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Effects of impairment-based exercise on performance of specific self-reported functional tasks in individuals with knee osteoarthritis.

ABSTRACT: Little is known regarding how impairment-based exercises may improve performance of specific functional tasks in people with knee osteoarthritis (OA).The purpose of this study was to compare the probability that participation in an impairment-based exercise program or the same impairment-based program supplemented with agility and perturbation training will improve patient-reported function on specific functional tasks.This study was a secondary analysis of data from a randomized clinical trial.The study was conducted in the outpatient physical therapy clinic of a large, university-based health center.One hundred eighty-three people with knee OA (122 women, 61 men) participated.Participants were randomly assigned to either a group that received agility and perturbation training with standard exercise therapy or a group that received only the standard exercise.Specific functional items were taken from the physical function subscale of the Western Ontario and McMasters Universities Osteoarthritis Index, the Lower Extremity Function Scale, and the Activities of Daily Living Scale of the Knee Outcome Survey.The probability of self-reported improvement in a variety of specific functional tasks was low following participation in either of the exercise programs. When only participants with moderate to severe difficulty performing specific functional tasks were considered in the analysis, the probability of success improved but was still limited.The results are generalizable only to self-reported assessment of performance of specific functional tasks.Impairment-based exercise may not be enough to make substantial improvement in performance of specific functional tasks. Task-specific exercise approaches need to be explored for people with knee OA.

SUBMITTER: Teixeira PE

PROVIDER: S-EPMC3229042 | biostudies-literature | 2011 Dec

REPOSITORIES: biostudies-literature

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Effects of impairment-based exercise on performance of specific self-reported functional tasks in individuals with knee osteoarthritis.

Teixeira Paulo E P PE Piva Sara R SR Fitzgerald G Kelley GK

Physical therapy 20111014 12

<h4>Background</h4>Little is known regarding how impairment-based exercises may improve performance of specific functional tasks in people with knee osteoarthritis (OA).<h4>Objective</h4>The purpose of this study was to compare the probability that participation in an impairment-based exercise program or the same impairment-based program supplemented with agility and perturbation training will improve patient-reported function on specific functional tasks.<h4>Design</h4>This study was a secondar ...[more]

PMID: 22003157

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Project description:BackgroundThere is currently no standardized method for measuring functional status in knee osteoarthritis (OA) patients, despite that it is one of the top priorities when determining eligibility for total knee arthroplasty (TKA). The purpose of the current investigation was to identify factors associated with discordance between individual self-report and performance-based measures of function for obese and non-obese men and women with knee OA.MethodsIn a cohort of 727 knee OA patients scheduled for TKA, physical function prior to surgery was assessed with the self-reported physical function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC-pf), and the performance-based Timed Up and Go (TUG). Data on sociodemographic characteristics, health status, knee pain intensity, symptomatic joint site count, and pain catastrophizing were collected via questionnaire. The primary outcome was the difference in rescaled score between a participant's self-report and performance-based measures of function. Multivariable linear regression stratified by sex and obesity status was used to identify factors associated with discordance.ResultsThe mean age of participants was 65.5 years and 55% were women. With younger age, self-reported scores indicated increasingly worse function compared to performance-based scores, regardless of sex or obesity status. Among non-obese individuals, greater knee pain intensity was associated with a participant's self-report score indicating increasingly worse function compared to their performance-based score. For obese women, pain catastrophizing, and number of symptomatic joints were also associated with discordance as was reporting fewer comorbidities.ConclusionsPhysical function may be differentially represented by self-reported and performance-based measures depending on a variety of patient factors. Our findings add to the evidence which suggests both measures should be used when assessing functional status prior to TKA.

Project description:BackgroundElevated patellofemoral joint stress has been associated with patellofemoral osteoarthritis (PFOA). Changes in lower limb kinematics, such as excessive femoral adduction and internal rotation and excessive rearfoot eversion during the stance phase of functional activities, may increase patellofemoral stress. There is a lack of studies that assess the effects of interventions for controlling femur and subtalar joint movements during functional activities on self-reported measures in individuals with PFOA. Thus, the primary aim of the study is to determine the immediate effects of the hip strap and foot orthoses during level-ground walking and the single-leg squat test on self-reported outcomes. The secondary aim is to investigate whether the hip strap and foot orthoses result in the kinematic changes that these devices are purported to cause.MethodsTwenty-nine individuals with PFOA aged 50 years or older will take part in the study. The main outcome is pain intensity. The secondary outcomes are other self-reported measures (global rating of change, acceptable state of symptoms, ease of performance, and confidence) and lower limb kinematics (peak femoral adduction and internal rotation, and peak rearfoot eversion). These outcomes will be assessed during functional tasks performed under three conditions: (i) control condition, (ii) hip strap intervention, and (iii) foot orthoses intervention. To investigate whether these interventions result in the lower limb kinematic changes that they are purported to cause, three-dimensional kinematics of the femur and rearfoot will be captured during each task. Linear mixed models with two fixed factors will be used to test associations between the interventions (control, hip strap, and foot orthoses) and conditions (level-ground walking and single-leg squat test) as well as interactions between the interventions and conditions.DiscussionTo the best of the authors' knowledge, this is the first study to evaluate the immediate effects of the hip strap and foot orthoses on self-reported measures and lower limb kinematics during functional tasks in individuals with PFOA. The findings of this study will enable future trials to investigate the effects of these interventions in rehabilitation programmes.Trial registrationClinicalTrials.gov NCT04332900 . Registered on 3 April 2020.

Dataset Information

Effects of impairment-based exercise on performance of specific self-reported functional tasks in individuals with knee osteoarthritis.

Publications

Effects of impairment-based exercise on performance of specific self-reported functional tasks in individuals with knee osteoarthritis.

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