scholarly journals Successful evaluation of spinal mobility measurements with the Epionics SPINE device in patients with axial spondyloarthritis compared to controls

2021 ◽  
pp. jrheum.201470
Author(s):  
David Kiefer ◽  
Xenofon Baraliakos ◽  
Daniela Adolf ◽  
Varvara Chatzistefanidi ◽  
Ilka Schwarze ◽  
...  
Keyword(s):  
Regression Models ◽  
Patient Reported Outcomes ◽  
Axial Spondyloarthritis ◽  
Performance Measure ◽  
Spinal Mobility ◽  
Logistic Regression Models ◽  
Additional Information ◽  
Patient Reported ◽  
Objective Performance ◽  
Epionics Spine

Objective To evaluate ES for quantification of spinal mobility in patients with axSpA. Methods A total of 153 individuals, 39 females and 114 males, were examined:134 axSpA patients, 40 non-(nr-) and 94 radiographic (r)-axSpA, and 19 healthy controls (HC), respectively. The results were compared using mean ES scores and modeling was performed using multivariable logistic regression models resulting in good validity and high discriminative power. Results ES measurements showed meaningful differences between axSpA patients and HC (all p<0.001) as well as between r- and nr-axSpA (p<0.01). In axSpA patients a negative correlation between ES and BASMI values was found: -0.76≤r≤-0.52 (p<0.05). BASFI scores showed a similar trend (r > -0.39). Patients with r-axSpA had a more limited and slower spinal mobility than those with nr-axSpA. Other patient reported outcomes did almost not correlate. Conclusion This study shows that the ES is an objective performance measure and a valid tool to assess spinal mobility in axSpA, also based on OMERACT criteria. RoK and RoM scores provide additional information on physical function of axSpA patients.

scholarly journals Patient-Reported Disease-Modifying Therapy Adherence in the Clinic: A Reliable Metric?

2018 ◽  
Vol 4 (2) ◽  
pp. 205521731877789 ◽  
Author(s):  
Devon S Conway ◽  
Maria Cecilia Vieira ◽  
Nicolas R Thompson ◽  
Kaila N Parker ◽  
Xiangyi Meng ◽  
...  
Keyword(s):  
Regression Models ◽  
Patient Reported Outcomes ◽  
Patient Reporting ◽  
Lesion Formation ◽  
Logistic Regression Models ◽  
Disease Modifying Therapy ◽  
Patient Reported ◽  
Relapsing Remitting ◽  
Disease Modifying ◽  
The Relationship

Background Adherence to multiple sclerosis (MS) disease-modifying therapy (DMT) is commonly assessed through patient reporting, but patient-reported adherence is rarely studied. Objective To determine rates of DMT adherence reported from patient to clinician, reasons for nonadherence, and relationships between adherence and outcomes. Methods We identified relapsing–remitting MS patients on DMT for ≥3 months. DMT adherence was defined as taking ≥80% of doses. Linear and logistic regression models were created used to determine the association of baseline adherence with several patient reported outcomes and the timed 25-foot walk at 6 months, 1 year, 2 years, and 3 years after the index visit. Results The analysis included 1148 patients, of whom 501 had data at 6 months, 544 at 1 year, 331 at 2 years, and 247 at 3 years. Baseline adherence was 94.9% and overall adherence was 93.1%. Forgetting was the most common reason for missed doses. In the adjusted models, adherence was not associated with the outcomes. Conclusions Higher than expected adherence and a lack of association between adherence and outcomes suggests patient reported adherence may not be reliable. Further research is needed to clarify the relationship between patient-reported adherence and relapses or new lesion formation.

scholarly journals Quadriceps Strength and Kinesiophobia Predict Long-Term Function After ACL Reconstruction: A Cross-Sectional Pilot Study

2020 ◽  
pp. 194173812094632
Author(s):  
Joshua J. Van Wyngaarden ◽  
Cale Jacobs ◽  
Katherine Thompson ◽  
Molly Eads ◽  
Darren Johnson ◽  
...  
Keyword(s):  
Physical Performance ◽  
Regression Models ◽  
Patient Reported Outcomes ◽  
Quadriceps Strength ◽  
Performance Measure ◽  
Cross Sectional ◽  
Physical Performance Measure ◽  
Patient Reported ◽  
Step Down

Background: Many patients live with long-term deficits in knee function after an anterior cruciate ligament reconstruction (ACLR). However, research is inconclusive as to which physical performance measure is most strongly related to long-term patient-reported outcomes after ACLR. Hypothesis: Quadriceps strength would be most strongly associated with patient-reported long-term outcomes after ACLR. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: A total of 40 patients (29 female) consented and participated an average of 10.9 years post-ACLR (range, 5-20 years). Patients completed the Lower Extremity Functional Scale (LEFS), the International Knee Documentation Committee (IKDC) Scale, Knee injury and Osteoarthritis Outcome Score Quality of Life (KOOS QoL) and Sport (KOOS Sport) subscales, and the Tampa Scale of Kinesiophobia (TSK-17). Each patient subsequently performed maximal isometric quadriceps contraction, a 60-second single-leg step-down test, and the single-leg single hop and triple hop for distance tests. Multivariate linear and logistic regression models determined how performance testing was associated with each patient-reported outcome when controlling for time since surgery, age, and TSK-17. Results: When controlling for time since surgery, age at the time of consent, and TSK-17 score, maximal isometric quadriceps strength normalized to body weight was the sole physical performance measure associated with IKDC ( P < 0.001), KOOS Sport ( P = 0.006), KOOS QoL ( P = 0.001), and LEFS scores ( P < 0.001). Single-leg step-down, single hop, and triple hop did not enter any of the linear regression models ( P > 0.20). Additionally, TSK-17 was associated with all patient-reported outcomes ( P ≤ 0.01) while time since surgery was not associated with any outcomes ( P > 0.05). Conclusion: Isometric quadriceps strength and kinesiophobia are significantly associated with long-term patient-reported outcomes after ACLR. Clinical Relevance: These results suggest that training to improve quadriceps strength and addressing kinesiophobia in the late stages of recovery from ACLR may improve long-term self-reported function.

Clinical Measures and Their Contribution to Dysfunction in Individuals With Patellar Tendinopathy

2019 ◽  
Vol 28 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Hyunjae Jeon ◽  
Melanie L. McGrath ◽  
Neal Grandgenett ◽  
Adam B. Rosen
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Regression Models ◽  
Patient Reported Outcomes ◽  
Pelvic Tilt ◽  
Knee Extension ◽  
Patellar Tendinopathy ◽  
Q Angle ◽  
Patient Reported ◽  
Flexion Strength

Context: Patellar tendinopathy (PT) is prevalent in physically active populations, and it affects their quality of living, performance of activity, and may contribute to the early cessation of their athletic careers. A number of previous studies have identified contributing factors for PT; however, their contributions to self-reported dysfunction remain unclear. Objective: The purpose of this investigation was to determine if strength, flexibility, and various lower-extremity static alignments contributed to self-reported function and influence the severity of PT. Design: Cross-sectional research design. Setting: University laboratory. Participants: A total of 30 participants with PT volunteered for this study (age: 23.4 [3.6] y, height: 1.8 [0.1] m, mass: 80.0 [20.3] kg, body mass index: 25.7 [4.3]). Main Outcome Measures: Participants completed 7 different patient-reported outcomes. Isometric knee extension and flexion strength, hamstring flexibility and alignment measures of rearfoot angle, navicular drop, tibial torsion, q-angle, genu recurvatum, pelvic tilt, and leg length differences were assessed. Pearson’s correlation coefficients were assessed to determine significantly correlated outcome variables with each of the patient-reported outcomes. The factors with the highest correlations were used to identify factors that contribute the most to pain and dysfunction using backward selection, linear regression models. Results: Correlation analysis found significant relationships between questionnaires and body mass index (r = −.35–.46), normalized knee extension (r = .38–.50) and flexion strength (r = −.34–.50), flexibility (r = .32–.38, q-angle (r = .38–.56), and pelvic tilt (r = −.40). Regression models (R2 = .22–.54) identified thigh musculature strength and supine q-angle to have greatest predictability for severity in patient-reported outcomes. Conclusions: These findings put an emphasis of bodyweight management, improving knee extensor and flexor strength, and posterior flexibility in PT patients.

Simplified biplanar classification for heterotopic ossification is more predictive of patient-reported outcomes than the Brooker classification after anterior total hip arthroplasty

2021 ◽  
pp. 112070002110391
Author(s):  
Leonard T Onsen ◽  
Vivian W Ouyang ◽  
Andrew E Jimenez ◽  
Peter F Monahan ◽  
Ajay C Lall ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Heterotopic Ossification ◽  
Hip Arthroplasty ◽  
Standard Error ◽  
Regression Models ◽  
Patient Reported Outcomes ◽  
Interobserver Reliability ◽  
Total Hip ◽  
Patient Reported ◽  
Grade 3

Background: Heterotopic ossification (HO) commonly occurs after total hip arthroplasty (THA) and can adversely impact clinical outcomes. The purpose of this study is to propose a more reliable HO grading method that is better predictive of patient-reported outcomes (PROs) after THA than the Brooker classification. Methods: 513 THAs (62 ± 10 years old) were reviewed. The incidence and grade of HO was evaluated using the Brooker grading system and a simplified biplanar classification system (grade 1: ⩾1 cm between bone on both anteroposterior and lateral views, grade 2: <1 cm between bone on either view). The modified Harris Hip Score (mHHS), Forgotten Joint Score (FJS), and visual analogue scale (VAS) for pain were collected at minimum of 2 years after surgery and were compared between HO grades using multiple regression models. Results: The incidence of HO varied by Brooker grade (grade 1, 23.4%; grade 2, 22.4%; grade 3, 7.2%; grade 4, 0%) and biplanar grade (grade 1: 45.6%; grade 2: 7.4%). The biplanar classification demonstrated higher interobserver reliability than the Brooker classification (κ = 0.95 and 0.91, respectively). Brooker grade 3 HO decreased the mHHS by 6.5 (standard error: 2.7) but did not have a significant effect on FJS or VAS. Biplanar grade 2 HO decreased the mHHS by 9.9 (standard error: 2.7), the FJS by 12.9 (standard error: 4.51) and increased the VAS pain score by 0.81 (standard error: 0.35). The Cox test was used to compare the fit of regression models and determined the biplanar classification was a significantly better predictor than the Brooker classification ( p < 0.001). Conclusions: Biplanar grade 2 HO had a significant negative influence on PROs. Contrary to previous literature, these results show clinical significance of non-bridging HO. Compared with the Brooker classification, the biplanar classification has greater interobserver reliability and is more predictive of outcomes after THA.

Study Protocol: The Association of Preoperative Opioid Use and Patient Outcomes v1

2021 ◽  
Author(s):  
Bethany Kavalakatt ◽  
Vidhya Gunaseelan ◽  
Mark C Bicket
Keyword(s):  
Patient Reported Outcomes ◽  
Hospital Readmissions ◽  
Monitoring Program ◽  
Study Groups ◽  
Emergency Department Visits ◽  
Opioid Use ◽  
Logistic Regression Models ◽  
Explanatory Variables ◽  
Ordered Logistic Regression ◽  
Patient Reported

The objective of this retrospective cohort study is to investigate the differences in clinical and patient-reported outcomes among patients after surgery based on the exposure of opioids in the year before surgery. Patients from the Michigan Surgical Quality Collaborative (MSQC) registry are included if they underwent one of nine procedural categories between January 1, 2017, and October 31, 2019. The primary exposure of interest is whether or not patients were prescribed opioids from day 365 to day 31 before admission to surgery as recorded in a state prescription drug monitoring program. The primary outcome of our study is postoperative pain as reported from the MSQC survey given between postoperative days 30 and 90. Secondary outcomes include the incidences of emergency department visits, hospital readmissions, and hospital reoperations in the 30 days after surgery as well as patient-reported outcomes of regret undergoing surgery, quality of life after surgery, and overall satisfaction after surgery. Multivariable ordered logistic regression models will be used to adjust for certain explanatory variables that pose differences between study groups.

Changes of patient-reported outcomes and protein fingerprint biomarkers after exercise therapy for axial spondyloarthritis

2017 ◽  
Vol 38 (1) ◽  
pp. 173-179 ◽  
Author(s):  
Marketa Husakova ◽  
Anne Sofie Siebuhr ◽  
Karel Pavelka ◽  
Maja Spiritovic ◽  
Anne-Christine Bay-Jensen ◽  
...  
Keyword(s):  
Exercise Therapy ◽  
Patient Reported Outcomes ◽  
Axial Spondyloarthritis ◽  
Patient Reported ◽  
Protein Fingerprint
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