A brief screening tool for knee pain in primary care (KNEST). 2. Results from a survey in the general population aged 50 and over

Jinks, Clare; Jordan, Kelvin; Ong, Bio Nio; Croft, Peter

doi:10.1093/rheumatology/keg438

Cited by 164 publications

(141 citation statements)

References 18 publications

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“…A cross-sectional questionnaire was mailed to a simple random sample of 2,234 older adults registered with a large general practice in central Cheshire, and a screening question identified individuals with knee pain (defined as any ache, pain, discomfort, or stiffness experienced in or around the knee joint within the past 12 months [21]). In order to optimize the response rate, a reminder postcard was mailed at 2 weeks and a second questionnaire was sent to all nonresponders at 4 weeks.…”

Section: Surveymentioning

confidence: 99%

“…The respondents were asked to rate their agreement with each statement on a 6-point Likert scale that included the responses "totally disagree," "largely disagree," "disagree to some extent," "agree to some extent," "largely agree," and "totally agree" (for clarity, the statements have been grouped into those relating to the benefits of exercise for knee pain and those relating to the delivery of exercise and exercise adherence and are shown in Figures 1 and 2). The questionnaire also included questions on the respondents' personal characteristics, their general health (including the Short Form 12 [24]) and questions to describe their knee problems (including the Knee Pain Screening Tool [21], the Chronic Pain Grade [25], and the Western Ontario and McMaster Universities Osteoarthritis Index [26]). …”

Section: Survey Instrumentmentioning

confidence: 99%

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Role of exercise for knee pain: What do older adults in the community think?

Holden¹,

Young²,

Hay³

et al. 2012

Arthritis Care & Research

108

106

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Objective. Older adults with knee pain report low levels of exercise and physical activity. One explanation for this might be that they believe exercise is unhelpful or even harmful for knee pain. We therefore explored the attitudes and beliefs of older adults in the community about the role of exercise for knee pain using mixed methods. Methods. A survey was mailed to 2,234 older adults registered with 1 general practice within the UK. The survey included 23 attitude statements derived from published exercise recommendations. Semistructured interviews were completed in a purposeful sample of questionnaire responders (n ‫؍‬ 22) and were recorded and analyzed thematically. Results. The questionnaire response rate was 59% (n ‫؍‬ 1,276), and 611 respondents reported knee pain in the past 12 months. There was considerable uncertainty about the benefits of exercise; <50% largely or totally agreed on any attitude statement relating to the benefit of exercise for knee pain. The interviews revealed that attitudes and beliefs about exercise for knee pain are linked to the individuals' perceptions about their knee problems, and that many different barriers and facilitators to exercise and physical activity exist. These barriers and facilitators could be grouped as those relating to the person, the knee problem itself, and social or environmental factors. Barriers and facilitators varied between different individuals and over time. Conclusion. The overall uncertainty within the community about the role of exercise for knee pain highlights the challenges faced by those living with knee pain in completing physical activity, and for health care professionals prescribing exercise for this patient group.

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Section: Surveymentioning

confidence: 99%

Section: Survey Instrumentmentioning

confidence: 99%

Role of exercise for knee pain: What do older adults in the community think?

Holden¹,

Young²,

Hay³

et al. 2012

Arthritis Care & Research

108

106

View full text Add to dashboard Cite

show abstract

“…corresponds to an entity which is less consistently reflective of osteoarthritis" (33). We would argue that osteoarthritis symptoms can be less frequent and such individuals do present to general practice in significant numbers where their symptoms may be attributed to osteoarthritis (52). A similar argument concerns the inclusion of individuals who reported knee pain as part of a more diffuse pain problem.…”

mentioning

confidence: 99%

Estimating the probability of radiographic osteoarthritis in the older patient with knee pain

Peat

Thomas

Duncan

et al. 2007

Arthritis & Rheumatism

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Objective. To determine whether clinical information can practically rule in or rule out the presence of radiographic osteoarthritis in older adults with knee pain. Methods. We conducted a cross-sectional diagnostic study involving 695 adults ages >50 years reporting knee pain within the last year identified by postal survey and attending a research clinic. Potential indicators of radiographic osteoarthritis were gathered by self-complete questionnaires, clinical interview, and physical examination. Participants underwent plain radiography (posteroanterior, skyline, and lateral views). Radiographic osteoarthritis was defined as the presence of definite osteophytes in at least 1 joint compartment of the index knee. Results. Independent predictors of radiographic osteoarthritis were age, sex, body mass index, absence of whole leg pain, traumatic onset, difficulty descending stairs, palpable effusion, fixed-flexion deformity, restricted-flexion range of motion, and crepitus. Using this model, 245 participants had a predicted probability >80% (practical rule in), of whom 231 (94%) actually had radiographic osteoarthritis (specificity 93%). Twenty-one participants had a predicted probability <20% (practical rule out), of whom only 2 (10%) had radiographic osteoarthritis (sensitivity 99.6%). The predicted probability of radiographic osteoarthritis for the remaining 429 participants fell into an intermediate category (20 -79%). Conclusion. Simple clinical information can be used to estimate the probability of radiographic osteoarthritis in individual patients. However, for the majority of community-dwelling older adults with knee pain this method enables the presence of radiographic osteoarthritis to be neither confidently ruled in nor ruled out. Prospective validation and updating of these findings in an independent sample is required.

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“…C hronic knee pain affects many people older than 50 years 1 and is the most common pain concern among older people consulting family physicians. 2 It is typically due to osteoarthritis and associated with declines in physical function.…”

mentioning

confidence: 99%

Acupuncture for chronic knee pain: a randomized clinical trial

Hinman¹,

McCrory²,

Pirotta³

et al. 2015

Deutsche Zeitschrift für Akupunktur

124

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IMPORTANCEThere is debate about benefits of acupuncture for knee pain.OBJECTIVE To determine the efficacy of laser and needle acupuncture for chronic knee pain. DESIGN, SETTING, AND PARTICIPANTSZelen-design clinical trial (randomization occurred before informed consent), in Victoria, Australia (February 2010-December 2012. Community volunteers (282 patients aged Ն50 years with chronic knee pain) were treated by family physician acupuncturists. INTERVENTIONSNo acupuncture (control group, n = 71) and needle (n = 70), laser (n = 71), and sham laser (n = 70) acupuncture. Treatments were delivered for 12 weeks. Participants and acupuncturists were blinded to laser and sham laser acupuncture. Control participants were unaware of the trial. RESULTS At 12 weeks and 1 year, 26 (9%) and 50 (18%) participants were lost to follow-up, respectively. Analyses showed neither needle nor laser acupuncture significantly improved pain (mean difference; −0.4 units; 95% CI, −1.2 to 0.4, and −0.1; 95% CI, −0.9 to 0.7, respectively) or function (−1.7; 95% CI, −6.1 to 2.6, and 0.5; 95% CI, −3.4 to 4.4, respectively) compared with sham at 12 weeks. Compared with control, needle and laser acupuncture resulted in modest improvements in pain (−1.1; 95% CI, −1.8 to −0.4, and −0.8; 95% CI, −1.5 to −0.1, respectively) at 12 weeks, but not at 1 year. Needle acupuncture resulted in modest improvement in function compared with control at 12 weeks (−3.9; 95% CI, −7.7 to −0.2) but was not significantly different from sham (−1.7; 95% CI, −6.1 to 2.6) and was not maintained at 1 year. There were no differences for most secondary outcomes and no serious adverse events. MAIN OUTCOMES AND MEASURES CONCLUSIONS AND RELEVANCEIn patients older than 50 years with moderate or severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function. Our findings do not support acupuncture for these patients.TRIAL REGISTRATION anzctr.org.au Identifier: ACTRN12609001001280 JAMA. 2014;312(13):1313-1322. doi:10.1001/jama.2014 Author Audio Interview at jama.com Related article page 1342Supplemental content at jama.com C hronic knee pain affects many people older than 50 years 1 and is the most common pain concern among older people consulting family physicians. 2 It is typically due to osteoarthritis and associated with declines in physical function. Nonpharmacological approaches are central to managing chronic knee pain. 3,4 Patients with joint pain and arthritis frequently use complementary and alternative medicine. 5 Acupuncture is the most popular of alternative medical systems, with use increasing over time. 5 Although traditionally administered with needles, laser acupuncture (low-intensity laser therapy to acupuncture points) is a noninvasive alternative with evidence of benefit in some pain conditions. 6-8 Efficacy of laser acupuncture compared with needles is unknown. Preliminary evidence suggests laser may be superior to needles for myofascial trigger points. 9 A meta-analysis supports needle acupuncture for osteoart...

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A brief screening tool for knee pain in primary care (KNEST). 2. Results from a survey in the general population aged 50 and over

Cited by 164 publications

References 18 publications

Role of exercise for knee pain: What do older adults in the community think?

Role of exercise for knee pain: What do older adults in the community think?

Estimating the probability of radiographic osteoarthritis in the older patient with knee pain

Acupuncture for chronic knee pain: a randomized clinical trial

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