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Patient-specific reference values for objective physical function tests: data from the Osteoarthritis Initiative.
Harkey, MS, Price, LL, Reid, KF, Lo, GH, Liu, SH, Lapane, KL, Dantas, LO, McAlindon, TE, Driban, JB
Clinical rheumatology. 2020;(6):1961-1970
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Abstract
INTRODUCTION/OBJECTIVE We aimed to establish sex-specific reference values of objective physical function tests among individuals with or at risk for knee osteoarthritis (KOA) across subsets of age, radiographic KOA severity, and body mass index (BMI). METHOD We included Osteoarthritis Initiative participants with data for objective physical function tests, sex, age, BMI, and radiographic KOA severity (Kellgren-Lawrence [KL] grade) at baseline. Objective physical function was quantified with 20-m walk speed, chair-stand speed, 400-m walk time, and knee extension and flexion strength. We created participant characteristic subsets for sex, age, KL grade, and BMI. Reference values were created as percentiles from minimum to maximum in 10% increments for each combination of participant characteristic subsets. Previously established clinically important differences for 20-m walk speed and knee extension strength were used to highlight clinically relevant differences. RESULTS Objective physical function reference values tables and an interactive reference value table were created across all combinations of sex, age, KL grade, and BMI among 3860 individuals with or at risk for KOA. Clinically relevant differences exist for 20-m walk speed and knee extension strength between males and females across age groups, KL grades, and BMI categories. CONCLUSIONS Establishing an individual's relative level of objective physical function by comparing their performance to individuals with similar sex, age, KL grade, or BMI may help improve interpretation of physical function performance. The interactive reference value table will provide clinicians and researchers a clinically accessible avenue to use these reference values.Key Points• Since greater age, radiographic knee osteoarthritis severity, and body mass index are all associated with worse objective physical function, reference values should consider the complex inter-play among these patient characteristics.• This study provides objective physical function reference values among subsets of individuals across the spectrum of sex, age groups, radiographic knee osteoarthritis severity, and body mass index categories.• These reference values offer a more patient-centered approach for interpreting an individual's relative level of objective physical function by comparing them to a more homogeneous group of individuals with similar participant characteristics.• We have provided a clinically accessible interactive table that will enable clinicians and researchers to input their patient's data to quickly and efficiently determine a patient's relative objective physical function compared to individual's with similar characteristics.
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Association Between Weight Loss and Spontaneous Changes in Physical Inactivity in Overweight/Obese Individuals With Knee Osteoarthritis: An Eight-Week Prospective Cohort Study.
Bartholdy, C, Christensen, R, Kristensen, LE, Gudbergsen, H, Bliddal, H, Overgaard, A, Rasmussen, MU, Henriksen, M
Arthritis care & research. 2020;(3):397-404
Abstract
OBJECTIVE To describe spontaneous changes in time spent being physically inactive that is measured continuously by accelerometry during an 8-week weight-loss intervention in overweight/obese individuals with knee osteoarthritis (OA). METHODS This study was designed as an observational cohort study including individuals from an OA outpatient clinic who were concomitantly overweight/obese and had symptomatic knee OA. Participants completed an 8-week dietary intervention that had been previously shown to induce substantial weight loss. The main outcome was accelerometer-based measurement of daily physical inactivity for 24 hours during the 8-week intervention period that was presented as change in the average daily time spent inactive (sitting, reclined, or sleeping) from 1 week prior to intervention to the last week of the intervention. RESULTS A total of 124 participants completed the dietary intervention and had valid accelerometer recordings. The mean weight loss was 12.7 kg (95% confidence interval [95% CI] -13.2, -12.1; P < 0.0001) after 8 weeks, which corresponded to a decrease in body mass index of 4.3 kg/m2 (95% CI -4.5, -4.2; P < 0.0001). Significant improvements in OA symptoms (assessed by the Knee Injury and Osteoarthritis Outcome Score [KOOS]) was found across all subscales; an improvement of 12.8 points (95% CI 10.6, 15.0; P < 0.0001) was observed for pain using the KOOS. No statistically significant change occurred in the average daily time spent inactive from baseline to follow-up (mean change 8.8 minutes/day [95% CI -12.1, 29.7]; P = 0.41). CONCLUSION Physical inactivity remains stable despite a clinically significant weight loss and improvements in knee OA symptoms. Change in inactivity does not seem to occur spontaneously, suggesting that focused efforts to reduce inactive behaviors are needed.
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Is knee osteoarthritis related to coffee drinking? A nationwide cross-sectional observational study.
Bang, CH, Kim, C, Kim, JH, Choi, SJ, Song, GG, Jung, JH
Clinical rheumatology. 2019;(3):817-825
Abstract
AIMS: Coffee is one of the most consumed beverages globally, and coffee consumption is increasing. Osteoarthritis (OA), the most common musculoskeletal disease in the elderly, is also becoming more prevalent. Coffee is associated with various diseases, but there has not yet been a study of the relationship between coffee and knee OA. Therefore, we investigated this relationship in elderly Koreans. METHODS Data from 2012 to 2013 were collected from the Korea National Health and Nutrition Examination Survey. We included 2302 participants in our study: 897 men and 1405 women. Participants with knee OA were defined as those whose knee joints exhibited radiographic change of Kellgren-Lawrence grade 2 or higher. Daily coffee consumption amounts were categorized as none, < 2 cups, 2-3 cups, 4-6 cups, and ≥ 7 cups based on self-reporting. RESULTS A multiple logistic regression model, the odds ratios (ORs) of knee OA in the < 2 cup, 2-3 cup, 4-6 cup, and ≥ 7 cup groups compared to the no-coffee group in men were 1.13 (95% CI 0.50-2.55), 1.79 (95% CI 0.81-3.97), 2.21 (95% CI 0.91-5.35), and 3.81 (95% CI 1.46-12.45), respectively. There was no significant association between coffee consumption and knee OA prevalence in women. CONCLUSION Daily more than 7 cups of coffee drinking was associated with a prevalence of knee OA in Korean men, and although the ORs did not increase significantly across consumption levels, the prevalence of knee OA tended to increase with increasing coffee consumption.
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Comparative study of CTX-II, Zn2+, and Ca2+ from the urine for knee osteoarthritis patients and healthy individuals.
Xin, L, Wu, Z, Qu, Q, Wang, R, Tang, J, Chen, L
Medicine. 2017;(32):e7593
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Abstract
The aim of the study was to explore the relationship between the concentration of C-telopeptide fragments of type II collagen (CTX-II), Zn, and Ca in urine and knee osteoarthritis (KOA).Eighty-two patients with KOA and 20 healthy volunteers were enrolled. Anteroposterior and lateral position x-rays of knee joints were collected. The images were classified according to Kellgren-Lawrence radiographic grading criterion. The patients were divided into group grade I, group grade II, group grade III, and grade IV. The concentration of CTX-II in the urine was detected by enzyme-linked immunosorbent assay. The concentration of Zn and Ca in urine was detected by inductively coupled plasma atomic emission spectrometry.Compared with the healthy individuals, the concentration of CTX-II was significantly higher in KOA patients. The concentration of CTX-II in KOA patients from high to low was as follows: group IV, group III, group II, and group I. There was no significant difference between group I and healthy individuals. The concentration of Zn and Ca in urine of KOA patients was higher than that in healthy individuals. There was no difference in each KOA group.The concentration of CTX-II is instrumental to diagnose the progress of KOA. The concentration of Zn and Ca in urine is helpful for early diagnosis of KOA.
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[Clinical observation on effect of xian-zhong injection on treating primary knee OA].
Fu, Y, He, XJ, Wang, B, Wang, YQ
Zhong yao cai = Zhongyaocai = Journal of Chinese medicinal materials. 2007;(3):371-4
Abstract
OBJECTIVE To research and evaluate the clinical efficacy of Xian-zhong injection in treating primary knee OA. METHODS By using Lequesne instituted ISOA and Kellgren-Lawrance instituted X-ray class standard, 127 non-operation primaary knee OA patients were divided into three grades (Light, Moderate, Severe). To adopt randomized single controlled trial, each grade was divided into two groups, respectively injected Xian-zhong injection or Sodium Hyaluronate injection. Every injection's volume was 2 ml and injected one per week, then consecutively injected one month. Finally we followed up in the first month, third month, sixth month, afterward we did every six months. RESULTS After followed up one - twenty-four months we found ISOA score less than thirteen and K-LA X-ray class standard less than III grade, the clinical efficacy of two kind of injections was better. But ISOA score more than thirteen and K-LA X-ray class standard mord than III grade, the clinical efficacy was bad. The follow-up showed that the total effective rate and excellent rate between Xian-zhong injection group and Sodium Hyaluronate injection group weren't significantly different. CONCLUSION Xian-zhong injection can improve the clinical efficacy of primary knee OA, it has the greatest researching value and using furthermore.