CAM use among overweight and obese persons with radiographic knee osteoarthritis

BMC Complementary and Alternative Medicine (Impact Factor: 2.02). 09/2013; 13(1):241. DOI: 10.1186/1472-6882-13-241
Source: PubMed


Obesity is associated with knee pain and is an independent predictor of incident knee osteoarthritis (OA); increased pain with movement often leads patients to adopt sedentary lifestyles to avoid pain. Detailed descriptions of pain management strategies by body mass index (BMI) level among OA patients are lacking. The objectives were to describe complementary and alternative medicine (CAM) and conventional medication use by BMI level and identify correlates of CAM use by BMI level.
Using Osteoarthritis Initiative baseline data, 2,675 patients with radiographic tibiofemoral OA in at least one knee were identified. Use of CAM therapies and conventional medications was determined by interviewers. Variables included SF-12, CES-D, Western Ontario and McMaster Universities Osteoarthritis Index, and Knee injury and Outcomes in Osteoarthritis Score quality of life. Multinomial logistic regression models adjusting for sociodemographic and clinical factors provided estimates of the association between BMI levels and treatment use; binary logistic regression identified correlates of CAM use.
BMI was inversely associated with CAM use (45% users had BMI >=35 kg/m2; 54% had BMI <=25 kg/m2), but positively associated with conventional medication use (54% users had BMI >=35 kg/m2; 35.1% had BMI <=25 kg/m2). Those with BMI >=30 kg/m2 were less likely to use CAM alone or in combination with conventional medications when compared to patients with BMI <=25 kg/m2.
CAM use is common among people with knee OA but is inversely associated with BMI. Understanding ways to further symptom management in OA among overweight and obese patients is warranted.

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Available from: Rachel Jawahar, Mar 19, 2014
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    ABSTRACT: The aim of the study was to evaluate the impact of BMI on the early outcomes of total knee arthroplasty in patients with primary osteoarthritis of the knee. The study involved a group of 59 patients who were examined twice. Patients were divided into 3 groups on the basis of their BMI (G1: BMI < 29.99 kg/m2; G2: BMI 30.00-34.99 kg/m2; G3: BMI > 35.00 kg/m2). A 10-point visual analogue scale (VAS) was used to assess the severity of pain in the affected knee joint (pre- and post-surgery). The WOMAC questionnaire was used to assess the functional status of the patient. The highest values of a correlation index (r) were observed for the correlations between the BMI and WOMAC questionnaire scores for pain (r = 0.55), the level of physical activity (r = 0.47) and the total score (r = 0.56). 1. Increased body weight and a high BMI (above 35.00 kg/m2) influence the level of pain severity in the operated knee joint and physical activity of the patient after the surgery. 2. The results indicate the need for further evaluation of BMI as a prognostic factor in the planning of physiotherapy in patients treated for idiopathic osteoarthritis of the knee joint after total knee arthroplasty.
    Full-text · Article · Apr 2015