Impact of osteoarthritis on activities of daily living: does joint site matter?

Clynes, Michael; Jameson, Karen; Edwards, Mark H.; Cooper, Cyrus; Dennison, Elaine

doi:10.1007/s40520-019-01163-0

Cited by 83 publications

(74 citation statements)

References 26 publications

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“…The pathologies of these diseases are highly variable, but all include a component of joint inflammation. Patients with high disease activity typically have impaired quality of life and activities of daily living (4)(5)(6)(7) .…”

Section: Introductionmentioning

confidence: 99%

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

et al. 2020

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The aim is to systematically assess the health impact of a low-inflammatory diet intervention (full-diet or supplement), compared to usual diet or other dietary interventions, on weight change, inflammatory biomarkers, joint symptoms, and quality of life in adults with osteoarthritis, rheumatoid arthritis or seronegative arthropathy (psoriatic, reactive, ankylosing spondylitis or IBD-related), on outcomes assessed in prospective studies within 6 months of intervention commencement (PROSPERO CRD42019136567). Search of multiple electronic library databases from inception to July 2019, supplemented by grey literature searches, for randomised and prospective trials assessing the above objective. After exclusion of 446 ineligible studies, five randomised and two prospective trials involving 468 participants with either osteoarthritis or rheumatoid arthritis were included. GRADE assessment for all outcomes was very low. Meta-analyses produced the following standardised mean differences (SMD) and 95 % confidence interval (CI) 2–4 months following commencement of the diets favouring the low-inflammatory diet: weight SMD −0⋅45 (CI −0⋅71, −0⋅18); inflammatory biomarkers SMD −2⋅33 (CI −3⋅82, −0⋅84). No significant effects were found for physical function (SMD −0⋅62; CI −1⋅39, 0⋅14), general health (SMD 0⋅89; CI −0⋅39, 2⋅16) and joint pain (SMD −0⋅98; CI −2⋅90, 0⋅93). In most studies, the quality of dietary intervention (dietitian input, use of validated dietary compliance tool) could not be gauged. In conclusion, very low-level evidence suggests that low-inflammatory diets or supplements compared to usual diets are associated with greater weight loss and improvement in inflammatory biomarkers. More high-quality trials are needed to assess the health effects of a low-inflammatory diet more comprehensively and conclusively in arthritic conditions.

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Section: Introductionmentioning

confidence: 99%

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

et al. 2020

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“…A possible explanation as to why polypharmacy is associated with poorer physical function in women but not men in our cohort are sex differences in the type and severity of NCDs. A higher proportion of women than men in our cohort reported osteoarthritis (43.4% vs 33.8%) and rheumatoid arthritis (5.0% and 4.5%) which are disorders whose detrimental impact on physical functioning is well documented [29]. Additionally, biological differences between men and women may play a role; it has previously been shown that the sex of the patient can have profound influences on drug metabolism, efficacy and therefore adverse effects [30].…”

Section: Discussionmentioning

confidence: 68%

Does self-report of multimorbidity in later life predict impaired physical functioning, and might this be useful in clinical practice?

et al. 2020

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Background Multimorbidity has been shown in several studies to relate to impaired physical function in later life. Aims To examine if self-report of multimorbidity predicts impaired physical functioning, as assessed by formal physical function testing, in community-dwelling older adults. Methods Non-communicable diseases (NCDs) were self-reported by 443 older community-dwelling UK adults via questionnaire, asking the question: ‘Have you been told by a doctor that you have any of the following conditions?’ Assessments of walking speed, chair stands and balance allowed us to create a composite score (0–12) on which impaired physical functioning was defined as ≤ 9. Results The mean age of participants was 75.5 ± 2.5 years for men and 75.8 ± 2.6 for women. The proportion of individuals with impaired physical functioning was 71.2% in women and 56.9% in men. Having four or more NCDs was associated with an increased risk of poor physical function in men and women (p < 0.05). The number of medications and medicated systems was associated with gait speed (p < 0.03 and < 0.02, respectively) and timed up-and-go tests (p < 0.03 and < 0.02, respectively) in women but not men. Discussion and conclusion Self-report of 4 or more NCDs was associated with an increased risk of poor physical function, an outcome which has previously been associated with adverse clinical sequelae. This observation may inform development of a simple screening tool to look for poor physical function in older adults.

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“…4,[6][7][8][9] OA of major joints, such as hip or knee, is associated with increasing and sometimes intolerable pain and movement disabilities10 that, with the progression of the disease, limit not only the professional performance, but also the everyday METHODS activities. 11 Several non-pharmacological (body weight loss, muscle strength-increasing exercises, physiotherapy) and pharmacological regimens (non-steroidal anti-inflammatory drugs po or im, intraarticular injections of viscosupplementation with hyaluronic acid, corticosteroids or biologicals) are used to treat this very painful and disabling condition. 12 Total knee arthroplasty (TKA) remains an ultimum refugium for the patients with end-stage osteoarthritis and its prevalence is also on the rise, along with the prevalence of OA.…”

Section: Multimodal Neural Block Analgesia Versus Morphine Analgesiamentioning

confidence: 99%

Multimodal neural block analgesia versus morphine analgesia after elective knee surgery

Lončar-Stojiljković¹

2019

Scripta Medica

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Background: Total knee arthroplasty has become a standard for treatment of endstage knee osteoarthritis. Due to intense and complex knee innervation, there is a need to improve the anaesthetic/analgesic approach to such operations. The aim of this randomised clinical trial was to compare the analgesic efficacy of the classical regimen and two of those based on the nerve blocks. Methods: A total of 60 patients was included and subjected to elective total knee arthroplasty under the general balanced anaesthesia. They were randomised to receive postoperatively (1) only morphine 5-10 mg q6h and paracetamol 1 g q6h (MP), (2) femoral nerve block (FNB) or (3) fascia iliac compartment nerve block (FICNB). Nerve blocks were produced by a single administration of 30-40 ml of bupivacaine 0.5%. Pain intensity, duration of neural block and additional consumption of analgesics were recorded postoperatively. Results: There were no demographic differences among the three groups of patients. Pain intensity was significantly lower in the two nerve block groups than in the MP group. The same two groups also demanded significantly less analgesics postoperatively than the MP group. Cardiovascular control was significantly better in the nerve block groups. There were no significant differences between the FNB and FIC-NB groups of patients regarding any of the studied parameters. Conclusion: In comparison with the classical MP analgesia, use of FNB or FICNB after the elective total knee arthroplasty results in lower pain scores, lower systolic blood pressure and less consumption of analgesics in the immediate postoperative course.

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Impact of osteoarthritis on activities of daily living: does joint site matter?

Cited by 83 publications

References 26 publications

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

Does self-report of multimorbidity in later life predict impaired physical functioning, and might this be useful in clinical practice?

Multimodal neural block analgesia versus morphine analgesia after elective knee surgery

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