Associations of Coexisting Pain and Fatigue Severity with Physical Performance and Quality of Life among Middle-Aged and Older Individuals with Chronic Knee Pain: A randomized controlled trial

Pain Medicine ◽  
2021 ◽  
Author(s):  
Yen Tzu Chen ◽  
Susan Lynn Murphy
Keyword(s):  
Quality Of Life ◽  
Physical Performance ◽  
Knee Pain ◽  
Moderate Pain ◽  
Mild Pain ◽  
Chronic Knee Pain ◽  
Moderate Fatigue ◽  
Fatigue Severity ◽  
Minute Walk

Abstract Objective To examine associations of combined pain and fatigue severity with physical performance and quality of life in people with chronic knee pain. Design Cross-sectional. Setting General community. Participants Adults (N = 193) aged ≥ 50 years with chronic knee pain. Methods Physical performance measures included Six-Minute Walk test, Timed Up and Go test, and 20-feet timed walk test. Quality of life (QOL) was measured by the Medical Outcomes Study Short Form-12 Health Survey. Brief Pain Inventory (BPI) and Brief Fatigue Inventory (BFI) were used to evaluate pain and fatigue. Multiple linear regression analyses were conducted to examine associations of coexisting pain and fatigue severity with physical performance and quality of life. Results Based on BPI and BFI scores, participants were categorized into four severity groups: mild pain/fatigue; moderate pain/mild fatigue; mild pain/moderate fatigue; and moderate pain/fatigue (which included severe pain/fatigue). The moderate pain/fatigue group had significantly worse physical performance on Six Minute Walk (standardized beta (β) = − 0.22, 95% confidence interval (CI) [-.38, -.06], P < 0.05), poorer physical (β = − 0.41, 95% CI [-.61, -.20], P < 0.001) and mental QOL (β = − 0.26, 95% CI [-.46, -.07], P < 0.05) compared to the mild pain/fatigue group. Moreover, the mild pain/moderate fatigue group had significantly lower levels of mental QOL (β = − 0.27, 95% CI [-.44, -.10], P < 0.05) when compared to the mild pain/fatigue group. The moderate pain/mild fatigue group did not differ statistically compared to the mild pain/fatigue group. Conclusions Coexisting moderate pain and moderate fatigue were related to worse physical performance and QOL. Fatigue contributed to lower levels of mental QOL. Clinical assessment of fatigue in addition to pain should be included as a standard examination for chronic knee pain.

scholarly journals The Influence of Knee Pain Location on Symptoms, Functional Status, and Knee-related Quality of Life in Older Adults With Chronic Knee Pain

2016 ◽  
Vol 32 (6) ◽  
pp. 463-470 ◽  
Author(s):  
Shawn Farrokhi ◽  
Yi-Fan Chen ◽  
Sara R. Piva ◽  
G. Kelley Fitzgerald ◽  
Jong-Hyeon Jeong ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Status ◽  
Knee Pain ◽  
Pain Location ◽  
Chronic Knee Pain ◽  
Related Quality

scholarly journals A Systematic Review of the Effectiveness of Rehabilitation Therapy to Treat People with Chronic Knee Pain Following A Total Knee Replacement.

2020 ◽  
Author(s):  
Nathan Adam Johns ◽  
Justine Naylor ◽  
Brinda Thirugnanam ◽  
Dean Mckenzie ◽  
Bernadette Brady ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Chronic Pain ◽  
Total Knee Replacement ◽  
Knee Pain ◽  
Knee Replacement ◽  
Chronic Knee Pain ◽  
Total Knee ◽  
Full Text Screening

Abstract Background:Chronic knee pain after a total knee replacement has been estimated to affect 10 to 30% of patients and is related to dissatisfaction with surgery, reduced function and reduced quality of life. Rehabilitation is often prescribed in the subacute period post-operatively, but it may offer benefit to the increasing numbers of patients with chronic pain after their knee replacement. The aim of this systematic review is to evaluate the effectiveness of rehabilitation to improve pain, function and quality of life in people with chronic knee pain persisting for more than 3 months following a total knee replacement.Methods: The systematic review was conducted following PRISMA guidelines with a search of the online databases Ovid Medline, Embase via Ovid, CINAHL Plus, PsycINFO, Ovid Emcare and Proquest from their earliest date to July 12, 2020. The search criteria included English language randomised controlled trials of rehabilitation strategies in any setting to treat people with chronic knee pain, defined as knee pain persisting for more than 3 months, following a total knee replacement. Rehabilitation programs included exercise therapy, patient education, cognitive and mind-body strategies and self-management and excluded medication trials, procedural techniques and complementary therapies. Results:There were 254 abstracts screened for eligibility with 13 remaining for full-text screening. Following full-text screening, there were no studies that met the eligibility criteria for evaluating rehabilitation therapy to treat chronic knee pain persisting for more than 3 months following a total knee replacement.Conclusion:Despite the high volume of knee replacement surgery and the high incidence of moderate to severe chronic pain ensuing, there is currently no evidence available that rehabilitation commencing three months after surgery can effectively treat chronic pain and disability following a total knee replacement.

Knee Pain and the Use of Various Types of Footwear—A Review

2018 ◽  
Vol 31 (10) ◽  
pp. 952-964
Author(s):  
Morad Chughtai ◽  
Jared Newman ◽  
Samuel Akil ◽  
Anton Khlopas ◽  
Assem Sultan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Knee Pain ◽  
The United States ◽  
Poor Quality ◽  
Knee Oa ◽  
Chronic Knee Pain ◽  
Different Types ◽  
Positive Results

AbstractKnee pain is a highly prevalent condition in the United States with multiple etiologies, with two of the most common sources being osteoarthritis (OA) and patellofemoral pain (PFP). These conditions can lead to reduced physical function and a poor quality of life. Various modalities have been used to decrease the amount of knee pain that individuals' experience; however, they are not always successful and can be expensive. Several studies have reported on specialized footwear for symptomatic alleviation of conditions that affect the knee, this is because it has been theorized that certain footwear can alter the forces placed by muscles on lower-extremity joints, and can potentially alleviate pain by reducing the load placed on the joint. Therefore, the purpose of this study was to review the current literature on the use of various types of footwear used in patients who suffer from knee pain. Specifically, we evaluated: (1) knee OA and (2) PFP and the effect that different footwear has on patients' symptoms. Multiple different types of footwear and orthosis were utilized to treat patients with chronic knee pain. However, the results from reported outcomes by different studies are conflicting, which warrant further studies. Nevertheless, there are enough positive results to view this as a potential major modality to utilize for the treatment of knee OA.

scholarly journals Effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Tianrong Chen ◽  
Calvin Kalun Or ◽  
Jiayin Chen
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Knee Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Exercise Programs ◽  
Randomized Controlled ◽  
Chronic Knee Pain

Abstract Objective The study sought to examine the effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain by a systematic review and meta-analysis of randomized controlled trials. Materials and Methods We searched MEDLINE, EMBASE, CINAHL Plus, and the Cochrane Library from database inception to August 2020. A meta-analysis and subgroup analyses, stratified by technology type and program feature, were conducted. Results Twelve randomized controlled trials were reviewed, all of which implemented the programs for 4 weeks to 6 months. Telephone, Web, mobile app, computer, and virtual reality were used to deliver the programs. The meta-analysis showed that these programs were associated with significant improvements in knee pain (standardized mean difference [SMD] = −0.29; 95% confidence interval [CI], −0.48 to −0.10; P = .003) and quality of life (SMD = 0.25; 95% CI, 0.04 to 0.46; P = .02) but not with significant improvement in physical function (SMD = 0.22; 95% CI, 0 to 0.43; P = .053). Subgroup analyses showed that some technology types and program features were suggestive of potential benefits. Conclusions Using technology to deliver the exercise programs appears to offer benefits. The technology types and program features that were associated with health values have been identified, based on which suggestions are discussed for the further research and development of such programs.

scholarly journals Chronic widespread pain and its associations with quality of life and function at a 20- year follow-up of individuals with chronic knee pain at inclusion

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Stefan Bergman ◽  
Carina Thorstensson ◽  
Maria L. E. Andersson
Keyword(s):  
Quality Of Life ◽  
Physical Function ◽  
Knee Pain ◽  
Population Based ◽  
Chronic Widespread Pain ◽  
Widespread Pain ◽  
Chronic Knee Pain ◽  
Radiographic Changes

Abstract Objective To study the prevalence of chronic widespread pain (CWP) and chronic regional pain (CRP), and their association to quality of life, pain, physical function at a 20-year follow-up in a population based cohort with chronic knee pain at inclusion. Methods 121 individuals (45% women, mean age 64 years, range 54–73) with chronic knee pain from a population-based cohort study, answered a questionnaire and had radiographic knee examination at a 20-year follow-up. The responders were divided into three groups according to reported pain; individuals having no chronic pain (NCP), chronic widespread pain (CWP) and chronic regional pain (CRP). Pain and physical function were assessed using Knee injury and Osteoarthritis Outcome Score (KOOS). Health related quality of life (HRQL) was assessed with Euroqol-5D-3 L (EQ5D) and Short form 36 (SF36). The associations between pain groups and KOOS, EQ5D, and SF36 were analysed by multiple logistic regression, controlled for age, gender and radiographic changes indicating knee osteoarthritis (OA). Results The prevalence of CWP was 30%, and CWP was associated to worse scores in all KOOS subscales, controlled for age, gender and radiographic changes. CWP was also associated to worse scores in EQ-5D and in seven of the SF-36 subgroups, controlled for age, gender and radiographic changes. Conclusion One third of individuals with chronic knee pain met the criteria for CWP. CWP was associated with patient reported pain, function and HRQL. This suggest that it is important to assess CWP in the evaluation of patients with chronic knee pain, with and without radiographic knee OA.

scholarly journals Effectiveness of contrast hydrotherapy on knee pain among osteoarthritis patients

2019 ◽  
Vol 10 (4) ◽  
pp. 3217-3222
Author(s):  
Thenmozhi P ◽  
Nisha P ◽  
Prema J ◽  
Shreeba R
Keyword(s):  
Quality Of Life ◽  
Knee Pain ◽  
Rating Scale ◽  
Pharmacological Intervention ◽  
Control Group ◽  
Routine Practice ◽  
Chronic Knee Pain ◽  
And Control ◽  
Experimental Group

Many patients with osteoarthritis experiences knee pain, but if untreated, it may lead to chronic knee pain. This may quietly limit the functional abilities and impairs the quality of life. Thus the study was conducted with the aim to determine the effect of contrast hydrotherapy on knee pain. Quasi-experimental research design was adopted with 30 samples who met the inclusion criteria. Samples were assigned into experimental and control group by convenience sampling technique. A pre-test was conducted by using Numerical pain rating scale in both experimental and control group. Contrast hydrotherapy was administered to the experimental group, and the control group was continued with the routine practice. Post-test was conducted after 7 days with the same tool for both the group. Data were analyzed using SPSS. The study findings revealed that contrast hydrotherapy was effective in reducing the level of knee pain at the level of p<0.05 in the experimental group. Contrast hydrotherapy is inexpensive, safer method, does not cost the time, reduce the risk pharmacological intervention and can be affordable by all the participants. This therapy may be recommended in both clinical and community setting to reduce the pain, thereby improves the quality of life.

scholarly journals Characteristics and health status of patients with and without confirmed HFpEF

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Deaton ◽  
F Forsyth ◽  
J Mant ◽  
D Edwards ◽  
R Hobbs ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cohort Study ◽  
Health Status ◽  
Functional Impairment ◽  
Funding Source ◽  
Walk Distance ◽  
Minute Walk Distance ◽  
Minute Walk

Abstract Aims Patients with heart failure with preserved ejection fraction (HFpEF) are usually older and multi-morbid and diagnosis can be challenging. The aims of this cohort study were to confirm diagnosis of HFpEF in patients with possible HFpEF recruited from primary care, to compare characteristics and health status between those with and without HFpEF, and to determine factors associated with health status in patients with HFpEF. Methods Patients with presumed HFpEF were recruited from primary care practices and underwent clinical assessment and diagnostic evaluation as part of a longitudinal cohort study. Health status was measured by Montreal Cognitive Assessment (MOCA), 6-minute walk test, symptoms, and the Kansas City Cardiomyopathy Questionnaire (KCCQ), and quality of life (QoL) by EQ-5D-5L visual analogue scale (VAS). Results 151 patients (mean age 78.5±8.6 years, 40% women, mean EF 56% + 9.4) were recruited and 93 (61.6%) were confirmed HFpEF (those without HFpEF had other HF and cardiac diagnoses). Patients with and without HFpEF did not differ by age, MOCA, blood pressure, heart rate, NYHA class, proportion with atrial fibrillation, Charlson Comorbidity Index, or NT-ProBNP levels. Patients with HFpEF were more likely to be women, overweight or obese, frail, and to be more functionally impaired by 6 minute walk distance and gait speed than those without. Although not statistically significant, patients with HFpEF had clinically significant differences (&gt;5 points) on the physical limitations, symptom burden and clinical summary subscales of the KCCQ, but did not differ by other subscales or by EQ-5D-5L VAS (70±17 vs 73±19, p=0.385). More patients with HFpEF reported daytime dyspnoea (63% vs 46%, p=0.035) and fatigue (81% vs 61%, p=0.008), but not other symptoms compared to those without HFpEF. For both groups BMI was moderately negatively correlated with KCCQ subscale scores, and 6 minute walk distance was positively correlated with KCCQ subscales. Conclusions Nearly 40% were not confirmed as HFpEF indicating the challenges of diagnosis. Patients with confirmed HFpEF differed by sex, overweight/obesity, frailty, functional impairment, and symptoms but not by age or comorbidities from those without HFpEF. These differences were reflected in some subscale scores of the KCCQ, but not how patients reported their quality of life on the KCCQ QoL subscale and EQ-5D-5L VAS. Older patients with HFpEF reported relatively high QoL despite poor health status by functional impairment, frailty and symptoms. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institute of Health Research School of Primary Care Research

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