Prognosis of Pain and Physical Functioning in Patients With Knee Osteoarthritis: A Systematic Review and Meta‐Analysis

Abstract

Objective. To systematically summarize the literature on the course of pain in patients with knee osteoarthritis (OA), prognostic factors that predict deterioration of pain, the course of physical functioning, and prognostic factors that predict deterioration of physical functioning in persons with knee OA. Methods. A search was conducted in PubMed, CINAHL, Embase, Psych-INFO, and SPORTDiscus up to January 2014. A meta-analysis and a qualitative data synthesis were performed. Results. Of the 58 studies included, 39 were of high quality. High heterogeneity across studies (I 2 >90%) and within study populations (reflected by large SDs of change scores) was found. Therefore, the course of pain and physical functioning was interpreted to be indistinct. We found strong evidence for a number of prognostic factors predicting deterioration in pain (e.g., higher knee pain at baseline, bilateral knee symptoms, and depressive symptoms). We also found strong evidence for a number of prognostic factors predicting deterioration in physical functioning (e.g., worsening in radiographic OA, worsening of knee pain, lower knee extension muscle strength, lower walking speed, and higher comorbidity count). Conclusion. Because of high heterogeneity across studies and within study populations, no conclusions can be drawn with regard to the course of pain and physical functioning. These findings support current research efforts to define subgroups or phenotypes within knee OA populations. Strong evidence was found for knee characteristics, clinical factors, and psychosocial factors as prognostics of deterioration of pain and physical functioning.

Changes in clinical symptoms and functional disability in patients with coexisting patellofemoral and tibiofemoral osteoarthritis: a 1-year prospective cohort study

“…However, there were no significant differences between patients who completed the follow-up study and those who did not in baseline characteristics, which might indicate that data are missing at random. We confirmed that baseline knee pain intensity, which is a previously reported prognostic factor for worsening pain and disability [41], did not differ between completer and non-completer. Another important limitation is the small sample size, as the study might not have sufficient statistical power to detect a potential association between presence of PFOA and clinical outcome changes, particularly in patients with isolated medial PFOA.…”

Monitoring joint health in haemophilia: Factors associated with deterioration

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Adaptation of Ruffier’s Test for Assessment of Heart Workability of Students With Health Problems

“…It was found that in Sankt Petersburg universities such diseases are 43%; in Ryazan -more than 19%; in Homel -less than 17%; in Ulyanovsk it does not exceed 15% [20]. Some scientists found that osteoarthritis (OA) of knee joint cover 20% of world population [32,33,53].…”