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Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7?years in community-dwelling older adults with hand pain.

ABSTRACT: BACKGROUND:To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7?years compared with progression determined from radiographs, clinical features and change in symptoms. METHODS:Participants were community-dwelling older adults (?50?years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7?years, and hand joints graded for OA severity using an established photographic atlas. Radiographic hand OA was assessed using the Kellgren and Lawrence grading system. Hand examination determined the presence of nodes, bony enlargement and deformity. Symptoms were reported in self-complete questionnaires. Radiographic and clinical progression and change in symptoms were compared to photographic progression. Differences were examined using analysis of covariance and Chi-Square tests. RESULTS:Of 253 individuals (61% women, mean age 63?years) the proportion with photographic progression at the joint and joint group-level was higher in individuals with radiographic or clinical progression compared to those without, although differences were not statistically significant. At the person-level, those with moderate photographic progression over 7?years had significantly higher summed radiographic and clinical scores (adjusted for baseline scores) compared to those with no or mild photographic progression. Similar findings were observed for change in symptoms, although differences were small and not statistically significant. CONCLUSION:Assessing hand OA on photographs shows modest longitudinal construct validity over 7?years compared with change in radiographic and clinical hand OA at the person-level. Using photographs to assess overall long-term change in a person with hand OA may be a reasonable alternative when hand examinations and radiographs are not feasible.

SUBMITTER: Marshall M

PROVIDER: S-EPMC6815403 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain.

Marshall Michelle M Jonsson Helgi H Helgadottir Gudrun P GP Nicholls Elaine E Myers Helen H Jansen Victoria V van der Windt Danielle D

BMC musculoskeletal disorders 20191027 1

<h4>Background</h4>To determine the longitudinal construct validity of assessing hand OA progression on digital photographs over 7 years compared with progression determined from radiographs, clinical features and change in symptoms.<h4>Methods</h4>Participants were community-dwelling older adults (≥50 years) in North Staffordshire, UK. Standardized digital hand photographs were taken at baseline and 7 years, and hand joints graded for OA severity using an established photographic atlas. Radiogr ...[more]

PMID: 31656178

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Project description:IntroductionWrist and hand represent the third most common body part in work-related injuries, being associated with long-term absenteeism. Telerehabilitation can promote access to treatment, patient adherence, and engagement, while reducing health care-related costs.ObjectiveReport the results of a fully remote digital care program (DCP) for wrist and hand pain (WP).MethodsA single-arm interventional study was conducted on individuals with WP applying for a DCP. Primary outcome was the mean change in the Numerical Pain Rating Scale after 8 weeks (considering a minimum clinically important change of 30%). Secondary outcomes were: disability (Quick Disabilities of the Arm, Shoulder, and Hand questionnaire), analgesic intake, surgery intention, mental health (patient health questionnaire [PHQ-9] and generalized anxiety disorder [GAD-7]), fear-avoidance beliefs (FABQ-PA), work productivity and activity impairment, and engagement.ResultsFrom 189 individuals starting the DCP, 149 (78.8%) completed the intervention. A significant pain improvement was observed (51.3% reduction (2.26, 95% CI 1.73; 2.78)) and 70.4% of participants surpassing minimum clinically important change. This change correlated with improvements in disability (52.1%), FABQ-PA (32.2%), and activities impairment recovery (65.4%). Improvements were also observed in other domains: surgery intent (76.1%), mental health (67.0% in anxiety and 72.7% in depression), and overall productivity losses (68.2%). Analgesic intake decreased from 22.5% to 7.1%. Mean patient satisfaction score was 8.5/10.0 (SD 1.8).ConclusionsThese findings support the feasibility and utility of a fully remote DCP for patients with WP. Clinically significant improvements were observed in all health-related and productivity-related outcomes, alongside very high patient adherence rates and satisfaction. This study strengthens that management of WP is possible through a remote DCP, decreasing access barriers and potentially easing health care expenditure.

Project description:BACKGROUND:The purpose of this study was to examine the differences of timewise changes in life-space mobility between elderly people living alone and those living with others among community-dwelling elderly people from a day care facility with a rehabilitation service for seniors. METHODS:The present study used a longitudinal design with repeated measures every 3?months. In conformity with our inclusion criteria, this study included 233 community-dwelling elderly users of a day care facility with rehabilitation services for seniors in Japan. We analyzed the life-space assessment (LSA) scores collected at five time points (baseline, 3?months, 6?months, 9?months, and 12?months) using mixed-effects models with random intercepts and slopes over time. In the present study, the explanatory variables of interest were time, and living situation (living alone or with others). As possible confounders, we considered the following: (a) age, (b) sex, (c) social frailty, (d) physical frailty, (e) mild cognitive impairment (MCI), (f) depression, and (g) economic satisfaction. RESULTS:The mean age of participants was 78.9?years (SD?=?7.7), their mean LSA score was 60.1 points (SD?=?25.7), and 42.9% of the participants were men. After adjusting for age, gender, frailty, depression, MCI, and economic satisfaction, the mean LSA score of older adults who lived with others was significantly lower (7.42 points, 95%CI?=?-?18.30 to -?0.15, p?=?0.048) than that older adults who lived alone. DISCUSSION:Community-dwelling older adults who used a day care center with rehabilitation services and lived with others had a smaller life-space at baseline than those who lived alone. This suggests that there is a need to pay more attention to social frailty among both older adults who live alone and those who live with others. CONCLUSIONS:According to a multilevel analysis growth model, elderly persons who lived with others had significantly lower life-space mobility than those who lived alone.

Dataset Information

Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7?years in community-dwelling older adults with hand pain.

Publications

Longitudinal validity of using digital hand photographs for assessing hand osteoarthritis progression over 7 years in community-dwelling older adults with hand pain.

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