Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

Objective. To evaluate the efficacy on physical functioning and safety of tailored exercise therapy in patients with knee osteoarthritis (OA) and comorbidities. Methods. In a randomized controlled trial, 126 participants were included with a clinical diagnosis of knee OA and at least 1 of the following target comorbidities: coronary disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, or obesity (body mass index ‡30 kg/m 2 ), with severity score ‡2 on the Cumulative Illness Rating Scale. The intervention group received a 20-week, individualized, comorbidity-adapted exercise program consisting of aerobic and strength training and training of daily activities. The control group received their current medical care for knee OA and were placed on a waiting list for exercise therapy. Primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index, subscale physical functioning (WOMAC-pf), and the 6-minute walk test (6MWT). Measurements were performed at baseline, after 20 weeks (directly posttreatment), and at 3 months posttreatment. Results. Statistically significant physical functioning differences over time were found between the intervention and control group (WOMAC: B 5 27.43 [95% confidence interval (95% CI) 29.99, 24.87], P < 0.001; and 6MWT: B 5 34.16 [95% CI 17.68, 50.64], P < 0.001) in favor of the intervention group. At 3 months followup, the mean improvements in the intervention group were 33% on the WOMAC scale and 15% on the 6MWT. These improvements are of clinical relevance. No serious adverse events occurred during the intervention. Conclusion. This is the first study showing that tailored exercise therapy is efficacious in improving physical functioning and safe in patients with knee OA and severe comorbidities.

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“…Comorbidity is present in 68-85% of patients with OA (6)(7)(8). Frequently, more than 1 comorbid disease is present (8).…”

Section: Introductionmentioning

confidence: 99%

“…Frequently, more than 1 comorbid disease is present (8). Common comorbidities in knee OA are cardiovascular diseases, type 2 diabetes mellitus, chronic obstructive pulmonary disease (COPD), and obesity (9).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial

MSc

Leeden

Cheung

et al. 2017

Arthritis Care & Research

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110

100

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“…The prevalence of CV disease in OA was found to be approximately 55% [4,5]. The reported prevalence of HT in OA was 40% in one study [6] and 75% in another [7].…”

Section: Introductionmentioning

confidence: 99%

Is the prevalence of arterial hypertension in rheumatoid arthritis and osteoarthritis associated with disease?

et al. 2012

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Objective. In this study, we compare the prevalence of HT in RA and OA patients, exposed to high-and low-grade chronic inflammation, respectively , to assess the possible association between chronic inflammation and HT. Methods.A total of consecutive 627 RA and 352 OA patients were enrolled in this multicentric study. HT was defined as a systolic blood pressure (BP) ≥140 and/or diastolic BP ≥90 mmHg or current use of any antihypertensive drug. Overweight/obesity was defined as body mass index (BMI) ≥25, and patients ≥65 years old were considered elderly.Results. The prevalence of HT was higher in the OA group than in the RA group [73.3% (95%CI 68.4, 77.7) and 59.5% (95%CI 55.6, 68.4) P<0.001 respectively]. When the results were adjusted for age and BMI the HT prevalence was similar in both groups [RA 59%(95%CI 55.1, 63.8) OA 60%(95%CI 58.4, 65.0)]. In both groups, the prevalence of HT was higher in the elderly and those who were overweight than in the younger patients and those with a BMI <25 .Overweight (BMI ≥25) and age ≥65 were independent predictors of HT in multivariate logistic regression model, which show no association of HT and the disease (RA or OA). Conclusion.The results indicated a robust association of age and BMI with HT prevalence in both RA and OA. The difference in HT prevalence between RA and OA is rather due to age and BMI then to features of the disease, putting into question specific association of HT with RA.

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“…Women show, in general, a greater risk of prevalent OA and more severe symptoms, particularly after menopausal age (Srikanth et al, 2005). OA is a leading cause of disability and decreased quality of life, as it produces important functional limitations in daily activities (Elliot et al, 2007;van Dijk et al, 2008;Salaffi et al, 2005). The socioeconomic burden of the condition is immense and is not only the leading cause of disability in Western countries but is also responsible for a large number of physician visits, hospitalisations, and time lost from work (Kotlarz et al, 2009;Bitton, 2009).…”

Section: Introductionmentioning

confidence: 99%

Treatment Preferences in Patients with Knee or Hip Osteoarthritis: An Overview

Rivero‐Santana¹,

Perestelo‐Pérez²,

Pérez-Ramos³

et al. 2012

Osteoarthritis - Diagnosis, Treatment and Surgery

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Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee

Cited by 228 publications

References 31 publications

Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial

Efficacy of Tailored Exercise Therapy on Physical Functioning in Patients With Knee Osteoarthritis and Comorbidity: A Randomized Controlled Trial

Is the prevalence of arterial hypertension in rheumatoid arthritis and osteoarthritis associated with disease?

Treatment Preferences in Patients with Knee or Hip Osteoarthritis: An Overview

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