Kamary Coriolano

Changes in Self-Reported Disability after Performance-Based Tests in Obese and Non-Obese Individuals Diagnosed with Osteoarthritis of the Knee.

Abstract Purpose: The purposes of this study are three-fold: (1) To examine whether the WOMAC questionnaire should be obtained before or after performance-based tests. (2) To assess whether self-reported disability scores before and after performance-based tests differ between obese and non-obese individuals. (3) To observe whether physical activity and BMI predict self-reported disability before and after performance based tests. Methods: A longitudinal study included thirty one participants diagnosed with knee osteoarthritis (OA) using the Kellgren-Lawrence Scale by an orthopedic surgeon. Results: All WOMAC scores were significantly higher after as compared to before the completion of performance-based tests. This pattern of results suggested that the WOMAC questionnaire should be administered to individuals with OA after performance-based tests. The obese OA was significantly different compared to the non-obese OA group on all WOMAC scores. Physical activity and BMI explained a significant proportion of variance of self-reported disability. Conclusion: Obese individuals with knee OA may over-estimate their ability to perform physical activities, and may under-estimate their level of disability compared to non-obese individuals with knee OA. In addition, self-reported physical activity seems to be a strong indicator of disability in individuals with knee OA, particularly for individuals with a sedentary life style. Implications for Rehabilitation Osteoarthritis is a progressive joint disabling condition that restricts physical function and participation in daily activities, particularity in elderly individuals. Obesity is a comorbidity commonly associated with osteoarthritis and it appears to increase self-reported disability in those diagnosed with osteoarthritis of the knee. In a relatively small sample, this study recommends that rehabilitation professionals obtain self-report questionnaires of disability after performance-based tests in obese individuals with osteoarthritis of the knee as they are more likely to give an accurate representation of their level of ability at this time.

Assessment of Knee Pain in Obese and Non-Obese Individuals Diagnosed with Osteoarthritis of the Knee Before and After Performance-Based Tests: A Pilot Study

Objective: 1) To examine whether self-reported pain, measured with the Western Ontario McMaster University Osteoarthritis Index pain subscale and Visual Analog Scale, of individuals diagnosed with knee Osteoarthritis would change after performance-based tests were completed; irrespective of their body weight and Body Mass Index. 2) To assess whether self-reported pain before and after performance-based tests differs between obese and non-obese individuals and whether both VAS and WOMAC scales of pain would demonstrate similar changes from before to after the completion of performance-based tests in obese and non-obese individuals with knee OA. 3) To observe whether depressive symptoms and BMI explain the variance of self-reported pain before and after performance based tests. Methods: This pilot study included 31 participants diagnosed with radiographic knee osteoarthritis by an orthopedic surgeon using the Kellgren-Lawrence Scale. The sample was divided in two groups of obese individuals with knee Osteoarthritis and non-obese individuals with knee osteoarthritis. Two self-reported measures, the Western Ontario McMaster University Osteoarthritis Index and Visual Analog Scale assessed knee pain before and after performance-based tests in these two groups of individuals. Depressive symptom was obtained with Back depression questionnaire II. Results: The Visual Analog Scale ratings showed a significant increase in pain in both groups, but the Western Ontario McMaster University Osteoarthritis Index pain subscale only captured a significant increase in the obese osteoarthritis group. A significant proportion of variance in pain before and after functional activities was explained by depressive symptoms and obesity, with higher levels of depression and obesity predicting worse reports of pain. Conclusion: The Visual Analog Scale pain rating may be a better tool for assessing knee pain of obese and non-obese individuals diagnosed with knee osteoarthritis. Furthermore, symptoms of depression might predict increase in knee pain and disability in obese individuals.

Functional and Physiological Determinants of Perceived Disability in Individuals Diagnosed with Osteoarthritis of the Hip

Objectives: The main objective of this pilot study was to investigate which standardized functional and physiological test best predicted perceived disability in a single group of 21 individuals diagnosed with osteoarthritis of the hip. Design: Men and women between 60 and 70 years old with osteoarthritis of the hip were selected. If participants passed study criteria, the Western Ontario McMaster University questionnaire (WOMAC), 6 Minute Walk Test (6MWT) and Timed up and Go (TUG), strength testing and aerobic testing were obtained in one single assessment. Results: Regression analysis revealed that wait time, hip abduction strength of the affected side, Aerobic Capacity (VO 2 Peak), hip Extension Peak Torque, hip Flexion Peak Torque, TUG and 6MWT were significantly correlated with the WOMAC. Yet, the 6MWT had the highest significant correlation (r = -0.86, p ≤ 0.0001); R2 = 0.75 or 75% with the WOMAC total scores, (r = -0.82, p ≤ 0.0001); R2 = 0.67 or 67% with the WOMAC function and (r = -0.60, p = .002); R2 = 0.36 or 36% with the WOMAC stiffness. While the VO 2 Peak revealed the highest significant correlation (r = 0.76, p ≤ .0001); R2 = 0.57 or 57% with the WOMAC pain. Conclusions: The 6MWT and the VO 2 Peak seem to be essential functional and physiological assessment tools to determine perceived disability in individuals with hip OA. The perceived disability may provide new or comprehensive knowledge of the disability problems experienced by individuals with osteoarthritis of the hip, and the association of patient perception with objective measures of functional and physiological capacity might strengthen the clinical value of this knowledge.