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Quality of Life in Symptomatic Anterior Cruciate Ligament Reconstructed Individuals, With and Without Radiographic Knee Osteoarthritis.
Related Articles

Quality of Life in Symptomatic Anterior Cruciate Ligament Reconstructed Individuals, With and Without Radiographic Knee Osteoarthritis.

J Orthop Sports Phys Ther. 2018 Apr 18;:1-37

Authors: Filbay SR, Ackerman IN, Dhupelia S, Arden NK, Crossley KM

Abstract
Study Design Clinical measurement, cross-sectional. Background ACL-reconstructed individuals commonly experience impaired longer-term quality of life (QOL) which may be related to persistent knee symptoms or radiographic osteoarthritis (ROA). Understanding the impact of knee symptoms and ROA on QOL after ACL-reconstruction may assist in developing appropriate management strategies. Objectives 1. Compare QOL between ACL-reconstructed groups: i) symptomatic with ROA, ii) symptomatic without ROA, iii) asymptomatic (unknown ROA status); 2. Identify specific aspects of QOL impairment in symptomatic ACL-reconstructed individuals with and without ROA. Methods 113 participants completed QOL measures (KOOS-QOL, ACL-QOL, AQoL-8D) 5-20 years after ACL reconstruction. 81 symptomatic individuals underwent radiographs and 32 asymptomatic individuals formed a comparison group. ROA was defined as Kellgren & Lawrence ≥2 for the tibiofemoral and/or patellofemoral joint. Mann-Whitney U tests compared outcomes between groups. Individual ACL-QOL items were used to explore specific aspects of QOL. Results In symptomatic ACL-reconstructed individuals, ROA was related to worse knee-related QOL (KOOS-QOL: median(IQR) 50(38, 69) vs. 69(56, 81), p<0.001; ACL-QOL: 51 (38, 71) vs. 66 (50, 82), p=0.04). Health-related QOL (AQoL-8D) was impaired in both symptomatic groups compared to the asymptomatic group. ACL-QOL item scores revealed greater limitations and concern surrounding sport and exercise, and social/emotional difficulties in the symptomatic group with ROA. Conclusions Osteoarthritis is associated with worse knee-related QOL in symptomatic ACL-reconstructed individuals. Diagnosing ROA in symptomatic ACL-reconstructed individuals may be valuable since these individuals may require unique management. Targeted strategies to facilitate participation in satisfying activities has potential to improve QOL in symptomatic ACL-reconstructed people with ROA. J Orthop Sports Phys Ther, Epub 18 Apr 2018. doi:10.2519/jospt.2018.7830.

PMID: 29669490 [PubMed - as supplied by publisher]




Validity and Responsiveness of the Short Version of Western Ontario Rotator Cuff Index (Short-WORC) in Patients With Rotator Cuff Repair.
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Validity and Responsiveness of the Short Version of Western Ontario Rotator Cuff Index (Short-WORC) in Patients With Rotator Cuff Repair.

J Orthop Sports Phys Ther. 2018 Apr 18;:1-38

Authors: Dewan N, MacDermid JC, MacIntyre N

Abstract
Study Design Clinical measurement. Background Recently, the Western Ontario Rotator Cuff Index (WORC) has been shortened; but few studies report measurement properties. Objective To compare the validity and responsiveness of disease-specific measures, short version of the Western Ontario Rotator Cuff Index (Short-WORC) and WORC with comparator measures (joint-specific: Shoulder Pain and Disability Index; SPADI, Simple Shoulder Test; SST); region-specific (Disabilities of the Arm, Shoulder and Hand; DASH); general health status (12-item short form health survey; SF-12v2)) in the patients undergoing rotator cuff repair (RCR). Methods We reviewed a cohort of patients (n=223) who completed the WORC, SPADI, SST, DASH and SF-12v2 pre-operatively, and at three and six months after RCR. Short-WORC scores were extracted from the WORC questionnaire. The construct validity (Pearson correlations) and internal responsiveness (effect size (ES), standardized response mean (SRM), relative efficiency (RE)) of Short-WORC were calculated. Results The Short-WORC was strongly correlated with WORC (r=0.89-0.96) and moderately to strongly correlated with non-disease-specific measures at pre- and post-operative assessments (r=0.51-0.92). The Short-WORC and WORC were equally responsive (REShort-WORC/WORC=1) at 0-6 months and highly responsive overall (0-3 month: ESShort-WORC=0.72, ESWORC=0.92, SRMShort-WORC=0.75, SRMWORC =0.81; 0-6 month: ESShort-WORC=1.05, EWORC=1.12, SRMShort-WORC=0.89, SRMWORC=0.89). Responsiveness of the comparator measures (SPADI, SST, DASH, SF12v2) was poor to moderate (0-3 month: ES=0.07-0.55, SRM= 0.09-0.49; 0-6 month: ES=0.05-0.78, SRM=0.07-0.78). Conclusion The Short-WORC and WORC have similar responsiveness in patients undergoing RCR; and are more responsive than non-disease-specific measures. Future studies should focus on validation of the Short-WORC with samples representing the spectrum of rotator cuff disorders. J Orthop Sports Phys Ther, Epub 18 Apr 2018. doi:10.2519/jospt.2018.7928.

PMID: 29669489 [PubMed - as supplied by publisher]




Physical Activity and Exercise Therapy Benefits More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis.
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Physical Activity and Exercise Therapy Benefits More Than Just Symptoms and Impairments in People With Hip and Knee Osteoarthritis.

J Orthop Sports Phys Ther. 2018 Apr 18;:1-36

Authors: Skou ST, Pedersen BK, Abbott JH, Patterson B, Barton C

Abstract
Synopsis Hip and knee osteoarthritis (OA) are among the leading causes of global disability, highlighting the need for early, targeted, and effective treatments. The benefits on symptoms and impairments of exercise therapy in people with hip and knee OA are substantial and supported by high-quality evidence, underlining that it should be part of first line treatment offered to all people with hip and knee OA in clinical practice. Furthermore, unlike other treatments for OA such as analgesia and surgery, exercise therapy is not associated with risk of serious harm. Promoting and helping people with OA become more physically active alongside participating in structured exercise therapy targeting symptoms and impairments is crucial considering the majority of people with hip and knee OA do not meet physical activity recommendations. OA is associated with a range of chronic comorbidities, including type 2 diabetes, cardiovascular disease, and dementia, all of which are associated with chronic low-grade inflammation. Physical activity and exercise therapy not only improves symptoms and impairments of OA, it is also effective as prevention of at least 35 chronic conditions and as treatment of at least 26 chronic conditions with one of the potential working mechanisms being exercise induced anti-inflammatory effects. Patient education may be crucial to ensure long-term adherence and sustained positive effects on symptoms, impairments, physical activity levels and comorbidities. J Orthop Sports Phys Ther, Epub 18 Apr 2018. doi:10.2519/jospt.2018.7877.

PMID: 29669488 [PubMed - as supplied by publisher]