Hiral Master

Patient-Reported Measures of Physical Function in Knee Osteoarthritis

Knee osteoarthritis is a common cause of an array of functional limitations in older adults, and the accurate assessment of such limitations is critical for practicing clinicians and scientists. Patient-reported measures are a valuable resource to track the type and severity of limitation, although the psychometric performance of each instrument should be thoroughly evaluated before adoption. This article reviews the validity, reliability, sensitivity to change, and responsiveness of 3 patient-reported measures of physical function: the Western Ontario and McMaster Universities Osteoarthritis Index, the Knee Injury and Osteoarthritis Outcome Score, and the Patient Reported Outcomes Measurement Information System Physical Function scale.

Are Older Adults With Symptomatic Knee Osteoarthritis Less Active Than the General Population? Analysis From the Osteoarthritis Initiative and the National Health and Nutrition Examination Survey

To compare objectively measured physical activity in older adults with symptomatic knee osteoarthritis (OA) with similarly aged adults without osteoarthritis (OA) or knee symptoms from the general population.

A Physical Therapist–Administered Physical Activity Intervention After Total Knee Replacement: Protocol for a Randomized Controlled Trial

Background. The definitive treatment for knee osteoarthritis is a total knee replacement, which results in a clinically meaningful improvement in pain and physical function. However, evidence suggests that physical activity (PA) remains unchanged after total knee replacement (TKR). Objective. The objective of this study is to investigate the efficacy, fidelity, and safety of a physical therapist‐administered PA intervention for people after TKR. Design. This study will be a randomized controlled trial. Setting. The setting is an outpatient physical therapy clinic. Participants. The participants are 125 individuals who are over the age of 45 and are seeking outpatient physical therapy following a unilateral TKR. Intervention. In addition to standardized physical therapy after TKR, the intervention group will receive, during physical therapy, a weekly PA intervention that includes a wearable activity tracking device, individualized step goals, and face‐to‐face feedback provided by a physical therapist. Control. The control group will receive standardized physical therapy alone after TKR. Measurements. The efficacy of the intervention will be measured as minutes per week spent in moderate to vigorous PA at enrollment, at discharge, and at 6 months and 12 months after discharge from physical therapy. The fidelity and safety of the intervention will be assessed throughout the study. Limitations. Participants will not be masked, PA data will be collected after randomization, and the trial will be conducted at a single site. Conclusions. The goal of this randomized controlled trial is to increase PA after TKR. A protocol for investigating the efficacy, fidelity, and safety of a physical therapist‐administered PA intervention for people after TKR is presented. The findings will be used to support a large multisite clinical trial to test the effectiveness, implementation, and cost of this intervention.

Minimum performance on clinical tests of physical function to predict walking 6000 steps/day in knee osteoarthritis: An observational study

Evidence of physical function difficulties, such as difficulty rising from a chair, may limit daily walking for people with knee osteoarthritis (OA). The purpose of this study was to identify minimum performance thresholds on clinical tests of physical function predictive to walking ≥6,000 steps/day. This benchmark is known to discriminate people with knee OA who develop functional limitation over time from those who do not.

Physical Function After Total Knee Replacement: An Observational Study Describing Outcomes in a Small Group of Women From China and the United States

OBJECTIVE To describe physical function before and six months after Total Knee Replacement (TKR) in a small sample of women from China and the United States. DESIGN Observational. SETTING Community environment. OUTCOMES Both groups adhered to the Osteoarthritis Research Society International (OARSI) protocols for the 6-minute walk and 30-second chair stand. We compared physical function prior to TKR and 6 months after using linear regression adjusted for covariates. PARTICIPANTS Women (N=60) after TKR. INTERVENTIONS Not applicable. RESULTS Age and body mass index in the China group (n=30; 66y and 27.0kg/m2) were similar to those in the U.S. group (n=30; 65y and 29.6kg/m2). Before surgery, the China group walked 263 (95% confidence interval [CI], -309 to -219) less meters and had 10.2 (95% CI, -11.8 to -8.5) fewer chair stands than the U.S. group. At 6 months when compared with the U.S. group, the China group walked 38 more meters, but this difference did not reach statistical significance (95% CI, -1.6 to 77.4), and had 3.1 (95% CI, -4.4 to -1.7) fewer chair stands. The China group had greater improvement in the 6-minute walk test than did the U.S. group (P<.001). CONCLUSIONS Despite having worse physical function before TKR, the China group had greater gains in walking endurance and similar gains in repeated chair stands than did the U.S. group after surgery.