In rural Tibet, the prevalence of lower limb pain, especially knee pain, is high: An observational study

School of Population Health, The University of Queensland, Brisbane, QLD, Australia.
Journal of physiotherapy (Impact Factor: 3.71). 12/2010; 56(1):49-54. DOI: 10.1016/S1836-9553(10)70054-0
Source: PubMed

ABSTRACT What is the point prevalence and 12-month prevalence of lower limb musculoskeletal pain in rural Tibet? Does this differ with gender or age? What factors that could contribute to lower limb musculoskeletal pain are commonly present?
Observational study using an investigator-administered questionnaire and observation walks through villages.
499 people aged 15 years and over living in 19 rural villages of Shigatse Municipality, Tibet.
The point prevalence of lower limb musculoskeletal pain was 40% (95% CI 34 to 46) while the 12-month prevalence was 48% (95% CI 42 to 54). In particular, the point prevalence of knee pain was 25% (95% CI 20 to 30) and the 12-month prevalence was 29% (95% CI 23 to 35), which was significantly higher than at any other site in the lower limb. On average, being female was not associated with lower limb musculoskeletal pain either currently (OR 1.3, 95% CI 0.9 to 1.9) or over the previous 12 months (OR 1.2, 95% CI 0.9 to 1.8), whereas being older than 50 years was, both for current pain (OR 4.1, 95% CI 2.8 to 6.1) and pain over the previous 12 months (OR 4.0, 95% CI 2.7 to 6.0). Observation walks through the villages revealed people squatting for sustained periods, carrying heavy loads for long distances, wearing poor quality footwear, and with severe bowing of the legs but no obesity.
Lower limb musculoskeletal pain, particularly knee pain, is common in this rural Tibetan population. They live an extremely arduous life that appears to place considerable pressure on their knees.

Download full-text


Available from: Damian Hoy, Sep 12, 2015
7 Reads
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Worldwide, osteoarthritis (OA) is estimated to be the fourth leading cause of disability. Most of this disability burden is attributable to the involvement of the hips or the knees. OA is strongly associated with ageing and the Asian region is ageing rapidly. Further, OA has been associated with heavy physical occupational activity, a required livelihood for many people living in rural communities in developing countries. Unfortunately, joint replacement surgery, an effective intervention for people with severe OA involving the hips or knees, is inaccessible to most people in these regions. On the other hand, obesity, another major risk factor, may be less prevalent, although it is on the increase. Determining region-specific OA prevalence and risk factor profiles will provide important information for planning future cost-effective preventive strategies and health care services. An update of what is currently known about the prevalence of hip and knee OA from population-based studies conducted in the Asian region is presented in this review. Many of the recent studies have conducted comparisons between urban and rural areas and poor and affluent communities. The results of Asian-based studies evaluating risk factors from population-based cohorts or case-control studies, and the current evidence on OA morbidity burden in Asia is also outlined.
    International Journal of Rheumatic Diseases 05/2011; 14(2):113-21. DOI:10.1111/j.1756-185X.2011.01608.x · 1.47 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Chronic diseases account for most of the disease burden in low- and middle-income countries, particularly those in Asia. We reviewed literature on chronic disease risk factors in Viet Nam to identify patterns and data gaps. All population-based studies published from 2000 to 2012 that reported chronic disease risk factors were considered. We used standard chronic disease terminology to search PubMed and assessed titles, abstracts, and articles for eligibility for inclusion. We summarized relevant study information in tables listing available studies, risk factors measured, and the prevalence of these risk factors. We identified 23 studies conducted before 2010. The most common age range studied was 25 to 64 years. Sample sizes varied, and sample frames were national in 5 studies. A combination of behavioral, physical, and biological risk factors was studied. Being overweight or obese was the most common risk factor studied (n = 14), followed by high blood pressure (n = 11) and tobacco use (n = 10). Tobacco and alcohol use were high among men, and tobacco use may be increasing among Vietnamese women. High blood pressure is common; however, people's knowledge that they have high blood pressure may be low. A high proportion of diets do not meet international criteria for fruit and vegetable consumption. Prevalence of overweight and obesity is increasing. None of the studies evaluated measured dietary patterns or total caloric intake, and only 1 study measured dietary salt intake. Risk factors for chronic diseases are common in Viet Nam; however, more recent and context-specific information is required for planning and monitoring interventions to reduce risk factors and chronic disease in this country.
    Preventing chronic disease 01/2013; 10(1):E05. DOI:10.5888/pcd10.120067 · 2.12 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Musculoskeletal (MSK) conditions cause an enormous global burden, and this is dramatically increasing in developing countries, particularly due to rapidly ageing populations and increasing obesity. Many of the global non-communicable disease (NCD) initiatives need to expand beyond the traditional ‘top four’ NCD groups by incorporating MSK diseases. It is critical that MSK initiatives in developing countries integrate well with health systems, rather than being stand-alone. A better inclusion of MSK conditions will avoid doubling of efforts and wasting of resources, and will help to promote a more streamlined, cost-effective approach. Other key opportunities for action include the following: ensuring the principles of ‘development effectiveness’ are met; strengthening leadership and commitment; building the research,information and evidence base; and reducing the incidence and disability of MSK conditions through better prevention. Each of these elements is necessary to mitigate and reduce the growing burden from the MSKs.
    Best practice & research. Clinical rheumatology 06/2014; 28(3). DOI:10.1016/j.berh.2014.07.006 · 2.60 Impact Factor
Show more