A review and synthesis of correlates of fatigue in osteoarthritis

Hackney, Alisha; Klinedinst, N. Jennifer; Renn, Cynthia L.; Fiskum, Gary

doi:10.1016/j.ijotn.2019.01.003

Cited by 18 publications

(17 citation statements)

References 58 publications

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“…The difference between our study results and Hawker's may be due to the lower pain severity reported in our study (WOMAC average pain = 6.78 ± 3.63 vs. 8.03 ± 4.22) and different fatigue scales used. While there is indication of cross‐sectional association between sleep quality and fatigue in OA studies, there is a lack of longitudinal evidence on this relationship in the symptomatic knee OA population. Our study found a bivariate correlation between fatigue and poor sleep but this relationship was not significant in the multivariable model.…”

Section: Discussionmentioning

confidence: 99%

Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study

et al. 2020

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Aim:The aim of the study was to identify sociodemographic, disease-related, physical and mental health-related determinants of fatigue at 2-year follow-up in individuals with symptomatic knee osteoarthritis (OA). Methods:A longitudinal analysis of participants with symptomatic knee OA from the Multicenter Osteoarthritis Study (MOST) was conducted to identify predictors of fatigue at 2-year follow-up. Participants self-reported fatigue at baseline for the first time in the MOST cohort and at follow-up using a 0-10 visual analog scale. At baseline, questionnaires on sociodemographics, disease-related symptoms, physical and mental health factors were completed. Data were analyzed using linear regressions with a backwards elimination approach. Results: Of the 2330 individuals in the MOST cohort at baseline, 576 had symptomatic knee OA and of these, 449 with complete fatigue values at baseline and follow-up were included in this analysis. Minimally important fatigue change (ie, worsening [≥1.13], no change [<0.82 or <1.13] and improvement [≥−0.82]) from baseline to follow-up were unequal within the population (34.5%, 26.9%, 38.5%; χ 2 [2, N = 449] = 9.32, P = .009). The multiple linear regression showed that baseline fatigue (unstandardized coefficient [Β] = 0.435; 95% confidence interval [CI] 0.348-0.523, P < .001), slow gait speed (Β = −1.124; 95% CI −1.962 to −0.285, P = .009), depressive symptoms (Β = 0.049; 95% CI 0.024-0.075, P < .001) and higher numbers of comorbidities (Β = 0.242; 95% CI 0.045-0.439, P = .016) were significant predictors of greater fatigue at follow-up. Conclusion: Fatigue is strongly associated with physical-and mental-related health factors. Individualized treatments that include combined psychological and physical function rehabilitation might be modalities for fatigue management. K E Y W O R D S fatigue, knee osteoarthritis, longitudinal, risk factors

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Section: Discussionmentioning

confidence: 99%

Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study

et al. 2020

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“…Fatigue dimensions may or may not be related to physical activity (PA) [7] and mental activity [8]. Factors such as depression, high pain, poor physical function, low PA levels [9,10] and high mental task demands [11] have been suggested as correlates of greater fatigue in the OA population.…”

Section: Introductionmentioning

confidence: 99%

Temporal associations between physical activity, mental activity and fatigue dimensions in knee osteoarthritis: an exploratory intensive longitudinal study

Fawole

Dell’Isola

Steultjens

et al. 2020

Fatigue: Biomedicine, Health & Behavior

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Background: Fatigue may include both physical and mental dimensions. Evidence suggests that physical and mental activity may influence fatigue in knee osteoarthritis (OA). However, how physical and mental activities relate to fatigue dimensions in knee OA is unclear. Purpose: This study estimated intra-day contributions of physical and mental fatigue to general fatigue and evaluated temporal associations between physical activity, mental activity and fatigue dimensions in knee OA. Methods: An intensive longitudinal study combined with ecological momentary assessment of mental activity intensity and fatigue dimensions was conducted on 23 participants with knee OA. Physical activity was monitored continuously with an accelerometer over seven days. Results: Physical fatigue contributed 33% more to general fatigue earlier in the day than mental fatigue, and 11% more near the end of the day. Within-day, previous general fatigue significantly and negatively predicted future step counts, light intensity physical activity time and light intensity physical activity + standing time. We found a significant bidirectional association between mental activity and general fatigue, a positive association between mental activity and mental fatigue and a significant negative association between mental fatigue and mental activity. Conclusions: Within-day general fatigue may be a significant fatigue dimension that reduces physical activity. Conversely there was no evidence that physical activity might contribute to lower scores on any fatigue dimensions in this population. To manage general fatigue, 3 | P a g e physical and mental fatigue might have to be targeted more precisely at different time of the day.

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“…Increased depression and increased joint pain are both associated with increased fatigue in osteoarthritis. There is inconclusive evidence, however, for the relationships between anxiety and disease severity and osteoarthritis fatigue (Hackney et al, 2019). Because of the limited amount of research surrounding this phenomenon, researchers recommend future work to continue to explore how these variables influence osteoarthritis fatigue.…”

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confidence: 99%

“…Lastly, there is a negative association between osteoarthritis fatigue and physical function. With increased fatigue in osteoarthritis, there is a decrease in functional ability (Hackney et al, 2019).…”

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confidence: 99%

“…Although included in the biobehavioral model of fatigue in osteoarthritis, biological factors have been much less explored in osteoarthritis fatigue. One biological factor potentially associated with osteoarthritis fatigue is systemic inflammation (Hackney et al, 2019). However, poor measurement of systemic inflammation in previous research makes it challenging to define its relationship with osteoarthritis fatigue from existing evidence.…”

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Association of Systemic Inflammation and Fatigue in Osteoarthritis: 2007−2010 National Health and Nutrition Examination Survey

Hackney

Klinedinst

Resnick

et al. 2019

Biological Research For Nursing

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Background/Purpose: Mechanistic insight into osteoarthritis fatigue is needed as clinical management of this condition is nonspecific. Systemic inflammation is associated with fatigue in other chronic diseases. The purpose of this study was to explore the relationship between systemic inflammation and fatigue in osteoarthritis, while controlling for covariates. Method: This secondary analysis with a cross-sectional, multiyear retrospective design used data from the 2007−2010 National Health and Nutrition Examination Survey. Adults with self-reported osteoarthritis who participated in an examination at a mobile center and had no comorbidities associated with fatigue or systemic inflammation were included ( n = 296). Complex sample analysis, independent samples t tests, and χ2 tests of independence were used to explore differences between nonfatigued and fatigued adults with osteoarthritis. Adjusted hierarchical logistic regression models were used to calculate odds of fatigue as a function of two systemic inflammatory markers, C-reactive protein (CRP), and white blood cell (WBC) count. Results: Fatigued adults with osteoarthritis had significantly higher CRP levels and WBC counts compared to nonfatigued adults with osteoarthritis. In adjusted logistic regression models, increased CRP was associated with higher odds of fatigue when controlling for age, days affected by pain, depressive symptoms, sleep quantity, and body mass index (Odds ratio [ OR] = 3.38, 95% CI [1.18, 9.69]). WBC count was not associated with higher odds of fatigue when controlling for these variables ( OR = 1.10, 95% CI [0.92, 1.32]). Conclusion: Systemic inflammation may have a relationship with fatigue in osteoarthritis. Future work is necessary to replicate these findings in more robust studies.

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A review and synthesis of correlates of fatigue in osteoarthritis

Cited by 18 publications

References 58 publications

Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study

Determinants of generalized fatigue in individuals with symptomatic knee osteoarthritis: The MOST Study

Temporal associations between physical activity, mental activity and fatigue dimensions in knee osteoarthritis: an exploratory intensive longitudinal study

Association of Systemic Inflammation and Fatigue in Osteoarthritis: 2007−2010 National Health and Nutrition Examination Survey

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