The older worker with osteoarthritis of the knee

ArticleinBritish Medical Bulletin 102(1):79-88 · April 2012with18 Reads
DOI: 10.1093/bmb/lds011 · Source: PubMed
Abstract
Changing demographics mean that many patients with large joint arthritis will work beyond traditional retirement age. This review considers the impact of knee osteoarthritis (OA) on work participation and the relation between work and total knee replacement (TKR). Two systematic searches in Embase and Medline, supplemented by three systematic reviews. Probably, although evidence is limited, knee OA considerably impairs participation in work (labour force participation, work attendance and work productivity). AREAS OF UNCERTAINTY/RESEARCH NEED: Little is known about effective interventions (treatments, work changes and policies) to improve vocational participation in patients with knee OA; or how type of work affects long-term clinical outcomes (e.g. pain, function and the need for revision surgery) in patients with TKRs. The need for such research is pressing and opportune, as increasing numbers of patients with knee OA or TKR expect to work on.
    • "As osteoarthritis (OA) is the most common joint disease worldwide, the individual and societal consequences in terms of musculoskeletal pain, disability and socioeconomic costs are substantial [2, 12]. Patients having knee OA suffer from pain and function impairments that hamper participation in daily activities [15] and participation in work [23] . At the end stage of the disease, the knee replacement surgery is the most common and effective treatment to reduce pain and improve functionality [7]. "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose The benefits of preoperative training programmes compared with alternative treatment are unclear. The purpose of this study was to evaluate the effectiveness of a high-intensity preoperative resistance training programme in patients waiting for total knee arthroplasty (TKA). Methods Forty-four subjects (7 men, 37 women) scheduled for unilateral TKA for osteoarthritis (OA) during 2014 participated in this randomized controlled trial. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Physical Functioning Scale of the Short Form-36 questionnaire (SF-36), a 10-cm visual analogue scale (VAS), isometric knee flexion, isometric knee extension, isometric hip abduction, active knee range of motion and functional tasks (Timed Up and Go test and Stair ascent–descent test) were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3) and finally 3 months after TKA (T4). The intervention group completed an 8-week training programme 3 days per week prior to surgery. Results Isometric knee flexion, isometric hip abduction, VAS, WOMAC, ROM extension and flexion and all the functional assessments were greater for the intervention group at T2, T3 and T4, whereas isometric knee extension was greater for this group at T2 and T4 compared with control. Conclusion The present study supports the use of preoperative training in end-stage OA patients to improve early postoperative outcomes. High-intensity strength training during the preoperative period reduces pain and improves lower limb muscle strength, ROM and functional task performance before surgery, resulting in a reduced length of stay at the hospital and a faster physical and functional recovery after TKA. The present training programme can be used by specialists to speed up recovery after TKA. Level of evidence I
    Article · Jan 2016
    • "We designed a 36-item self-administered questionnaire regarding knowledge of knee OA from literatures and proven hypotheses. Validated items on risk factors [14, 16, 19, 21, 30, 36, 37,394041454647, signs and symptoms [8, 13, 14, 18, 48], disabilities [8, 14, 21], and prevention and management [17, 22,26272829303132 extracted from previous studies were conjugated as knowledge scales in the present study. The questionnaire was first piloted among 50 railway workers and slightly modified according to their comments. "
    [Show abstract] [Hide abstract] ABSTRACT: . Symptomatic knee osteoarthritis, an ancient malady greatly impairing modern population quality of life, has stimulated global attention to find effective modes of prevention and intervention. Purpose . This study aimed to assess factors affecting knowledge of symptomatic knee osteoarthritis (knee OA) among Malaysian railway workers. Methods . A cross-sectional study was conducted among 513 railway workers involving eight major states within Peninsular Malaysia using population-based sampling. The assessment instrument was a face-validated, prepiloted, self-administered instrument with sociodemographics and knowledge items on knee OA. Results . Mean (±SD) age of the respondents was 41.4 (±10.7), with the majority aged 50 years or older (34.9%). Of the total respondents, 53.6% had low levels of knowledge of knee OA disease. Multivariate analysis found that four demographic predictors, age ≥50 years, family history of knee OA, self-awareness, and clinical diagnosis of the disease entity, were significantly associated with knowledge scores. Conclusion . The finding of a low level knee OA knowledge among Malaysian railway workers points to an urgent need for massive information to be disseminated among the workers at risk to foster primary prevention and self-care.
    Full-text · Article · Feb 2014
    • "PROMs like the KOOS [7] and Oxford [8] score have been widely used to test the effectiveness of surgical interventions in decreasing complaints but do not ask specific activities performed mostly at work. Little is known about the impact of TKA on patients' reintegration into the workplace [2,3]. Nine studies have reported to some extent at what point in time patients return to work242526272829303132. "
    [Show abstract] [Hide abstract] ABSTRACT: The Work, Osteoarthritis or joint-Replacement Questionnaire (WORQ) was developed to assess physical difficulty experienced in work before or following total knee arthroplasty (TKA). Thirteen questions were designed. The WORQ was tested for internal consistency by factor analysis, internal reliability (Crohnbach's α), and construct validity. A test-retest reproducibility was performed for analyzing standard error of measurement (SEM agreement), reliability (ICC) and smallest detectable change (SDC) in individuals and groups. Lastly responsiveness (standardized response means [SRM]), floor and ceiling effects and interpretability (minimal important change [MIC]) were analyzed. It is shown that the WORQ is a reliable, valid and responsive questionnaire that can be used to evaluate the impact of knee complaints following TKA on patients' ability to work.
    Full-text · Article · Jan 2014
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