MHQ has several unique aspects and advantages justifying its use in hand OA, including the unique assessment of work performance, aesthetics, and satisfaction. However, MHQ, AUSCAN and FIHOA appear to measure different aspects of pain and function.
Purpose It is important for patients of working age to resume work after total hip or knee arthroplasty (THA/TKA). A higher preoperative level of physical activity is presumed to lead to a better or faster recovery. Aim is to examine the association between preoperative physical activity (PA) level (total and leisure-time) and time to return-to-work (RTW). Methods A prospective multicenter survey study. Time to RTW was defined as the length of time (days) from surgery to RTW. PA level was assessed with the SQUASH questionnaire. Questionnaires were filled in before surgery and 6 weeks and 3, 6 and 12 months post-surgery. Multiple regression analyses were conducted separately for THA and TKA patients. Results 243 patients were enrolled. Median age was 56 years; 58% had undergone a THA. Median time to RTW was 85 (THA) and 93 (TKA) days. In the multiple regression analysis, neither preoperative total PA level nor leisure-time PA level were significantly associated with time to RTW. Conclusions Preoperative physical activity level is not associated with a shorter time to RTW in either THA or TKA patients. Neither preoperative total PA level nor leisure-time PA level showed an association with time to RTW, even after adjusting for covariates. Trial registry Dutch Trial Register: NTR3497 .
Background:Several tools are available to measure hand pain and function in hand osteoarthritis (OA), though all have their disadvantages, e.g. being not freely available (Australian/Canadian Hand OA Index, AUSCAN), outdated (Functional assessment In Hand OA, FIHOA) or a single-item tool (Visual Analogue Scale, VAS). The MHQ is free to use, validated in other diseases, and has 6 scales assessing pain, function (overall function and activities of daily living [ADL]), and 3 unique domains: work performance, aesthetics, satisfaction (all range 0–100, and higher is better except for pain).Objectives:To investigate truth and discrimination of MHQ in hand OA.Methods:At baseline (n=383) and two-year follow-up (n=293) symptomatic hand OA patients from the Hand OSTeoArthritis in Secondary care (HOSTAS) cohort completed questionnaires (MHQ, AUSCAN, FIHOA, VAS pain). Work status was categorized into (fulltime/part-time) employed, reduced working capacity (sick leave or partial/complete disability to work), or not in the workforce (unemployed or retired). Reduced working capacity could be due to hand OA or other causes. Anchor questions assessed whether level of pain/function was acceptable or unacceptable, and different (worse, unchanged or improved) compared to baseline. Number of joints with deformities was assessed, and split into tertiles (<3, 3–5, >5). To appraise validity of MHQ pain and function domains correlation with existing instruments (Spearman correlation coefficients, rs) was evaluated. Using external anchors to categorize patients, validity of the unique domains and discrimination of all domains was visualized in cumulative probability plots (figure 1), and mean between-group difference (MD) was calculated with linear regression.Results:At baseline patients (84% women, median age 60.3, 90% fulfilling ACR criteria) reported moderate pain (median, interquartile range MHQ pain 45, 31.3–60) and functional impairment (MHQ overall function 57.5, 50–67.5; ADL 80.5, 68.2–89.6). MHQ pain and function scales correlated well with existing instruments (table 1). Patients with reduced working capacity had worse MHQ work performance scores than employed patients (MD -25.7, 95% confidence interval [CI] -32.8;-18.6), and scores were worse if it was due to hand OA than when there was another cause (MD -21.4, -37.1;-5.8). MHQ aesthetics scores were worse in patients with more deformities (MD -1.03, -1.60;-0.45 per additional deformity). Patients with ‘unacceptable’ pain/function had worse MHQ satisfaction scores (eg. pain: MD -27.2, -37.1;-17.3). All instruments measuring pain/function could discriminate between patients with acceptable vs. unacceptable pain/function (not shown). MHQ ADL scale and AUSCAN function outperformed MHQ overall function and FIHOA in discriminating between patients whose function improved vs. worsened over time (not shown). For discrimination of change in pain over time, MHQ and AUSCAN pain both outperformed VAS pain.Conclusions:MHQ performs at least as good and may replace existing instruments in mea...
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