Osteoarthritis of the hip or knee which coexistin

Authors: Kerstin G Reeuwijk Mariëtte de Rooij Gabriella M van Dijk Cindy Veenhof Martijn P Steultjens Joost Dekker

Publish Date: 2010/02/23

Volume: 29, Issue: 7, Pages: 739-747

PDF Link

Abstract

Exercise therapy is generally recommended in osteoarthritis OA of the hip or knee However coexisting disorders may bring additional impairments which may necessitate adaptations to exercise for OA of the hip or knee For the purpose of developing an adapted protocol for exercise therapy in OA patients with coexisting disorders information is needed on which specific coexisting disorders in OA are associated with activity limitations and pain To describe the relationship between specific coexisting disorders activity limitations and pain in patients with OA of the hip or knee a crosssectional cohort study among 288 older adults 50–85 years of age with OA of hip or knee was conducted Subjects were recruited from three rehabilitation centers and two hospitals Demographic data clinical data information about coexisting disorders ie comorbidity and other disorders activity limitations WOMAC physical functioning domain and pain visual analogue scale VAS were collected by questionnaire Statistical analysis included descriptive statistics and multivariate regression analysis Coexisting disorders associated with activity limitations were chronic back pain or hernia arthritis of the hand or feet and other chronic rheumatic diseases all musculoskeletal disorders diabetes and chronic cystitis nonmusculoskeletal disorders hearing impairments in a facetoface conversation vision impairments in long distances and dizziness in combination with falling all sensory impairments and overweight and obesity Coexistent disorders associated with pain were arthritis of the hand or feet other chronic rheumatic diseases musculoskeletal disorders and diabetes nonmusculoskeletal disorder Specific disorders coexisting next to OA and associated with additional activity limitations and pain were identified These coexisting disorders need to be addressed in exercise therapy and rehabilitation for patients with OA of the hip or kneeOsteoarthritis OA is one of the diseases with the highest rates of comorbidity 1 Previous studies have reported comorbidity rates of 68 to 85 2 3 4 5 Diseases that frequently occur next to OA are diabetes hypertension and cardiovascular disorders other disorders including overweight and back pain occur frequently as well 1 4 6 Thus coexisting disorders—defined as coexisting diseases and coexisting other disorders eg overweight—are highly prevalent in OAExercise therapy is generally recommended in OA of the hip or knee Exercise is effective in reducing activity limitations and pain in OA 7 8 However coexisting disorders may bring additional impairments which necessitate adaptations to the exercise protocol for OA of the hip or knee For the future purpose of developing such an adapted protocol information is needed on which specific coexisting disorders in OA are disabling ie which coexisting disorders are associated with activity limitations and pain Coexisting disorders causing activity limitations and pain are likely to cause restrictions to exercise therapy as well necessitating adaptations in the exercise protocolPreviously we have reported which coexisting disorders are associated with additional activity limitations and pain in OA of hip or knee 5 9 In these studies we used the Cumulative Illness Rating Scale CIRS 10 11 12 to assess coexisting disorders The CIRS yields information on global categories of coexisting diseases eg ear eye nose and throat diseases or endocrine and metabolic diseases Although quite informative more detailed information on which specific coexisting disorders are disabling is required in order to be able to develop the exercise therapy protocol with adaptations for coexisting disorders The objective of the study was to describe the relationship between specific coexisting disorders activity limitations and pain in patients with hip or knee OAThe present study is a secondary analysis of previously reported data 5 The design of this crosssectional study is summarized below The reader is referred to the original publication for a more detailed description of the design 5 The study was approved by the Medical Ethical Committee of the VU University Medical Centre Amsterdam the NetherlandsParticipants were recruited from three rehabilitation centers and two hospitals Departments of Orthopedics Rheumatology or Rehabilitation Inclusion criteria were a diagnosis of OA of the hip or knee by medical specialist according to radiological criteria or clinical criteria of the American College of Rheumatology 13 14 b 50 years of age or older c referral to hospital or rehabilitation center less than a year before inclusion d at least moderate functional problems Lequesne algofunctional index score ≥5 15 and e informed consent Exclusion criteria were a 85 years of age or older b insufficient understanding of the Dutch language and c expected death due to fatal illness within 1 year after inclusionPatients were invited to a test location The data used in the present study were gathered by means of interview demographic and clinical data and questionnaires activity limitations pain and coexistent disorders Xrays were used to evaluate radiological impairment of the hip or knee

Keywords: