Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
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Hootman JM, Barbour KE. State-specific prevalence of walking among adults with arthritis--United States, 2011. MMWR Morb Mortal Wkly Rep 2013; 62:331-4. [PMID: 23636026 PMCID: PMC4604927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Song J, Hochberg MC, Chang RW, Hootman JM, Manheim LM, Lee J, Semanik PA, Sharma L, Dunlop DD. Racial and ethnic differences in physical activity guidelines attainment among people at high risk of or having knee osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65:195-202. [PMID: 22807352 DOI: 10.1002/acr.21803] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 07/09/2012] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This cross-sectional study examined racial/ethnic differences in meeting the 2008 United States Department of Health and Human Services Physical Activity Guidelines aerobic component (≥150 moderate-to-vigorous minutes/week in bouts of ≥10 minutes) among persons with or at risk of radiographic knee osteoarthritis (RKOA). METHODS We evaluated African American versus white differences in guideline attainment using multiple logistic regression, adjusting for sociodemographic (age, sex, site, income, and education) and health factors (comorbidity, depressive symptoms, overweight/obesity, and knee pain). Our analyses included adults ages 49-84 years who participated in accelerometer monitoring at the Osteoarthritis Initiative 48-month visit (n = 1,142 with RKOA and n = 747 at risk of RKOA). RESULTS Two percent of African Americans and 13.0% of whites met the guidelines. For adults with and at risk of RKOA, significantly lower rates of guidelines attainment among African Americans compared to whites were partially attenuated by health factor differences, particularly overweight/obesity and knee pain (with RKOA: adjusted odds ratio [OR] 0.24, 95% confidence interval [95% CI] 0.08-0.72; at risk of RKOA: OR 0.28, 95% CI 0.07-1.05). CONCLUSION Despite known benefits from physical activity, attainment of the physical activity guidelines among persons with and at risk of RKOA was low. African Americans were 72-76% less likely than whites to meet the guidelines. Culturally relevant interventions and environmental strategies in the African American community targeting overweight/obesity and knee pain may reduce future racial/ethnic differences in physical activity and improve health outcomes.
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Affiliation(s)
- Jing Song
- Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
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Lee J, Song J, Hootman JM, Semanik PA, Chang RW, Sharma L, van Horn L, Bathon JM, Eaton CB, Hochberg MC, Jackson R, Kwoh CK, Mysiw WJ, Nevitt M, Dunlop DD. Obesity and other modifiable factors for physical inactivity measured by accelerometer in adults with knee osteoarthritis. Arthritis Care Res (Hoboken) 2013; 65:53-61. [PMID: 22674911 DOI: 10.1002/acr.21754] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/25/2012] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To investigate the public health impact of obesity and other modifiable risk factors related to physical inactivity in adults with knee osteoarthritis (OA). METHODS The frequency of inactivity as defined by the US Department of Health and Human Services was assessed from objective accelerometer monitoring of 1,089 participants (ages 49-84 years) with radiographic knee OA during the Osteoarthritis Initiative 48-month visit (2008-2010). The relationship between modifiable factors (weight status, dietary fat, fiber, smoking, depressive symptoms, knee function, knee pain, and knee confidence) with inactivity was assessed using odds ratios (ORs) and attributable fractions (AFs), controlling for descriptive factors (age, sex, race, education, lives alone, employment, frequent knee symptoms, and comorbidity). RESULTS Almost half (48.9%) of participants with knee OA were inactive. Being overweight (OR 1.8, 95% confidence interval [95% CI] 1.2-2.5) or obese (OR 3.9, 95% CI 2.6-5.7), having inadequate dietary fiber intake (OR 1.6, 95% CI 1.2-2.2), severe knee dysfunction (OR 1.9, 95% CI 1.3-2.8), and severe pain (OR 1.7, 95% CI 1.1-2.5) were significantly related to inactivity, controlling for descriptive factors. Modifiable factors with significant average AFs were being overweight or obese (AF 23.8%, 95% CI 10.5-38.6%) and inadequate dietary fiber (AF 12.1%, 95% CI 0.1-24.5%), controlling for all factors. CONCLUSION Being obese or overweight, the quality of the diet, severe pain, and severe dysfunction are significantly associated with physical inactivity in adults with knee OA. All components should be considered in designing physical activity interventions that target arthritis populations with low activity levels.
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Affiliation(s)
- Jungwha Lee
- Northwestern University, Chicago, IL 60611, USA.
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Murphy LB, Sacks JJ, Brady TJ, Hootman JM, Chapman DP. Anxiety and depression among US adults with arthritis: prevalence and correlates. Arthritis Care Res (Hoboken) 2012; 64:968-76. [PMID: 22550055 DOI: 10.1002/acr.21685] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There has been limited characterization of the burden of anxiety and depression, especially the former, among US adults with arthritis in the general population. The study objective was to estimate the prevalence and correlates of anxiety and depression among US adults with doctor-diagnosed arthritis. METHODS The study sample comprised US adults ages ≥ 45 years with doctor-diagnosed arthritis (n = 1,793) from the Arthritis Conditions Health Effects Survey (a cross-sectional, population-based, random-digit-dialed telephone interview survey). Anxiety and depression were measured using separate and validated subscales of the Arthritis Impact Measurement Scales. Prevalence was estimated for the sample overall and stratified by subgroups. Associations between correlates and each condition were estimated with prevalence ratios and 95% confidence intervals using logistic regression models. RESULTS Anxiety was more common than depression (31% and 18%, respectively); overall, one-third of respondents reported at least 1 of the 2 conditions. Most (84%) of those with depression also had anxiety. Multivariable logistic regression modeling failed to identify a distinct profile of characteristics of those with anxiety and/or depression. Only half of the respondents with anxiety and/or depression had sought help for their mental health condition in the past year. CONCLUSION Despite the clinical focus on depression among people with arthritis, anxiety was almost twice as common as depression. Given their high prevalence, their profound impact on quality of life, and the range of effective treatments available, we encourage health care providers to screen all people with arthritis for both anxiety and depression.
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Affiliation(s)
- Louise B Murphy
- Arthritis Program, Division of Population Health, CDC, Atlanta, Georgia 30341, USA.
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Hootman JM, Helmick CG, Brady TJ. Hootman et al. Respond. Am J Public Health 2012. [DOI: 10.2105/ajph.2012.300870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Jennifer M. Hootman
- All authors are with Arthritis Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Charles G. Helmick
- All authors are with Arthritis Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
| | - Teresa J. Brady
- All authors are with Arthritis Program, Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA
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Jones DL, Settipalli S, Goins RT, Goodman JM, Hootman JM. Community readiness for adopting a physical activity program for people with arthritis in West Virginia. Prev Chronic Dis 2012; 9:E70. [PMID: 22420313 PMCID: PMC3372974 DOI: 10.5888/pcd9.110166] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The health benefits of physical activity are well established in older adults with arthritis. Despite these benefits, many older adults with arthritis are not active enough to maintain health; therefore, increasing physical activity in adults with arthritis is a public health priority. The purpose of this study was to use the Community Readiness Model to assess readiness for adopting a physical activity program for people with arthritis in 8 counties in West Virginia. METHODS During 2007 and 2008, we conducted a telephone survey among 94 key informants who could provide insight into their community's efforts to promote physical activity among older adults with arthritis. We matched survey scores with 1 of 9 stages of readiness, ranging from 1 (no awareness) to 9 (high level of community ownership). RESULTS The survey placed the counties in stage 3 (vague awareness), indicating recognition of the need for more physical activity programming; community efforts were not focused and leadership was minimal. The interviews suggested that culturally sensitive, well-promoted free or low-cost programs conducted by community volunteers may be keys to success in West Virginia. CONCLUSION Information derived from our survey can be used to match intervention strategies for promoting physical activity among people with arthritis to communities in West Virginia according to their level of readiness.
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Affiliation(s)
- Dina L Jones
- Department of Orthopaedics, West Virginia University, PO Box 9196, 1 Medical Center Dr, Morgantown, WV 26506-9196, USA.
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Hootman JM, Helmick CG, Brady TJ. A public health approach to addressing arthritis in older adults: the most common cause of disability. Am J Public Health 2012; 102:426-33. [PMID: 22390506 PMCID: PMC3487631 DOI: 10.2105/ajph.2011.300423] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2011] [Indexed: 11/04/2022]
Abstract
Arthritis is highly prevalent and is the leading cause of disability among older adults in the United States owing to the aging of the population and increases in the prevalence of risk factors (e.g., obesity). Arthritis will play a large role in the health-related quality of life, functional independence, and disability of older adults in the upcoming decades. We have emphasized the role of the public health system in reducing the impact of this large and growing public health problem, and we have presented priority public health actions.
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Affiliation(s)
- Jennifer M Hootman
- Arthritis Program, 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.
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Dunlop DD, Song J, Semanik PA, Chang RW, Sharma L, Bathon JM, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Mysiw WJ, Nevitt MC, Hootman JM. Objective physical activity measurement in the osteoarthritis initiative: Are guidelines being met? Arthritis Rheum 2011; 63:3372-82. [PMID: 21792835 PMCID: PMC3205278 DOI: 10.1002/art.30562] [Citation(s) in RCA: 178] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Osteoarthritis (OA) clinical practice guidelines identify a substantial therapeutic role for physical activity, but objective information about the physical activity of this population is lacking. The aim of this study was to objectively measure levels of physical activity in adults with knee OA and report the prevalence of meeting public health physical activity guidelines. METHODS Cross-sectional accelerometry data from 1,111 adults with radiographic knee OA (49-84 years old) participating in the Osteoarthritis Initiative accelerometry monitoring ancillary study were assessed for meeting the aerobic component of the 2008 Physical Activity Guidelines for Americans (≥150 minutes/week moderate-to-vigorous-intensity activity lasting ≥10 minutes). Quantile regression was used to test median sex differences in physical activity levels. RESULTS Aerobic physical activity guidelines were met by 12.9% of men and 7.7% of women with knee OA. A substantial proportion of men and women (40.1% and 56.5%, respectively) were inactive, having done no moderate-to-vigorous activity that lasted 10 minutes or more during the 7 days. Although men engaged in significantly more moderate-to-vigorous activity (average daily minutes 20.7 versus 12.3), they also spent more time in no or very-low-intensity activity than women (average daily minutes 608.2 versus 585.8). CONCLUSION Despite substantial health benefits from physical activity, adults with knee OA were particularly inactive based on objective accelerometry monitoring. The proportions of men and women who met public health physical activity guidelines were substantially less than those previously reported based on self-reported activity in arthritis populations. These findings support intensified public health efforts to increase physical activity levels among people with knee OA.
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Affiliation(s)
- Dorothy D Dunlop
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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Hootman JM, Driban JB, Sitler MR, Harris KP, Cattano NM. Reliability and validity of three quality rating instruments for systematic reviews of observational studies. Res Synth Methods 2011; 2:110-8. [DOI: 10.1002/jrsm.41] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 06/01/2011] [Accepted: 08/18/2011] [Indexed: 01/09/2023]
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; USA
| | | | - Michael R. Sitler
- Biokinetics Research Laboratory; Athletic Training Division, Department of Kinesiology; Temple University; Philadelphia; PA; USA
| | - Kyle P. Harris
- Biokinetics Research Laboratory; Athletic Training Division, Department of Kinesiology; Temple University; Philadelphia; PA; USA
| | - Nicole M. Cattano
- Department of Sports Medicine; West Chester University of Pennsylvania; West Chester; PA; USA
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Furner SE, Hootman JM, Helmick CG, Bolen J, Zack MM. Health-related quality of life of US adults with arthritis: analysis of data from the behavioral risk factor surveillance system, 2003, 2005, and 2007. Arthritis Care Res (Hoboken) 2011; 63:788-99. [PMID: 21538946 DOI: 10.1002/acr.20430] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE To describe the health-related quality of life (HRQOL) of persons with and without arthritis in the 50 US states and the District of Columbia, and to determine correlates of poor HRQOL in persons with arthritis. METHODS Data from the Behavioral Risk Factor Surveillance System were used. Descriptive analyses were age standardized and multivariate analyses used logistic regression. RESULTS Of persons ages ≥18 years with arthritis, 27% reported fair/poor health, compared to 12% without arthritis. The mean numbers of physically unhealthy, mentally unhealthy, and activity-limited days for persons with arthritis exceeded those for persons without arthritis. In regression analyses, black non-Hispanics reported better HRQOL than white non-Hispanics, especially in the ≥14 versus 0 days comparisons. Yet no difference existed in self-reported health status between these two groups. Having a low family income and being unable to work were both strongly associated with poor HRQOL. Being physically active was associated with better HRQOL. Binge drinking was associated with poor HRQOL for some measures, but was associated with better self-reported health. Cost being a barrier to care and having diabetes mellitus were strongly associated with worse HRQOL. CONCLUSION Adults from the US with arthritis had worse HRQOL than those without. Physical health and mental health were both affected by arthritis; therefore, efforts to alleviate the arthritis burden should address both domains. Given the current and projected high prevalence of arthritis, we face a significant burden of poor HRQOL. Increasing physical activity, reducing comorbidities, and increasing access to health care could improve the HRQOL of persons with arthritis.
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Affiliation(s)
- Sylvia E Furner
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA.
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Hootman JM, Carroll DD, McKinght-Leily L, Allen KD. Physical Activity and Frequent Sleep Insufficiency Among US Adults with Arthritis. Med Sci Sports Exerc 2011. [DOI: 10.1249/01.mss.0000401587.28960.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Do BT, Hootman JM, Helmick CG, Brady TJ. Monitoring healthy people 2010 arthritis management objectives: education and clinician counseling for weight loss and exercise. Ann Fam Med 2011; 9:136-41. [PMID: 21403140 PMCID: PMC3056861 DOI: 10.1370/afm.1210] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Our goal was to monitor the progress of 3 Healthy People 2010 (HP2010) objectives encouraging self-management education and clinician counseling for weight loss and physical activity among adults with doctor-diagnosed arthritis. METHODS Using the national 2002 and 2006 National Health Interview Survey (NHIS) and state-based 2003 and 2007 Behavioral Risk Factor Surveillance System (BRFSS), we estimated the change in proportion of persons counseled for each objective, overall and by selected characteristics. RESULTS Nationally, the proportion of overweight and obese adults with doctor-diagnosed arthritis who were counseled by their clinician to lose weight to lessen their arthritis symptoms increased significantly from 35.0% (95% confidence interval [CI], 32.8%-37.2%) in 2002 to 41.3% (95% CI, 38.7%-44.0%) in 2006 but have yet to reach the 2010 target of 46%. There was no change in the proportion of adults with doctor-diagnosed arthritis who had ever taken a self-management education class (approximately 11%) or who had been counseled to engage in physical activity (approximately 52%), whose targets for 2010 are 13% and 67%, respectively. States had variable findings. CONCLUSIONS Nationally, significant progress has been made by clinicians for weight counseling of overweight and obese adults with doctor-diagnosed arthritis but not for the other 2 arthritis management objectives. Because clinician counseling can have important effects on the latter, this discrepancy suggests a need to focus on barriers to physician counseling for these outcomes.
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Affiliation(s)
- Barbara T Do
- Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA
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Kelley GA, Kelley KS, Hootman JM, Jones DL. Effects of community-deliverable exercise on pain and physical function in adults with arthritis and other rheumatic diseases: A meta-analysis. Arthritis Care Res (Hoboken) 2010; 63:79-93. [DOI: 10.1002/acr.20347] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Kelley GA, Kelley KS, Hootman JM, Jones DL. Effects Of Exercise On Pain And Physical Function In Adults With Arthritis: A Meta-Analysis. Med Sci Sports Exerc 2010. [DOI: 10.1249/01.mss.0000386726.49201.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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