Higher physical activity and lower pain levels before surgery predict non-improvement of knee pain 1 year after TKA

Корнилов, Николай Николаевич; Lindberg, Maren Falch; Сараев, Александр Викторович; Куляба, Т. А.; Rosseland, Leiv Arne; Lerdal, Anners

doi:10.1007/s00167-017-4713-5

Cited by 23 publications

(17 citation statements)

References 61 publications

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“…On the other hand, reducing the practice of PA can have a great impact on bodily pain [51]. Although some studies contradict this theory [52,53], other studies clearly affirm that adequate practice of PA helps to decrease bodily pain and, therefore, to improve levels of catastrophism [54,55]. A clear example is the study carried out by Ardoin and Canot [56] in which a program of sports activities adapted to people suffering from chronic pain was applied.…”

Section: Discussionmentioning

confidence: 99%

Do Health-Related Quality of Life and Pain-Coping Strategies Explain the Relationship between Older Women Participants in a Pilates-Aerobic Program and Bodily Pain? A Multiple Mediation Model

Ruíz-Montero

Ruiz

Martín-Moya

et al. 2019

IJERPH

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This study (1) analyzes the differences between non-participating and participating older women in terms of clinical characteristics, pain coping strategies, health-related quality of life and physical activity (PA); (2) studies the associations between non-participants and participants, clinical characteristics, pain coping strategies, HRQoL and bodily pain and PA; and (3) determines whether catastrophizing, physical role, behavioural coping, social functioning and emotional role are significant mediators in the link between participating in a Pilates-aerobic program (or not) and bodily pain. The sample comprised 340 older women over 60 years old. Participants of the present cross-sectional study completed measures of clinical characteristics: HRQoL using the SF-36 Health Survey, pain-coping strategies using the Vanderbilt Pain Management Inventory (VPMI) and PA using the International Physical Activity Questionnaire (IPAQ). Significant differences between non-participants and participants, were found in clinical characteristics, pain-coping strategies (both, p < 0.05), HRQoL (p < 0.01), and PA (p < 0.001). Moreover, catastrophizing support mediated the link between non-participants and participants and bodily pain by 95.9% of the total effect; 42.9% was mediated by PA and 39.6% was mediated by behavioural coping. These results contribute to a better understanding of the link between PA and bodily pain.

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Section: Discussionmentioning

confidence: 99%

Do Health-Related Quality of Life and Pain-Coping Strategies Explain the Relationship between Older Women Participants in a Pilates-Aerobic Program and Bodily Pain? A Multiple Mediation Model

Ruíz-Montero

Ruiz

Martín-Moya

et al. 2019

IJERPH

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“…PROs support patients and clinicians in shared decision-making, which may improve outcomes [13] and could reduce costs [9]. Although there is evidence that preoperative patient characteristics [14–16] have an impact on HRQoL and satisfaction with surgery after TKA [17, 18], evidence in Germany is lacking.…”

Section: Introductionmentioning

confidence: 99%

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Felix

Becker

Vogl

et al. 2019

Health Qual Life Outcomes

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BackgroundEvaluation of variations in pre- and postoperative patient reported outcomes (PRO) and the association between preoperative patient characteristics and health and satisfaction outcomes after total knee arthroplasty (TKA) may support shared decision-making in Germany. Since previous research on TKA health outcomes indicated valuation differences in longitudinal data, experienced-based population weights were used for the first time as an external valuation system to measure discrepancies between patient and average population valuation of HRQoL.MethodsBaseline data (n = 203) included sociodemographic and clinical characteristics and PROs, measured by the EQ-5D-3 L and WOMAC. Six-month follow-up data (n = 161) included medical changes since hospital discharge, PROs and satisfaction. A multivariate linear regression analysis was performed to evaluate the relationship between preoperative patient characteristics and PRO scores. Patient acceptable symptom state (PASS) was calculated to provide a satisfaction threshold. Patient-reported health-related quality of life (HRQoL) valuations were compared with average experienced-based population values to detect changes in valuation.ResultsOne hundred thirty-seven subjects met inclusion criteria. All PRO measures improved significantly. Preoperative WOMAC and EQ-5D VAS, housing situation, marital status, age and asthma were found to be predictors of postoperative outcomes. 73% of study participants valued their preoperative HRQoL higher than the general population valuation, indicating response shift. Preoperatively, patient-reported EQ-5D VAS was substantially higher than average experienced-based population values. Postoperatively, this difference declined sharply.Approximately 61% of the patients reported satisfactory postoperative health, being mainly satisfied with results if postoperative WOMAC was ≥82.49 (change ≥20.25) and postoperative EQ-5D VAS was ≥75 (change ≥6).ConclusionOn average, patients benefited from TKA. Preoperative WOMAC and EQ-5D VAS were predictors of postoperative outcomes after TKA. Particularly patients with high absolute preoperative PRO scores were more likely to remain unsatisfied. Therefore, outcome prediction can contribute to shared-decision making. Using general population valuations as a reference, this study underlined a discrepancy between population and patient valuation of HRQoL before, but not after surgery, thus indicating a potential temporary response shift before surgery.

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“…However, mounting evidence is indicating that preoperative demographic, self-reported and physical performance metrics are predictive of poorer physical performance following surgery. Older age [8], higher body mass [8], lower limb weakness [2, 6], knee pain [9], lower self-perceived function [10] and poorer physical activity level [11] preoperatively have all shown to be indicative of poorer postoperative physical performance. The implant design has also shown to effect postoperative clinical outcomes post-TKA [12].…”

Section: Introductionmentioning

confidence: 99%

Preoperative quadriceps weakness preferentially predicts postoperative aberrant movement patterns during high-demand mobility following total knee arthroplasty

et al. 2019

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Background: Nearly all patients with total knee arthroplasty show aberrant movement patterns during tasks requiring greater joint demand compared to matched peers. Greater movement compensatory leads to increased loading onto other joints, decrease functional capacity and limited reserve for independence later in life. Understanding how preoperative predictors contribute to postoperative aberrant movement patterns are needed to make better decisions for patients considering total knee arthroplasty. Methods: Forty-seven patients were tested preoperatively and 6 months following primary total knee arthroplasty. Demographic (age, sex, body mass), self-reported (knee pain, perception of physical performance, physical activity level), physical performance (quadriceps strength, lower limb power and timed stair climbing) and surgical metrics were collected as predictor variables. Three-dimensional models based on joint mechanic asymmetry during a decline walking task were collected at 6 months postoperatively. Decline walking is a preferred means to assess the surgical knee’s contribution to limb performance during high-demand tasks. Bootstrap inclusion fraction was employed to compare the stability of each predictor variable prior to the final regression model. Results: Preoperative quadriceps strength (β=0.33; p=0.04) showed a significant relationship on knee extensor angular impulse during loading phase. No other predictor variable had any meaningful relationship on aberrant movement patterns (p>0.05). Conclusion: Our findings highlight patients’ preoperative quadriceps strength as a meaningful predictor of postoperative performance. Preoperative quadriceps strength should be addressed when considering the knee’s ability to contribute to higher demanding mobility tasks following surgery.

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Higher physical activity and lower pain levels before surgery predict non-improvement of knee pain 1 year after TKA

Abstract: Prognostic study, Level II.

Cited by 23 publications

References 61 publications

Do Health-Related Quality of Life and Pain-Coping Strategies Explain the Relationship between Older Women Participants in a Pilates-Aerobic Program and Bodily Pain? A Multiple Mediation Model

Do Health-Related Quality of Life and Pain-Coping Strategies Explain the Relationship between Older Women Participants in a Pilates-Aerobic Program and Bodily Pain? A Multiple Mediation Model

Patient characteristics and valuation changes impact quality of life and satisfaction in total knee arthroplasty – results from a German prospective cohort study

Preoperative quadriceps weakness preferentially predicts postoperative aberrant movement patterns during high-demand mobility following total knee arthroplasty

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