scholarly journals Baseline clinical characteristics of predicted structural and pain progressors in the IMI-APPROACH knee OA cohort

RMD Open ◽  
2021 ◽  
Vol 7 (3) ◽  
pp. e001759
Author(s):  
Eefje Martine van Helvoort ◽  
Christoph Ladel ◽  
Simon Mastbergen ◽  
Margreet Kloppenburg ◽  
Francisco J Blanco ◽  
...  
Keyword(s):  
Structural Damage ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Pearson Correlation ◽  
Joint Space Width ◽  
Correlation Coefficients ◽  
Joint Space ◽  
Numeric Rating Scale ◽  
Knee Oa ◽  
Private Research

ObjectivesTo describe the relations between baseline clinical characteristics of the Applied Public-Private Research enabling OsteoArthritis Clinical Headway (IMI-APPROACH) participants and their predicted probabilities for knee osteoarthritis (OA) structural (S) progression and/or pain (P) progression.MethodsBaseline clinical characteristics of the IMI-APPROACH participants were used for this study. Radiographs were evaluated according to Kellgren and Lawrence (K&L grade) and Knee Image Digital Analysis. Knee Injury and Osteoarthritis Outcome Score (KOOS) and Numeric Rating Scale (NRS) were used to evaluate pain. Predicted progression scores for each individual were determined using machine learning models. Pearson correlation coefficients were used to evaluate correlations between scores for predicted progression and baseline characteristics. T-tests and χ2 tests were used to evaluate differences between participants with high versus low progression scores.ResultsParticipants with high S progressions score were found to have statistically significantly less structural damage compared with participants with low S progression scores (minimum Joint Space Width, minJSW 3.56 mm vs 1.63 mm; p<0.001, K&L grade; p=0.028). Participants with high P progression scores had statistically significantly more pain compared with participants with low P progression scores (KOOS pain 51.71 vs 82.11; p<0.001, NRS pain 6.7 vs 2.4; p<0.001).ConclusionsThe baseline minJSW of the IMI-APPROACH participants contradicts the idea that the (predicted) course of knee OA follows a pattern of inertia, where patients who have progressed previously are more likely to display further progression. In contrast, for pain progressors the pattern of inertia seems valid, since participants with high P score already have more pain at baseline compared with participants with a low P score.

Validation of the Three-Item Skindex-Mini Among Hidradenitis Suppurativa Patients With Diverse Racial Backgrounds

2020 ◽  
Vol 24 (5) ◽  
pp. 457-460
Author(s):  
Lauren A.V. Orenstein ◽  
Adaugo Amah ◽  
Fiona M. Shaw ◽  
Chao Zhang ◽  
Robert A. Swerlick ◽  
...  
Keyword(s):  
Hidradenitis Suppurativa ◽  
Rating Scale ◽  
Clinical Care ◽  
Pearson Correlation ◽  
Life Quality ◽  
Correlation Coefficients ◽  
Numeric Rating Scale ◽  
Secondary Outcome ◽  
Cross Sectional ◽  
And Function

Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that severely impairs patients’ quality of life (QoL). Instruments such as the 10-item Dermatology Life Quality Index and 16-item Skindex-16 have been used to assess QoL in HS; however, it is unknown whether the shorter 3-item Skindex-mini can also provide an accurate assessment of skin-related QoL in patients with HS. Objectives The aim was to assess how well the Skindex-16 correlates with its shorter adaptation, the Skindex-mini, in capturing QoL among patients with HS. Methods This retrospective cross-sectional study included all HS patients seen in the HS Clinic at The Emory Clinic between January 1, 2019, and August 16, 2019. We compared the correlation between the symptom, emotion, and function domains of the Skindex-16 and Skindex-mini using Pearson correlation coefficients (CC). Secondary outcome measures included individual survey item analysis, ItchyQuant scores, and numeric rating scale of pain. Results We identified 108 encounters among 75 unique hidradenitis suppurativa patients (43 black/African American, 18 white, 5 Asian/Pacific Islander, 3 Latino, 4 Other, 2 unknown). Pearson CC between the Skindex-16 and Skindex-mini domain scores for all encounters were 0.770 ( P < .001), 0.787 ( P < .001), and 0.801 ( P < .001) for the symptom, emotion, and function domains, respectively. The mean pain and ItchyQuant scores were 4.14 (SD 3.31) and 3.55 (SD 3.34), respectively. Conclusions The Skindex-mini correlated highly with the Skindex-16 in a racially diverse group of patients with HS. The Skindex-mini is a streamlined QoL instrument that could be practically implemented into routine clinical care among diverse patients presenting to dermatology.

Identifying Phenotypes of Knee Osteoarthritis by Separate Quantitative Radiographic Features May Improve Patient Selection for More Targeted Treatment

2013 ◽  
Vol 40 (6) ◽  
pp. 891-902 ◽  
Author(s):  
Margot B. Kinds ◽  
Anne C.A. Marijnissen ◽  
Max A. Viergever ◽  
Pieter J. Emans ◽  
Floris P.J.G. Lafeber ◽  
...  
Keyword(s):  
Bone Density ◽  
Clinical Characteristics ◽  
Joint Space Width ◽  
Specific Treatment ◽  
Joint Space ◽  
Radiographic Features ◽  
Knee Oa ◽  
Improve Patient Selection ◽  
Space Width ◽  
Varus Angle

Objective.Expression of osteoarthritis (OA) varies significantly between individuals, and over time, suggesting the existence of different phenotypes, possibly with specific etiology and targets for treatment. Our objective was to identify phenotypes of progression of radiographic knee OA using separate quantitative features.Methods.Separate radiographic features of OA were measured by Knee Images Digital Analysis (KIDA) in individuals with early knee OA (the CHECK cohort: Cohort Hip & Cohort Knee), at baseline and at 2-year and 5-year followup. Hierarchical clustering was performed to identify phenotypes of radiographic knee OA progression. The phenotypes identified were compared for changes in joint space width (JSW), varus angle, osteophyte area, eminence height, bone density, for Kellgren-Lawrence (K-L) grade, and for clinical characteristics. Logistic regression analysis evaluated whether baseline radiographic features and demographic/clinical characteristics were associated with each of the specific phenotypes.Results.The 5 clusters identified were interpreted as “Severe” or “No,” “Early” or “Late” progression of the radiographic features, or specific involvement of “Bone density.” Medial JSW, varus angle, osteophyte area, eminence height, and bone density at baseline were associated with the Severe and Bone density phenotypes. Lesser eminence height and bone density were associated with Early and Late progression. Larger varus angle and smaller osteophyte area were associated with No progression.Conclusion.Five phenotypes of radiographic progression of early knee OA were identified using separate quantitative features, which were associated with baseline radiographic features. Such phenotypes might require specific treatment and represent relevant subgroups for clinical trials.

The efficacy of transcatheter arterial embolization for knee pain on patients with knee osteoarthritis: A case series

2021 ◽  
pp. 1-6
Author(s):  
Kun Yung Kim ◽  
Gi-Wook Kim
Keyword(s):  
Conservative Treatment ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Transcatheter Arterial Embolization ◽  
Rating Scale ◽  
Case Series ◽  
Arterial Embolization ◽  
Numeric Rating Scale ◽  
Knee Oa ◽  
Before And After

BACKGROUND: Knee osteoarthritis (OA) is accompanied by inflammation and angiogenesis. Modifying angiogenesis through transcatheter arterial embolization (TAE) can be a potential treatment for knee OA. OBJECTIVE: We subjected five OA knees in three patients to TAE and report the results of our post-treatment observations. CASE DESCRIPTION: Three patients that had experienced knee pain for a minimum of one year prior to the study, and whose pain had persisted despite conservative treatment, were included in this study. Patients more often chose conservative treatment over surgical treatment. Pain and functional scales were evaluated before, immediately, and 1 month after TAE using the Numeric Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). TAE was performed by an experienced interventional radiologist. The average values of NRS evaluated before and after 5 TAEs were 5.2 before TAE, 3 immediately after TAE, and 3.6 after 1 month of TAE, and the average values of WOMAC were 52, 38.4, and 36.4, respectively. There were no major adverse effects. CONCLUSION: The examined cases support the conclusion that TAE is an effective treatment for patients with knee OA. Substantial pain relief and WOMAC improvement were observed both immediately and one month after TAE.

scholarly journals Correlations Between Clinical Trial Outcomes Based on Symptoms, Functional Impairments, and Quality of Life in Children and Adolescents With ADHD

2017 ◽  
Vol 23 (13) ◽  
pp. 1578-1591 ◽  
Author(s):  
David R. Coghill ◽  
Alain Joseph ◽  
Vanja Sikirica ◽  
Mark Kosinski ◽  
Caleb Bliss ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Children And Adolescents ◽  
Rating Scale ◽  
Controlled Trial ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Parent Report ◽  
Functional Impairments ◽  
Risk Avoidance

Objective: To assess relationships between treatment-associated changes in measures of ADHD symptoms, functional impairments, and health-related quality of life in children and adolescents with ADHD. Method: Pearson correlation coefficients were calculated post hoc for changes from baseline to endpoint in outcomes of one randomized, placebo- and active-controlled trial of lisdexamfetamine (osmotic-release methylphenidate reference) and one of guanfacine extended-release (atomoxetine reference). Results: Changes in ADHD Rating Scale IV (ADHD-RS-IV) total score generally correlated moderately with changes in Child Health and Illness Profile−Child Edition: Parent Report Form (CHIP-CE:PRF) Achievement and Risk Avoidance ( r ≈ .4), but weakly with Resilience, Satisfaction, and Comfort ( r ≈ .2); and moderately with Weiss Functional Impairment Rating Scale–Parent (WFIRS-P) total score ( r ≈ .5). CHIP-CE:PRF Achievement and Risk Avoidance correlated moderately to strongly with WFIRS-P total score ( r ≈ .6). Conclusion: The ADHD-RS-IV, CHIP-CE:PRF, and WFIRS-P capture distinct but interconnected aspects of treatment response in individuals with ADHD.

Convolutional Neural Network-Based Automatic Measurement of Joint Space Width to Predict Radiographic Severity and Progression of Knee Osteoarthritis

2021 ◽  
Author(s):  
James Chung Wai Cheung ◽  
Yiu Chow TAM ◽  
Lok Chun CHAN ◽  
Ping Keung CHAN ◽  
Chunyi WEN
Keyword(s):  
Neural Network ◽  
Knee Osteoarthritis ◽  
Convolutional Neural Network ◽  
Pearson Correlation ◽  
Joint Space Width ◽  
Joint Space ◽  
Receiver Operating Curve ◽  
Radiographic Severity ◽  
X Ray ◽  
Space Width

Abstract Objectives To develop a deep convolutional neural network (CNN) for the segmentation of femur and tibia on plain x-ray radiographs, hence enabling an automated measurement of joint space width (JSW) to predict the severity and progression of knee osteoarthritis (KOA). Methods A CNN with ResU-Net architecture was developed for knee X-ray imaging segmentation. The efficiency was evaluated by the Intersection over Union (IoU) score by comparing the outputs with the annotated contour of the distal femur and proximal tibia. By leveraging imaging segmentation, the minimal and multiple JSWs in the tibiofemoral joint were estimated and then validated by radiologists’ measurements in the Osteoarthritis Initiative (OAI) dataset using Pearson correlation and Bland–Altman plot. The estimated JSWs were deployed to predict the radiographic severity and progression of KOA defined by Kellgren-Lawrence (KL) grades using the XGBoost model. The classification performance was assessed using F1 and area under receiver operating curve (AUC). Results The network has attained a segmentation efficiency of 98.9% IoU. Meanwhile, the agreement between the CNN-based estimation and radiologist’s measurement of minimal JSW reached 0.7801 (p < 0.0001). Moreover, the 32-point multiple JSW obtained the highest AUC score of 0.656 to classify KL-grade of KOA. Whereas the 64-point multiple JSWs achieved the best performance in predicting KOA progression defined by KL grade change within 48 months, with AUC of 0.621. The multiple JSWs outperform the commonly used minimum JSW with 0.587 AUC in KL-grade classification and 0.554 AUC in disease progression prediction. Conclusion Fine-grained characterization of joint space width of KOA yields comparable performance to the radiologist in assessing disease severity and progression. We provide a fully automated and efficient radiographic assessment tool for KOA.

scholarly journals Middle East experience from the Asia And Latin America Fracture Observational Study (ALAFOS): Baseline characteristics of postmenopausal women with osteoporosis using teriparatide

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052094085
Author(s):  
Abdul Aziz Elsalmawy ◽  
Nadia S. Al-Ali ◽  
Yasser Yaghi ◽  
Hussein Assaggaf ◽  
Ghassan Maalouf ◽  
...  
Keyword(s):  
Latin America ◽  
Middle East ◽  
Observational Study ◽  
United Arab Emirates ◽  
Clinical Characteristics ◽  
Rating Scale ◽  
Osteoporotic Fractures ◽  
Visual Analog Scale Score ◽  
Numeric Rating Scale ◽  
Mineral Density

Objective We aimed to describe the baseline clinical characteristics and fracture history of patients taking teriparatide in routine clinical practice in the Middle East (ME) subregional cohort of the Asia and Latin America Fracture Observational Study (ALAFOS). Methods Herein, we report baseline clinical characteristics of patients who were prescribed teriparatide (20 µg/day, subcutaneous injection) in four participant ME countries (Saudi Arabia, United Arab Emirates, Kuwait, and Lebanon). Results The ME cohort included 707 patients mean (SD) age 69.3 (11.6) years. Mean (SD) bone mineral density (BMD) T-scores at baseline were −3.13 (1.28) for lumbar spine, −2.88 (0.94) for total hip, and −2.65 (1.02) for femoral neck. Osteoporotic fractures after age 40 years were reported in 45.8% (vertebral fracture 14.4%, hip fracture 18.4%) and comorbidities in 57.4% of patients. Before starting teriparatide, 19.9% of patients took other osteoporosis medications. The median (Q1; Q3) EuroQoL 5-Dimension 5-Level visual analog scale score for perceived overall health status was 70 (50; 80). Mean (SD) worst back pain in the previous 24 hours was 4.0 (3.2) using a 10-point numeric rating scale. Conclusion This analysis indicated that in ME countries, teriparatide is usually prescribed to patients with low BMD and high comorbidities, with prior fractures.

scholarly journals Association between disease progression and depression onset in persons with radiographic knee osteoarthritis

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3390-3399
Author(s):  
Alan M Rathbun ◽  
Michelle D Shardell ◽  
Alice S Ryan ◽  
Michelle S Yau ◽  
Joseph J Gallo ◽  
...  
Keyword(s):  
Disease Progression ◽  
Disease Severity ◽  
Gait Speed ◽  
Joint Space Width ◽  
Joint Space ◽  
Knee Oa ◽  
Increased Risk ◽  
Pain Subscale ◽  
Space Width

Abstract Objectives Osteoarthritis (OA) disease progression may lead to deteriorating psychosocial function, but it is unclear what aspects of disease severity are related to the onset of depression. This study assessed which components of OA disease progression cumulatively contribute to depression onset in persons with radiographic knee OA. Methods Osteoarthritis Initiative participants (n = 1651) with radiographic disease (Kellgren-Lawrence grade ≥2) in one or both knees and below the screening threshold for probable depression [Center for Epidemiological Studies Depression (CES-D) scale &lt;16] at baseline were included. Disease severity was measured from baseline to the third annual follow-up visit using joint space width, 20-meter gait speed, and the Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, each categorized into quintiles. Depression onset (CES-D ≥ 16) was assessed annually at four follow-up visits. Marginal structural models that account for time-dependent confounding and attrition evaluated the association between each time-varying disease severity measure and depression onset. Results Each disease severity measure exhibited a non-linear relationship concerning the probability of depression onset, with the higher quintiles generally being associated with a larger risk. The highest quintile (relative to the lowest) of joint space width and gait speed were both significantly associated with depression onset. By contrast, none of the higher pain quintiles compared with the lowest were significantly associated with the onset of depression. Conclusion Faster disease progression as measured by either worsening structural severity or decreasing physical performance corresponds to an increased risk of depression among individuals with radiographic knee OA.

scholarly journals High Kellgren-Lawrence Grade and Bone Marrow Lesions Predict Worsening Rates of Radiographic Joint Space Narrowing; The SEKOIA Study

2016 ◽  
Vol 43 (3) ◽  
pp. 657-665 ◽  
Author(s):  
Mark H. Edwards ◽  
Camille Parsons ◽  
Olivier Bruyère ◽  
Forence Petit Dop ◽  
Roland Chapurlat ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Plain Radiograph ◽  
Joint Space Width ◽  
Joint Space ◽  
Rate Of Change ◽  
Mri Findings ◽  
Men And Women ◽  
Tibiofemoral Joint ◽  
Knee Oa ◽  
Knee Mri

Objective.Determinants of radiographic progression in osteoarthritis (OA) are poorly understood. We investigated which features on baseline magnetic resonance imaging (MRI) acted as predictors of change in joint space width (JSW).Methods.A total of 559 men and women over the age of 50 years with clinical knee OA [Kellgren-Lawrence (KL) grade 2–3] were recruited to the placebo arm of the SEKOIA study (98 centers; 18 countries). Minimal tibiofemoral joint space and KL grade on plain radiograph of the knee were assessed at baseline and at yearly followup up to 3 years. In a subset, serial knee MRI examinations were performed. Individuals with a bone marrow lesion (BML) ≥ grade 2 at the tibiofemoral joint at baseline were classified as BML-positive. Relationships between change in JSW and risk factors were assessed using linear regression.Results.The mean age of study participants was 62.8 (SD 7.5) years and 73% were female; 38.6% had BML. Mean baseline JSW was 3.65 mm. This reduced by 0.18 (0.30) mm/year in men and 0.13 (0.23) mm/year in women. Those with BML had a significantly higher rate of annualized change in JSW; this relationship remained robust after adjustment for age, sex, and baseline KL grade [β = −0.10 (95% CI −0.18, −0.02) mm/yr]. Age, sex, baseline KL grade, and other MRI findings did not influence the rate of change in JSW.Conclusion.The rate of change in JSW was similar in men and women. BML on knee MRI predicted the rate of radiographic change in JSW. This relationship was independent of age, sex, and baseline KL grade.

scholarly journals OP0185 KNEE JOINT DISTRACTION IS MORE EFFICIENT IN RESTORING CARTILAGE THICKNESS THAN HIGH TIBIAL OSTEOTOMY IN PATIENTS WITH SEVERE KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 114.2-115
Author(s):  
M. Jansen ◽  
S. Maschek ◽  
R. Van Heerwaarden ◽  
S. Mastbergen ◽  
W. Wirth ◽  
...  
Keyword(s):  
Stock Options ◽  
Joint Space Width ◽  
Joint Space ◽  
Cartilage Thickness ◽  
Tibial Osteotomy ◽  
Knee Oa ◽  
Leg Axis ◽  
Cartilage Restoration ◽  
Joint Distraction ◽  
Space Width

Background:Both high tibial osteotomy (HTO) and knee joint distraction (KJD) are joint preserving surgical techniques unloading the affected femorotibial compartment in patients with knee osteoarthritis (OA). While HTO permanently unloads the more affected compartment (MAC) by overcorrecting the leg axis, KJD temporarily unloads the whole joint by separating the tibia and femur for 5 mm for 6 weeks. In a previous randomized controlled trial (RCT), comparable clinical benefit and radiographic joint space width (JSW) increase over 2 years follow-up were demonstrated for both treatments1. Yet, comparison of JSW before and after HTO may be unreliable, as pseudo-widening of the unloaded compartment may occur due to the induced leg axis change. Therefore, direct cartilage thickness measurements need to be compared between KJD and HTO, to accurately evaluate the efficacy of both treatment options on cartilage structure.Objectives:To compare two-year cartilage thickness changes after treatment with KJDvsHTO and identify factors predicting cartilage thickness restoration.Methods:Patients indicated for HTO were randomized to KJD (KJDHTO) or HTO treatment. Patients indicated for total knee arthroplasty received KJD (KJDTKA). Standardized semi-flexed weight-bearing radiographs and 3T MRIs with 3D spoiled gradient recalled imaging sequence with fat suppression (SPGR-fs) were acquired before and two years after surgical treatment. Cartilage thickness in the knee was measured using Chondrometrics Works 3.0 software. On the radiographs the mean JSW in the MAC were measured with KIDA software. Readers were blinded to the type of intervention and acquisition order. The primary and secondary outcomes were the mean MAC cartilage thickness (ThCtAB) and percentage of denuded bone area (dABp) change before and two years after treatment (MRI), with radiographic joint space width (JSW) used as a reference.Results:No statistically significant differences in the baseline characteristics were seen between KJDHTO(n=18) and HTO (n=33). The KJDTKAgroup (n=18) had a higher age and Kellgren-Lawrence grade (KLG) than the HTO and KJDHTOgroups.KJDHTOpatients did not show significant changes in MAC cartilage thickness, dABp, or JSW over time (all p>0.10; figure 1). HTO patients displayed a decrease in MAC cartilage thickness and an increase in dABp (both p<0.03), but an increase in JSW (p=0.006). KJDTKAshowed a significant increase in MAC cartilage thickness and JSW and decrease in dABp (all p<0.01). Baseline OA severity was the strongest predictor of cartilage restoration. KJD patients with severe OA (KJDsevere; KLG ≥3) showed significant restoration (all p<0.01; figure 2); mild OA patients (KJDmild; KLG ≤2) showed a slight deterioration. KJDsevereshowed a significantly greater cartilage restoration response in the MAC than HTOseverefor cartilage thickness (p=0.005) and dABp (p=0.003), but not JSW change (p=0.521). The changes in all three parameters did not differ significantly between KJDmildand HTOmild(all p>0.08).Conclusion:In patients with severe knee OA, KJD is more efficient in restoring cartilage thickness than HTO is. In these patients, KJD causes significant cartilage restoration while HTO, despite shifting the leg axis and demonstrating radiographic joint space widening, shows loss of cartilage as measured on MRI. In patients with mild knee OA, neither HTO nor KJD treatment results in significant cartilage restoration and both treatments show a slight deterioration that is likely the result of natural OA progression. As such, this research promotes the choice KJD as joint-preserving surgery in case of knee OA patients with more severe structural damage.References:[1]MP Jansenet al, Cartilage 2019.Disclosure of Interests:Mylène Jansen: None declared, Susanne Maschek Shareholder of: Stock/stock options at Condrometrics GmbH, Employee of: Employment at Condrometrics GmbH, Ronald Van Heerwaarden: None declared, Simon Mastbergen: None declared, Wolfgang Wirth Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy to Galapagos NV, Employee of: Employment at Condrometrics GmbH, Floris Lafeber Shareholder of: Co-founder and shareholder of ArthroSave BV, Felix Eckstein Shareholder of: Stock/stock options at Condrometrics GmbH, Consultant of: Consultancy at Merck KGaA, Samumed, Bioclinica, Galapagos, Servier, Novartis, Employee of: Employment at Condrometrics GmbH, Speakers bureau: Development of educational presentations for Medtronic

scholarly journals PENGARUH TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION DENGAN DAN TANPA TERAPI LATIHAN TERHADAP NYERI DAN KINERJA FISIK PADA PENDERITA OSTEOARTRITIS LUTUT

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
Inge Jiemesha ◽  
Engeline Angliadi
Keyword(s):  
Physical Performance ◽  
Exercise Therapy ◽  
Pharmacological Treatment ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Joint Disease ◽  
Timed Up And Go ◽  
Knee Oa ◽  
Before And After ◽  
Numeric Rating

Abstract: Osteoarthritis (OA) of the knee is a chronic degenerative joint disease which causes disability affecting the quality of life. Its management may include pharmacological and non-pharmacological treatment. In the non-pharmacological treatment there are a variety of treatment options. This study aimed to prove the effect of Transcutaneous Electrical Nerves Stimulation (TENS) with and without exercise on pain and physical performance in patients with knee OA. There were thirty five patients with knee OA who met the inclusion criteria that visited the Medical Rehabilitation Department of Prof. Dr. R.D. Kandou Hospital. The samples were divided into 2 groups: TENS with exercise therapy and TENS without exercise therapy. Each group undergone their therapy for 6 weeks with a frequency of 2 times per week. Pain was measured by using the Numeric Rating Scale (NRS) and physical performance was measured by using the Timed-Up and Go test (TUG) and the Stair Climb Test (SCT). There were 91.4% females meanwhile overweight and obese patients were 34.3%. The results showed that there were significant differences in pain and physical performance between before and after TENS with exercise (P <0.001) as well as before and after TENS without exercise (P < 0.001). There was no difference in pain and physical performance between the two groups. Conclusion: TENS with and without exercise can reduce pain and improve physical performance in patients with knee osteoarthritis.Keywords: knee osteoarhtritis, TENS, pain, physical performanceAbstrak: Osteoartritis (OA) lutut adalah penyakit degeneratif sendi yang bersifat kronis dan menyebabkan disabilitas yang memengaruhi kualitas hidup penderita. Tatalaksana OA lutut terdiri dari farmakologi dan non-farmakologi dengan bermacam-macam pilihan terapi. Penelitian ini bertujuan untuk membuktikan pengaruh Transcutaneous Electrical Nerves Stimulation (TENS) dengan dan tanpa terapi latihan terhadap nyeri dan kinerja fisik pada penderita OA lutut. Sebanyak 35 penderita OA lutut lama maupun baru yang memenuhi kriteria inklusi, yang berkunjung ke Poliklinik Rehabilitasi Medik RSUP Prof Dr. R.D. Kandou dan bersedia mengikuti penelitian. Sampel dibagi menjadi 2 kelompok: diberikan TENS dengan terapi latihan dan yang tanpa terapi latihan selama 6 minggu dengan frekuensi 2 kali per minggu. Nyeri diukur dengan Numeric Rating Scale (NRS) dan kinerja fisik diukur dengan Timed-Up and Go test (TUG) dan Stair Climb Test (SCT). Dari hasil analisis 35 subyek penelitian didapatkan 32 orang (91,4%) subyek wanita, serta indeks massa tubuh yang overweight dan obese sebanyak 34,3 %. Hasil uji perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS dengan terapi latihan memperlihatkan perbedaan bermakna (P <0,001). Hasil perbedaan nyeri dan kinerja fisik sebelum dan sesudah TENS juga memperlihatkan perbedaan bermakna (P <0,001). Pada hasil uji perbedaan nyeri dan kinerja fisik pada kedua kelompok didapatkan tidak terdapat perbedaan antara keduanya. Simpulan: TENS dengan dan tanpa terapi latihan dapat mengurangi nyeri dan meningkatkan kinerja fisik pada penderita osteoartritis lutut.Kata kunci: osteoartritis lutut, TENS, nyeri, kinerja fisik

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