Physical functioning in patients with end-stage knee osteoarthritis: A cross-sectional study in Jordan using self-reported questionnaire and performance-based tests.

BACKGROUND: Knee osteoarthritis (OA) is a debilitating condition that leads to functional limitations. Self-reported questionnaires and performance-based tests are tools commonly used for measuring physical function. OBJECTIVES: (1) To evaluate the impact of end-stage knee OA on functional outcomes and examine the association between self-reported and performance-based measures of function in patients with end-stage knee osteoarthritis awaiting total knee arthroplasty (2) To explore the interrelationships among pain, strength, and overall physical function in this patient population. METHODS: In this cross-sectional analysis, 33 patients with end-stage knee OA were recruited and completed the knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS) and executed performance-based tests including the Timed Up and Go, the 30-second chair stand test, and the Stair Climbing Test. Knee pain, and isometric hip and knee strength were evaluated. RESULTS: Patients perceived deficits in their physical functionwith a score of 35/100 on the KOS-ADLS and demonstrated functional limitations in all performed tasks. KOS-ADLs was weakly associated with TUG and 30s-CST (r=-0.301, p= 0.047, and r= 0.39, p= 0.014. respectively). Knee pain was linked with the KOS-ADL score and GRS score (r=-0.406, p= 0.010; r=-0.343, p= 0.027; respectively), while the strength of the affected side was correlated with the performed (p=< 0.001) and reported function outcomes (p= 0.007). CONCLUSION: Participants exhibit declines in both perceived and executed functional abilities. Self-reported and performance-based functional measures are weakly correlated within our study group, highlighting the importance of incorporating both measures in clinical practice for a comprehensive evaluation of physical function. Pain was linked to subjective aspect of physical function, while strength was connected to perceived and performed functional capacity. Implementing a tailored rehabilitation program targeting muscle weakness and pain holds the potential to mitigate functional decline in individuals awaiting total knee arthroplasty (TKA).

Effects of the combination of pulsed electromagnetic field with progressive resistance exercise on knee osteoarthritis: A randomized controlled trial.

BACKGROUND: Knee osteoarthritis (OA) is a common and disabling disease among the elderly population. The optimal conservative treatment for knee OA is not well established. OBJECTIVE: This study aimed to assess the effectiveness of pulsed electromagnetic field (PEMF) combined with progressive resistance exercise (PRE) in improving physical function and pain in patients with knee OA. METHODS: Thirty-four patients with knee OA (17 in each group) participated in a single-blind randomized control study. Patients were randomly assigned to receive 24 sessions of either combined PEMF and PRE (treatment group) or PRE only (control group). Patients were evaluated at pre-treatment, post-treatment (2 months), and at 3-month and 6-month follow-ups using the Knee Injury and Osteoarthritis Outcome Score (KOOS), Numeric Pain Rating Scale (NPRS); walking speed and 5-times chair stand test. Mixed ANOVA was used for statistical analysis with Bonferroni adjustments. RESULTS: There was no significant group-by-time interaction for any outcome (P> 0.05). However, both groups scored significantly higher on the NPRS and KOOS at post-treatment, 3-, and 6-month follow-up compared to their baseline. Further, both groups completed the 5-times chair stand test and walking speed test with significantly less time at all post-treatment time points than the pre-treatment. None of the study outcomes (NPRS, KOOS, walking speed, and 5 times chair stand) were significantly different between groups at any of the time points. CONCLUSION: Both treatment options, PRE only versus PRE with PEMF, were equally effective in decreasing pain and improving physical function in patients with knee OA. This would suggest that the optimal parameters for PEMF that may show beneficial effects for knee OA when added to PRE training need to be determined.

Impact of end-stage knee osteoarthritis on perceived physical function and quality of life: A descriptive study from Jordan.

OBJECTIVE: Of the present study was to evaluate the impact of end-stage knee OA on patient's perception of their functional abilities and quality of life (QoL) using the self-reported questionnaire; the Knee Injury and Osteoarthritis Outcome Score (KOOS), and to determine the contribution of knee pain on patient's perceived outcomes. METHODS: Patients with end-stage knee OA who are on the waiting list for total knee arthroplasty were recruited in this cross-sectional study. Patients were asked to fill out the KOOS questionnaire. Knee pain for both sides was quantified on a continuous scale from 0-10. Age, and anthropometric data were recorded. Descriptive statistics were calculated for patients' characteristics, and for the scores of each KOOS subscale. Hierarchical linear regression models were created to determine the contributions of knee pain on two KOOS subscales; the function in daily living (KOOS-ADL), and the knee-related quality of life (KOOS-QoL). RESULTS: Patients in this study scored low across KOOS subscales (27.7% - 54.2%) with the QoL subscale being the lowest. After accounting for age and BMI, hierarchical linear regressions revealed that knee pain in both sides were determinants of self-perceived KOOS-ADLs, while only knee pain in the most-affected side significantly contributed to lower KOOS-QOL scores. CONCLUSION: End-stage knee OA negatively impact the patients' perceived function and quality of life. Patients' KOOS scores were similar to those reported in other countries, with QoL being the domain most affected. Our findings demonstrate that the level of knee pain has a determinant effect on our patients' perceptions of functional abilities and QoL. As waiting-list patients, addressing knee pain with a targeted regimen prior to TKA, as well as increasing patient's awareness about knee pain management, may improve/ or minimize deterioration in perceived functional ability and QoL while awaiting TKA.

Cross cultural adaptation, validity, and reliability of Central Sensitization Inventory in Arabic language.

PURPOSE: The Central Sensitization Inventory (CSI) is a tool that aid in identifying symptoms associated with nociplastic pain. The aim of this study is to adapt CSI to Arabic language, and to examine its psychometric properties. METHODS: Adaptation process followed recommended guidelines. Participants with self-reported chronic pain completed a web-based survey. The internal consistency was calculated. Test-retest reliability was examined by allowing 7-9 day gap between two rounds of measurements. Convergent validity was examined by measuring the correlation with Pain Catastrophizing Scale (PCS), EQ-VAS, and EQ-5D-3L. Discriminant validity was examined by testing four priori hypotheses. Factor analysis with principal components extraction was conducted. RESULTS: CSI-Arabic (CSI-Ar) was successfully produced. Its internal consistency and test-retest reliability were excellent (Cronbach's α = 0.88 and ICC2,1=0.94). The standard error of measurement and minimal detectable change 95% were 3.45 and 9.57, respectively. CSI total score correlation with PCS, EQ-5D-3L, and EQ-VAS was moderate. The results lend support to the four hypothesis related to discriminant validity. Factor analysis revealed a four-factor structure of CSI-Ar. CONCLUSIONS: CSI-Ar showed an internal consistency, test-retest reliability, and validity that are comparable to similar studies. The results support the use of CSI-Ar in assessing chronic pain in Arabic-speaking population.Implications for rehabilitationCentral sensitization (CS) mechanisms are thought to contribute to chronic pain.Identifying the presence of CS would personalize management.The Central Sensitization Inventory (CSI) is a valid and reliable tool to aid in identifying symptoms associated with CS.The Arabic version of the CSI is valid and reliable to use in Arabic speaking patients suffering from chronic pain.

Thigh tissue composition exhibits a curvilinear relationship with aging: A cross-sectional study.

OBJECTIVES: To explore whether quadratic model will better estimate the relationship between aging and thigh tissue composition in a cohort that range in age from young to older adults. METHODS: 51 healthy subjects participated in this investigation. All subjects underwent CT imaging for the thigh. Cross-sectional area of the fat and muscular tissues in the thigh were quantified. Hierarchical regression models were created. Age was entered first into the models to estimate its linear relationship with the thigh tissues. Then the squared value of the age variable was entered second to identify whether a quadratic model would better estimate the relationship between the variables. RESULTS: The linear model was significant for thigh muscular tissue. Quadratic models were able to account for additional significant prediction of the cross-sectional area of thigh tissues. Muscular area decreased with aging until 60 years after that it didn't change. Fat areas increased with aging until 45-50 years and then it decreased. CONCLUSIONS: The cross-sectional area of different thigh tissues exhibit a curvilinear pattern with aging. Muscular tissue area may not change after 60 years; this could be explained by the reduction in fat that may infiltrate inside the muscles and offset the muscular reduction.

The Association Between Femoral Neck-Shaft Angle and Aging and Its Influence on the Performance of Functional Activity: A Cross-Sectional Investigation.

The purposes of this study were first to examine the association between aging and both the magnitude and asymmetry in the femoral neck-shaft angle (NSA). The second purpose was to determine the effects of both the magnitude and NSA asymmetry on the performance of functional activities in healthy individuals. Fifty-one subjects participated in this study. The femoral NSA was measured on computed tomography scout images. The participants performed four performance tests. Four hierarchical regression models were constructed to explore the effect of each predictor on the outcomes. Aging was associated with NSA asymmetry, but not with the degree of NSA. Age contributed significantly to the variability of all functional performance tests except the 10-m walking speed. The degree of the NSA did not contribute to the prediction of the functional performance tests. However, asymmetry in the NSA added significantly to the prediction of all functional performance tests except the 10-m walking speed.

Determine real change in performance during single session of functional testing.

OBJECTIVE: Performance-based measures of function are used in both clinical and research settings. During functional testing procedures, participants' performance change from one trial to another. Therefore, there is a need to know how much change in performance is considered a real change from one trial to another during the same testing visit. METHODS: The current study has a cross-sectional design. A sample of 51 healthy subjects participated in this investigation. Participants attended 1 testing visit during which all subjects completed the functional tests twice. The functional tests used in the current study were: timed up and go, 10-meter walking time, 5 times chair rise, and climbing stairs. RESULTS: Intra-class correlation coefficients were high on all functional tests for the whole sample and for different subgroups of age and gender. There were small standard error of measurement (SEM) and MDC values for the whole sample on all functional performance tests. Age groups showed different SEM and MDC on the repeated performance of tests. However, gender didn't have an effect on SEM and MDC. CONCLUSIONS: The current study provides data that can guide clinicians in determining whether trial-to-trial changes in performance would be real changes or just measurement error.

Knee joint laxity does not moderate the relationship between quadriceps strength and physical function in knee osteoarthritis patients: A cross-sectional study.

BACKGROUND: Knee osteoarthritis is a common and a disabling musculoskeletal disorder. Patients with knee osteoarthritis have activity limitations which are linked to the strength of the quadriceps muscle. Previous research reported that the relationship between quadriceps muscle strength and physical function is moderated by the level of knee joint frontal plane laxity. The purpose of the current study is to reexamine the moderation effect of the knee joint laxity as measured by stress radiographs on the relationship between quadriceps muscle strength and physical function. METHODS: One-hundred and sixty osteoarthritis patients participated in this cross-sectional study. Isometric quadriceps muscle strength was measured using an isokinetic dynamometer. Self-rated and performance-based physical function were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and Get Up and Go test, respectively. Stress radiographs which were taken while applying varus and valgus loads to knee using the TELOS device. Knee joint laxity was determined by measuring the distance between joint surfaces on the medial and lateral sides. Hierarchical multiple regression models were constructed to study the moderation effect of laxity on the strength function relationship. RESULTS: Two regression models were constructed for self-rated and performance-based function. After controlling for demographics, strength contributed significantly in the models. The addition of laxity and laxity-strength interaction did not add significant contributions in the regression models. CONCLUSION: Frontal plane knee joint laxity measured by stress radiographs does not moderate the relationship between quadriceps muscle strength and physical function in patients with osteoarthritis.

Physical performance of elderly adults in association with thigh tissue composition: a cross-sectional study.

[Purpose] Literature has revealed age-related changes in body regional tissues in the form of reduced muscle size and increased adipose tissue. There is also a decline in the performance of physical function with aging. The aim of this study is to examine the partial and part correlations between physical performance and thigh tissue composition among elderly adults. [Subjects and Methods] Twenty-two elderly participants enrolled in this cross-sectional study. Mid-thigh CT images were used to determine the cross-sectional area of the muscular and adipose tissues. Principal component score of physical function was calculated from 5 performance based physical function tests using principal component analysis. Partial and part correlation statistics were used to explore the association between physical performance and tissue composition. [Results] There were significant, moderate negative partial and part associations between the principal component score and cross-sectional area of thigh muscles, quadriceps muscle and quadriceps normal density muscle. Significant, moderate positive partial and part correlations were found between intramuscular adipose tissue and the principal component score. [Conclusion] Elderly adults' performance of physical function is associated with regional tissue composition.

Is quadriceps muscle strength a determinant of the physical function of the elderly?

[Purpose] To determine the relationships of the quadriceps rate of torque development and the time to peak torque with the physical function of the elderly. [Subjects and Methods] Twenty-one subjects participated in this study. Quadriceps strength was measured using isometric and isokinetic torque tests. Time to peak torque and rate of torque development were calculated from the torque time curve of the isokinetic and isometric torque tests, respectively. Physical activities were measured using 4 physical activity tests. Pearson correlation coefficients were used to examine the relationships among the variables. [Results] The time to peak torque showed significant correlations with all measures of physical activity tests. Rate of torque development showed significant correlation with the timed stair-climbing test. Isometric and isokinetic torques had no significant correlations with any of the physical activity tests. [Conclusion] Time to maximum torque and the rate of torque development might be more important than peak torque in determining the physical function of the elderly.