scholarly journals P127 Factors associated with self-reported fatigue in hip and/or knee osteoarthritis: a systematic review

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Henrietta O Fawole ◽  
Opeyemi A Idowu ◽  
Ukachukwu O Abaraogu ◽  
Jody L Riskowski ◽  
Andrea Dell'Isola ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Longitudinal Studies ◽  
Evidence Synthesis ◽  
Cross Sectional ◽  
Factors Associated ◽  
Knee Oa ◽  
Best Evidence Synthesis

Abstract Background Fatigue is an important, under-researched and poorly understood symptom among hip and/or knee osteoarthritis (OA) populations. To devise the best fatigue management strategy in these populations, it is necessary to evaluate the evidence on risk factors for fatigue. This study aimed to give an overview and evaluate the evidence on the factors associated with fatigue in hip and/or knee OA populations. Methods We conducted a systematic review using MEDLINE, AMED, CINAHL, ProQuest, and Web of Science Core Collections databases from inception to June 2019. Inclusion criteria comprised cross-sectional and longitudinal studies on patients with a diagnosis of hip and/or knee OA, included a measure of self-reported fatigue and studies that performed a subgroup analysis of hip/knee OA from other included populations. Two reviewers simultaneously screened articles for eligibility and extracted the following data: study design, fatigue outcome tool, follow-up time and association between factors and fatigue. The methodological quality of the included studies was assessed using the National Heart, Lung and Blood Institute quality appraisal tool. Study quality and study designs were combined to determine the level of evidence using best-evidence synthesis, which comprised six levels of evidence (Table 1). Results Eighteen studies (10 cross-sectional designs, 8 longitudinal designs) were included. A majority of the studies included were of good quality, whilst two had fair quality and one poor quality. Lower physical function, more pain, higher depressive symptoms, lower physical activity, older age, increased anxiety, greater pain catastrophizing, worse radiographic evidence, higher body mass index, greater comorbidity/illness burden, lower six minutes walk and increased joint stiffness were included in the best evidence synthesis. From the best evidence grading, most of these factors had limited or conflicting evidence on its association with fatigue within the hip/knee OA populations. However, lower physical function and higher depressive symptoms were graded as having strong evidence on their associations with fatigue while higher pain levels had moderate evidence. Conclusion Lower physical function levels, higher depressive symptoms and higher pain are related to fatigue in the hip/knee OA population. More longitudinal studies are warranted to investigate the potential association of other identified factors and fatigue. Disclosures H.O. Fawole None. O.A. Idowu None. U.O. Abaraogu None. J.L. Riskowski None. A. Dell'Isola None. M.P. Steultjens None. S.F.M. Chastin None.

scholarly journals Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Henrietta O Fawole ◽  
Opeyemi A Idowu ◽  
Ukachukwu O Abaraogu ◽  
Andrea Dell’Isola ◽  
Jody L Riskowski ◽  
...  
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Physical Function ◽  
Longitudinal Studies ◽  
Evidence Synthesis ◽  
Current Evidence ◽  
Activity Levels ◽  
Knee Oa ◽  
Best Evidence Synthesis ◽  
Physical Activity Levels

Abstract Objective The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. Methods A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case–control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). Results Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. Conclusion Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations.

scholarly journals Pain Trajectories in Knee Osteoarthritis—A Systematic Review and Best Evidence Synthesis on Pain Predictors

2020 ◽  
Vol 9 (9) ◽  
pp. 2828
Author(s):  
Davide Previtali ◽  
Luca Andriolo ◽  
Giorgio Di Laura Frattura ◽  
Angelo Boffa ◽  
Christian Candrian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Evidence Synthesis ◽  
Grey Literature ◽  
Cochrane Library ◽  
Related Factors ◽  
Knee Oa ◽  
Experienced Pain ◽  
Best Evidence Synthesis ◽  
Pain Trajectories

Different profiles of pain progression have been reported in patients with knee osteoarthritis (OA), but the determinants of this heterogeneity are still to be sought. The aim of this systematic review was to analyze all studies providing information about knee OA pain trajectories to delineate, according to patients’ characteristics, an evidence-based evolution pattern of this disabling disease, which is key for a more personalized and effective management of knee OA. A literature search was performed on PubMed, Web of Science, Cochrane Library, and grey literature databases. The Cochrane Collaboration’s tool for assessing risk of bias was used, and a best-evidence synthesis was performed to define the predictors of pain evolution. Seven articles on 7747 patients affected by knee OA (mainly early/moderate) were included. Daily knee OA pain trajectories were unstable in almost half of the patients. In the mid-term, knee OA had a steady pain trajectory in 85% of the patients, 8% experienced pain reduction, while 7% experienced pain worsening. Low education, comorbidities, and depression were patient-related predictors of severe/worsening knee OA pain. Conversely, age, alcohol, smoking, pain coping strategies, and medications were unrelated to pain evolution. Conflicting/no evidence was found for all joint-related factors, such as baseline radiographic severity.

Factors Associated with Intermittent, Constant, and Mixed Pain in People with Knee Osteoarthritis

2021 ◽  
Author(s):  
Fatme Hoteit ◽  
Debbie Erhmann Feldman ◽  
Lisa C. Carlesso
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Multinomial Logistic Regression ◽  
Secondary Analysis ◽  
Cross Sectional ◽  
System Sensitivity ◽  
Factors Associated ◽  
Lower Likelihood ◽  
Paindetect Questionnaire ◽  
Mixed Pain

Purpose: To explore factors associated with intermittent, constant, and mixed pain in people with knee osteoarthritis. Method: We conducted a secondary analysis of a cross-sectional multicenter study with adults ≥ 40 years with knee osteoarthritis. Participants completed questionnaires on personal (e.g., demographics, comorbidities), physical (e.g., physical function), psychological (e.g., depressive symptoms), pain (e.g., qualities), and tests for physical performance and nervous system sensitivity. We qualified patients’ pain as intermittent, constant, or mixed using the Modified painDETECT Questionnaire and assessed associations with the variables using multinomial logistic regression. Results: The 279 participants had an average age of 63.8 years (SD = 9.6), BMI of 31.5 kg/m2 (SD = 8.7), and 58.6% were female. Older age (odds ratio [OR] 0.95; 95% CI: 0.90, 1.00) and higher self-reported physical function ([OR] 0.94; 95% CI: 0.91, 0.98) were associated with a lower likelihood of mixed pain compared with intermittent pain. Higher pain intensity ([OR] 1.25; 95% CI: 1.07, 1.47) was related to a 25% higher likelihood of mixed pain compared with intermittent pain. Conclusions: This study provides initial data for associations of personal, pain, and physical function factors with different pain patterns. Awareness of these factors can help clinicians develop targeted strategies for managing patients’ pain.

scholarly journals Synergistic effects of hip/knee osteoarthritis and comorbidities on mobility and self-care limitations among older adults: Cross-sectional analysis of the Oxford pain, Activity and Lifestyle study

2020 ◽  
Vol 10 ◽  
pp. 2235042X2097452
Author(s):  
Philippa JA Nicolson ◽  
Esther Williamson ◽  
Hopin Lee ◽  
Alana Morris ◽  
Angela Garrett ◽  
...  
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Knee Osteoarthritis ◽  
Synergistic Effects ◽  
Self Care ◽  
Postal Questionnaire ◽  
Community Dwelling ◽  
Mobility Limitations ◽  
Cross Sectional ◽  
Knee Oa

Objective: To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults. Methods: We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years or older who completed a postal questionnaire. Participants reported demographic information, hip/knee OA, comorbidities and mobility and self-care limitations. We used modified Poisson regression models to estimate the independent and combined relative risks (RR) of mobility or self-care limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the combined effect and the sum of the individual effects, known as the synergy index. Results: Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them 42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR: 3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58, 95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and 22% respectively. Conclusions: This study demonstrates that synergism between hip/knee OA and anxiety or depressive symptoms contribute to self-care limitations. These findings highlight the importance of assessing and addressing anxiety or depressive symptoms when managing older adults with hip/knee OA to minimize self-care limitations.

scholarly journals Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Francis Q. S. Dzakpasu ◽  
Alison Carver ◽  
Christian J. Brakenridge ◽  
Flavia Cicuttini ◽  
Donna M. Urquhart ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Pain ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Insufficient Evidence ◽  
Cross Sectional ◽  
Experimental Intervention ◽  
Best Evidence Synthesis ◽  
Cross Sectional Studies ◽  
Full Day

Abstract Background Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions. Methods Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies’ risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review. Results Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP – OR = 1.19(1.03 – 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 – 1.92)] and neck/shoulder pain [OR = 1.73(1.46 – 2.03)], but not with extremities pain [OR = 1.17(0.65 – 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting. Conclusions We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases. Protocol registration PROSPERO ID #CRD42020166412 (Amended to limit the scope)

scholarly journals Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: A systematic review and best evidence synthesis

2018 ◽  
Vol 15 (3) ◽  
pp. 903-908 ◽  
Author(s):  
Giorgio di Laura Frattura ◽  
Giuseppe Filardo ◽  
Dario Giunchi ◽  
Augusto Fusco ◽  
Stefano Zaffagnini ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Evidence Synthesis ◽  
Best Evidence Synthesis ◽  
Risk Of Falls ◽  
Total Knee

Factors associated with successful rehabilitation in older adults: A systematic review and best evidence synthesis

2021 ◽  
Vol 42 (1) ◽  
pp. 83-93
Author(s):  
Patricia J. van der Laag ◽  
Susanne A.M. Arends ◽  
Martine S. Bosma ◽  
Agnes van den Hoogen
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Evidence Synthesis ◽  
Factors Associated ◽  
Best Evidence Synthesis ◽  
Successful Rehabilitation

scholarly journals Differences in quality of life between patients with severe hip and knee osteoarthritis

2018 ◽  
Vol 75 (1) ◽  
pp. 62-67
Author(s):  
Slavica Jandric
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Statistical Significance ◽  
Womac Score ◽  
Linear Regression Models ◽  
Cross Sectional ◽  
Knee Oa

Background/Aim. Osteoarthritis (OA) is the clinical manifestation of degenerative joint changes. The aim of this study was to investigate differences in quality of life (QoL) between patients with severe hip and knee OA. Methods. This is the cross-sectional study of 195 patients (average age 63.2 ? 11.1 yrs), with a diagnosis of OA of the hip and knee that were assigned to receive a total hip or knee replacement. The patients were divided into three groups in relation to localization of OA. The first group included patients with hip OA; the second group consisted of patients with knee OA and the third group with both hip and knee OA. Demographic and clinical data were collected for each patient. We measured health related quality of life (QoL) by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires. Statistical significance of differences was at the level of p < 0.05. Results. The best QoL was in the group of knee OA (42.7 ? 11.3) and the worst in the group with both hip and knee OA patients (35.8 ? 12.7). QoL assessed by WOMAC score and the domain of physical function were significantly different among three groups of patients with OA (F = 5.377, p < 0.01 and F = 5.273, p < 0.01) respectively). Results of three multiple linear regression models where WOMAC score was dependent variable and age, body mass index (BMI), social class, pain, stiffness, physical function, hypertension, cardiomyopathy, diabetes mellitus were independent variables, have shown that QoL was statistically significantly associated with pain and physical function in the hip and knee OA groups, whereas in the group with both hip and knee OA patients, QoL was associated with BMI, pain, physical function and diabetes mellitus. Conclusion. QoL of patients with severe hip and knee osteoarthritis in relation to localization was significantly different. QoL in severe hip and knee OA patients was significantly associated with pain and physical function, but in patients with both hip and knee OA QoL was also associated with BMI and diabetes mellitus.

Total Knee Arthroplasty in Patients With Knee Osteoarthritis: Effects on Proprioception. A Systematic Review and Best Evidence Synthesis

2019 ◽  
Vol 34 (11) ◽  
pp. 2815-2822
Author(s):  
Giorgio di Laura Frattura ◽  
Stefano Zaffagnini ◽  
Giuseppe Filardo ◽  
Iacopo Romandini ◽  
Augusto Fusco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Osteoarthritis ◽  
Knee Arthroplasty ◽  
Evidence Synthesis ◽  
Best Evidence Synthesis ◽  
Total Knee

scholarly journals Isokinetic Dynamometry as a Tool to Predict Shoulder Injury in an Overhead Athlete Population: A Systematic Review

Sports ◽  
2020 ◽  
Vol 8 (9) ◽  
pp. 124
Author(s):  
Andrea Bagordo ◽  
Kimberly Ciletti ◽  
Kevin Kemp-Smith ◽  
Vini Simas ◽  
Mike Climstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
External Rotation ◽  
Evidence Synthesis ◽  
Peak Torque ◽  
Shoulder Injury ◽  
Isokinetic Dynamometry ◽  
Cross Sectional ◽  
Best Evidence Synthesis ◽  
Cross Sectional Studies

Prospective and cross-sectional studies have used pre-season isokinetic dynamometry strength and endurance measurements of shoulder internal rotation (IR) and external rotation (ER) to determine if they can be correlated to injury. However, to date, no review has provided a synthesis of all available literature on this topic. The aim of this systematic review was to identify isokinetic dynamometry studies that assess shoulder IR and ER strength and endurance in the overhead athletic population in relation to shoulder injury. Electronic databases (PubMed, CINAHL, and SportDiscus) were searched through September 2019 using pre-determined search terms. Both prospective and cross-sectional studies were included in this review. Studies were assessed for quality using either Appraisal Tool for Cross-sectional Studies (AXIS) or Critical Appraisal Skills Programme (CASP). Data on outcome measures of strength and endurance peak torque (PT) and ratios (ER:IR) were extracted and further analysed using a best evidence synthesis approach. A total of 13 articles met the inclusion criteria. Conflicting evidence was found when reviewing all studies without differentiating by study type. Prospective study designs revealed strong evidence that reduced IR endurance and reduced strength ratios are predictive of shoulder injury. Cross-sectional literature showed only conflicting and limited evidence for all outcome measures. At this stage, more research is needed in individual sporting populations using prospective cohort designs.

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