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Khoja, Latif. "Hip and knee frontal plane biomechanics in people with medial compartment knee osteoarthritis." Thesis, Kingston, Ont. : [s.n.], 2008. http://hdl.handle.net/1974/1054.
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Swift, Amelia. "A clinical study exploring hip and knee osteoarthritis pain transmission using cerebrospinal fluid." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3691/.
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Background: Osteoarthritis affects approximately 40% of older adults but molecular mediation of OA pain in the dorsal horn is unexplored clinically. This study explored amino acids and cytokines related to pain signalling and sensitisation to determine whether significant differences existed in their concentration in comparison with pain-free controls after adjustment for age, gender and psychological distress. Method: After ethical approval people having primary hip or knee arthroplasty (OA group) or urological surgery (pain-free controls) were recruited. Pain at rest, (PAR), pain on movement (POM) (0-10 numerical rating scale), and HADS data was collected before aspiration of 2ml sample of CSF. HPLC and multiplex bead array assay was conducted and data explored using ANCOVA and logistic regression. Results: Data from 21 control (75% male) and 59 OA (46% male) participants revealed that HADS, serine, leucine, valine, and TNFα were significantly higher and IL-12 was significantly lower in the OA group. IFNγ was significantly lower in the PAR group. Discussion: This study suggests central sensitisation is involved in OA. Psychological distress is an integral part of the OA experience. Amino acid and cytokine involvement in pain transmission is complex; further work exploring human CSF in painful conditions with clinical follow up is recommended.
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Stephens, Matthew Jon Craig. "Study of toll-like receptor expression and activity in hip and knee osteoarthritis." Thesis, University of Brighton, 2016. https://research.brighton.ac.uk/en/studentTheses/7dcf2464-c0a2-43f2-89b0-2c3378125d3c.
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The Toll-like receptors (TLRs) are a family of highly conserved pattern recognition receptors involved in the detection of pathogenic invasion and tissue damage. Activation of TLRs can occur through binding to pathogen associated molecular patterns (PAMPs) but also host derived damage associated molecular patterns (DAMPs), which are highly abundant in the OA joint (Sokolove and Lepus, 2013). Originally thought of as a disease of wear and tear, osteoarthritis (OA) is better described as a disease of chronic inflammation, with the production of pro-inflammatory and degenerative products perpetuating disease activity. Resident joint cells can react through TLRs to these damage products and thereby induce the production and secretion of pro-inflammatory cytokines and matrix degradative enzymes. This study sought to identify TLR expression and activity within synovial fibroblasts categorised by joint location and cartilage sub-categorised by OA progression. TLR induced pro-inflammatory cytokine induction from these cells along with matrix degenerative enzyme production was analysed to determine the pathogenic contribution of the cell types. Significant differences in expression of TLR2, TLR3 and TLR4 were noted between hip and knee derived synovial fibroblasts. Increased expression correlated to a higher pro-inflammatory cytokine production from knee opposed to hip derived synovial fibroblasts. This difference in inflammatory cytokines production comparing knee to hip became even more apparent when observing spontaneous production from synovial membrane cultures that demonstrated TNF, IL-6 and IL-8 to be significantly higher in cultures from the knee opposed to hip. Knee synovial fluid was also noted to have a significantly lower level of MMP1 compared with hip derived samples supporting a hypothesis that knee and hip osteoarthritis pathogeneses may differ. Analysis of articular chondrocytes at different stages of disease progression demonstrated altered phenotypes. Chondrocytes isolated from regions of degeneration had an altered TLR expression pattern and subsequently produced significantly elevated IL-6 and MMP13 following TLR stimulation relative to those isolated from intact regions of cartilage. These data suggest that TLR-induced cytokine secretion by synovial fibroblasts and chondrocytes potentially contribute to disease pathology and hypothetically have two separate phenotypes of disease progression. It also highlights the possible need for tailored treatment of OA dependent on joint location providing some explanation of differences in efficacy of trialled biologic therapies.
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Protopapadaki, Anastasia. "Biomechanical analysis of stair climbing and gait : impact of hip and knee osteoarthritis." Thesis, University of East London, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.487404.
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Background and purpose: The ability to perfonn everyday activities is essential for maintaining independence in daily life. A number of studies have reported the effect of hip and knee osteoarthritis (OA) on biomechanical characteristics of the lower limb during gait. There is a dearth of studies reporting biomechanical analysis of stair climbing in OA subjects, particularly those with hip OA. Thet:efore, the pwpose ofthis study was to investigate the impact of hip and knee OA on the biomechanical characteristics ofhip, knee and ankle joints during stair climbing and gait. Methods: Three age matched groups (range 50-75 years) participated in this study: control group, hip OA group and knee OA group. The laboratory staircase consisted of 4 steps (rise height 18 cm, tread length 28.5 em). Sagittal joint angles, vertical ground reaction forces, sagittal joint moment, and EMG activity of lower limb muscles were recorded using 3D Vicon motion analysis system, Bertec force plates and Telemetry EMG. . Results: Both hip and knee OA subjects moved with significantly (p<0.05) slower speed during gait, stair ascent and stair descent which were accompanied with alterations in lower limb kinematics, kinetics and EMG activity in comparison to the controls. Hip OA subjects showed a significant (p
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Brunton, Luke R. "Assessing functional ability in patients with severe hip and knee osteoarthritis : an assessment of measures of function in hip and knee joint replacement." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.686424.
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Introduction/Background: Outcomes assessment in orthopaedics has advanced over the last decade. There are various different methods that can be used in a clinical setting to assess function and pain. During a clinical consultation, a simple, quick and restricted history, examination and review of investigations can be undertaken. Aim: I wished to ascertain whether function improved as a result of knee or hip joint replacement, and which of the commonly used existing methods of assessing function are of most value in this context. Methods: To achieve this aim, I recruited a broad spectrum of patients about to undergo primary or revision surgery for hip (n=42) or knee (n=51) joint disease. The study design was an observational cohort study, with data collection points pre-operatively and at 3 months post-operatively. Results: Most participants had less pain and better function 3 months after surgery than pre-operatively. However, the mean scores obscured the fact that several participants showed no improvement or worsening on some of the scores. Participants with the worst functional scores at baseline were most likely to improve. Performance tests showed less overall improvement than self-assessment measures. Overall walking times correlate well with all the other scores, with the exception of the Short Form-12 mental component score and American Knee Society Knee Score. However, in hip participants those with the best Harris Hip Scores did not have the best walking times, or the best Western Ontario and McMaster Arthritis Index or best Short Form-12 scores. Flexion beyond 90 degrees did not correlate with functional scores at the hip. Both inter and intra-rater reliability findings were good for both the Harris Hip Score and American Knee society score. Conclusions: Differences are identified in the outcome between different health status instruments commonly used in assessing function by self report questionnaires, surgeon based and performance based assessments. More research is needed to identify either the best method or more likely different instruments to identify important specific domains after hip and knee joint surgery.
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Werkner, Janet Elaine. "Measuring the family helper costs of disabling osteoarthritis of the hip or knee in older persons." Case Western Reserve University School of Graduate Studies / OhioLINK, 1990. http://rave.ohiolink.edu/etdc/view?acc_num=case1054748702.
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Goldsmith, Andrew Alan John. "Biphasic modelling of synthetic articular cartilage." Thesis, University of Bath, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.321846.
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Sanders, Caroline. "Explaining, experiencing and treating osteoarthritis of the hip and knee : perspectives of patients and GPs." Thesis, University of Bristol, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.424062.
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de, Flon Peter. "Långdistanslöpning och artros : En systematisk litteraturstudie." Thesis, Gymnastik- och idrottshögskolan, GIH, Institutionen för idrotts- och hälsovetenskap, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:gih:diva-3359.
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Sammanfattning Syfte och frågeställningar Syftet med denna studie var att sammanställa kvalitet på och resultat av studier som undersökt om långdistanslöpning ger artros i höft-, knä- eller fotleder. Finns det vetenskaplig evidens för att långdistanslöpning ger artros i höft-, knä- eller fotleder? Vilka styrkor och svagheter har de studier som försökt utröna om samband finns mellan långdistanslöpning och artros i höft-, knä- eller fotleder? Metod Sökning av litteratur utfördes i PubMed, CINAHL, Cochrane Library och PEDro. Detta resulterade i att tio artiklar inkluderades för närmare granskning och sammanställning. Utifrån artiklarnas sammantagna bevisvärde poängsattes och graderades artiklarna efter evidensnivå enligt Statens Beredning för medicinsk Utvärderings (SBU) granskningsmallar för kohortstudier med kontrollgrupper. Resultat Endast en av tio studier visar ett positivt samband mellan långdistanslöpning och artros i höft-, knä- eller fotleder, i detta fall höftledsartros. Studierna har ingen tydlig och gemensam definition över vad långdistanslöpning är. De granskade studierna använder sig av olika mätmetoder för att bedöma leddegenerationen, både av självrapportering och av olika diagnostiska kriterier för artros. Alla studier har inslag av selektionsbias. Slutsats En indikation på att det inte finns ett vetenskapligt stöd för att långdistanslöpning ger höft-, knä- eller fotledsartros hos människor. Studierna har brister i hantering av confounders och selektionsbias och bedöms vara av låg eller medelhög kvalitet.Abstract Aim The purpose of this study was to compile the quality and results of studies that examined if long-distance running gives osteoarthritis of the hip, knee or ankle joints. Is there scientific evidence that long-distance running gives osteoarthritis of the hip, knee or ankle? What strengths and weaknesses of the studies attempted to determine if the link between long-distance running and osteoarthritis of the hip, knee or ankle joints. Method Search of the literature was performed in PubMed, CINAHL, Cochrane Library, and PEDro. This resulted in ten articles that were included for further review and compilation. Based on the articles combined probative value was scored and graded articles for level of evidence according to the National Council on Technology Evaluation (SBU) examination templates for cohort studies with control groups. Results Only one of the ten studies showed a positive association between long distance running and osteoarthritis of the hip, knee or ankle joints, in this case hip joint. The studies have not a clear and common definition of what long-distance running is. The studies reviewed use different metrics to assess joint degeneration, both by self-report and of different diagnostic criteria for osteoarthritis. All studies have an element of selection bias. Conclusion An indication that there is no scientific evidence that long-distance running gives hip, knee or ankle osteoarthritis in humans. The studies were inadequate handling of confounders and selection bias and judged to be of low or medium quality.
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Klinger, Lea Elisabeth. "Occupational adaptation to pain in community dwelling elderly with osteoarthritis of the hip and/or knee." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq21092.pdf.
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Gibson, Clare Naomi. "The effect of personality on recovery from total hip replacement and total knee replacement in patients with osteoarthritis." Thesis, University of Sheffield, 2007. http://etheses.whiterose.ac.uk/6097/.
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Background: Total hip replacement (THR) and total knee replacement (TKR) are increasingly common procedures to treat the pain and disability associated with osteoarthritis. There is a large variability in time to achieve functional milestones following these procedures and of success of surgery measured by pain and functional ability. Factors which affect outcome are poorly understood, but research in health psychology suggests psychological variables may play an important role. Objectives: To explore the relationships between selected psychological variables with pain and function pre-operatively in patients awaiting THR and TKR, on achievement of key functional milestones as an inpatient post-operatively, and of pain and function three-months post-operatively. Design: A correlational study of patients undergoing primary unilateral THR and TKR as a result of osteoarthritis. Subjects: 105 THR, 70 TKR. Psychological Measures: NEO-Five Factor Inventory, Multi-dimensional Health Locus of Control Questionnaire, Coping Strategies Questionnaire. Outcome Measures: Oxford Hip Score, Harris Hip Score, Oxford Knee Score, Knee Society Knee Score, key functional physiotherapy milestones. Results: Hip Study: Catastrophizing was a significant predictor of greater pain and worse function both pre-and post-operatively. Pain control efficacy was predictive of less pain and better function pre- and post-operatively. In addition, conscientiousness was a predictor of worse pre-operative function. Few psychological variables were predictive of physiotherapy outcome measures. Knee Study: Neuroticism was found to be a predictor of worse pain both pre- and post- operatively. Pre-operatively openness to experience was predictive of less pain and better function. Post-operatively, a chance locus of control was predictive of worse functioning. Few psychological variables were predictive of physiotherapy outcome measures. Conclusions: Psychological variables influence pain and function both pre- and post- operatively in THR and TKR. The psychological variables may exert their actions through pain control efficacy. There is scope to develop an intervention targeting negative psychological variables and improve outcome.
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Lin, Yuzhen. "Effects of a community-based water exercise programme on elderly patients with osteoarthritis of the knee or hip." Thesis, University of Sheffield, 2001. http://etheses.whiterose.ac.uk/6050/.
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Cato, Helena. "Utvärdering av träningsmetoden Functional Moves® för patienter i ålder 30-65 år med höft- och knäsmärta : En prospektiv jämförande interventionsstudie." Thesis, Linnéuniversitetet, Institutionen för idrottsvetenskap (ID), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-55657.
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Introduktion: Artros är en folksjukdom. I Sverige har var fjärde person äldre än 45 år läkardiagnostiserad artros och förekomsten ökar med ökande antal överviktiga och äldre. Genom att upptäcka och behandla tidiga stadier av artros ger vi artros patienterna en bättre förutsättning gällande funktion och symtom. Syfte: Syftet var att undersöka om Functional Moves® är en verkningsfull behandlingsmetod avseende Quadriceps styrka, balans, knästabilitet, gångförmåga samt självskattad upplevelse av symtom som smärta, funktion och livskvalitet jämfört med konventionell individuell styrke- och rörlighetsträning för patienter med höft- och knäsmärta i åldern 30-65 år. Metod: Interventionsgruppen (n=21) testades med fysiska tester samt självskattningsformulär KOOS (Knee osteoarthritis outcome score) HOOS (Hip osteoarthritis outcome score) före åtta veckors träning med Functional Moves®. Referensgruppen (n=13) testades på samma sätt och tränade i åtta veckor, med konventionell rehab träning för höft- och knäartros. Båda grupperna utvärderades inom en vecka efter avslutad träning med samma tester. Artrosskolan ingick i både interventions- och referensgruppen. Resultat: Interventionsgruppen hade signifikant bättre resultat på alla fysiska tester förutom enbensuppresning höger. Referensgruppen hade signifikant förbättring på enbentlängdhopp bilateralt, SOLEC vänster samt sidledshopp höger. Alla testvärden förbättrades signifikant i självskattning av frågeformulären KOOS/HOOS i både interventions- och referensgruppen. Konklusion: I denna studie har Functional Moves® visat en signifikant förbättring avseende Quadriceps styrka vänster, balans, knästabilitet, gångförmåga samt mindre skattad smärta och ansträngning vid gångtest. Functional Moves® borde erbjudas patienter i primärvården framförallt för de som har en vardag som ställer större krav på höft- och knäled.Introduction: Osteoarthritis is a common disease. In Sweden, every fourth person older than 45 physician-diagnosed arthritis, and the incidence increases with increasing number of obese and the elderly by preventing, detecting and treating early stages of osteoarthritis, we osteoarthritis patients a better condition. Objective: The objective was to investigate whether the Functional Moves® is an effective treatment method in respect Quadriceps strength, balance, knee stability, walking capability and self-rated experience symptoms such as pain, function and quality of life compared with conventional individual strength and flexibility training for patients with hip and knee pain in age of 30-65 years. Method: The intervention group (n = 21) were tested with physical tests and self-assessment forms KOOS (Knee osteoarthritis outcome score) HOOS (Hip osteoarthritis outcome score) HOOS before eight weeks of training, with Functional moves®. The control group (n = 13) tested the same way and trained for eight weeks, with conventional rehabilitation training of hip and knee osteoarthritis. Both groups were evaluated within one week after training with the same tests. Osteoarthritis School was included in both the intervention and control group. Results: The intervention group had significantly better results on all the physical tests except one leg uprising right. The control group had significant improvement in one leg jump on both legs. SOLEC left and right side jump. All test values were significantly improved in the self-evaluation of the questionnaires KOOS / HOOS in both the intervention and control group. Conclusion: In this study, Functional moves® shown a significant improvement in Quadriceps strength left, balance, knee stability, walking capability and lower-rated pain and effort during a walking test. Functional Moves® should be offered to patients in primary care especially for those who have a living that put´s great demands on the hip and knee.
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Costa, Diana. "Fisioterapia em meio aquático no tratamento conservador da osteoartrite da anca e joelho: revisão de literatura." Bachelor's thesis, [s.n.], 2018. http://hdl.handle.net/10284/7020.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Recolher e sumariar a evidência científica disponível em bases de dados científicas para perceber a eficácia de técnicas de fisioterapia em meio aquático no tratamento conservador da osteoartrite da anca e/ou do joelho. Metodologia: Pesquisa computadorizada nas bases de dados PubMed / Medline, Web of Knowledge e PEDro para identificar estudos randomizados controlados que avaliam a efetividade de técnicas de fisioterapia em meio aquático no tratamento conservador da osteoartrite da anca e do joelho. Resultados: Nesta revisão foram incluídos 9 estudos, com classificação metodológica na escala de PEDro ≥ 7. Conclusão: Técnicas de fisioterapia em meio aquático verificaram-se eficazes, ainda que a maioria a curto prazo.
Objective: Collect and summarize available scientific evidence in scientific databases to realize the efficacy of physiotherapy techniques in the aquatic environment in the conservative treatment of osteoarthritis of the hip and/or the knee. Methodology: Computerized research in the databases PubMed / Medline, Web of Knowledge and PEDro for designing randomized controlled studies that evaluating a physical analysis of physiotherapy in aquatic knee treatment of osteoarthritis of ankle and knee. Results: In this review, 9 studies were included, with methodological classification in the PEDro scale ≥ 7. Conclusion: Techniques of physiotherapy in the aquatic environment were verified to do, although the majority in the short term.
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Weigl, Martin. "Long-term outcome in patients with osteoarthritis of the hip or knee after comprehensive rehabilitation: A prospective 2 year follow-up study." Diss., lmu, 2002. http://nbn-resolving.de/urn:nbn:de:bvb:19-1402.
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Van, der Linde Lavinia. "The effect of ballet exercise classes on BMI, perceived pain, physical function and quality of life in patients with osteoarthritis (OA) of the hip and knee." University of the Western Cape, 2012. http://hdl.handle.net/11394/5290.
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Magister Scientiae (Physiotherapy) - MSc(Physio)Introduction: Osteoarthritis (OA) is one of the prevalent debilitating diseases in South Africa, often leading to activity limitations, participation restrictions and a poor quality of life. Older people often lead more sedentary lifestyles, which may further aggravate their symptoms. Exercise therapy has demonstrated good outcomes in the OA population. Many dance interventions have become popular in OA treatment and results suggest their effects to be more successful than traditional physiotherapy exercises regimes. Ballet dance exercises have not yet been explored in the treatment of OA, even though it has been proposed to have positive effects on the body. Purpose: to determine the effect of a program of ballet dance exercise classes on BMI, perceived pain, physical function and quality of life in patients with osteoarthritis (OA) of the hip and knee, compared to the existing Midros Clinic program of exercise classes. Methods: The study used a randomized, cross-sectional, quantitative, experimental study using pre- and post-intervention as well as multiple time-point testing. A sample of 52 males and females were recruited in Midros, Middelburg Cape. The inclusion criteria of the study were persons aged 65 years and older, with OA of the hip and/or knee, clinically diagnosed according to the criteria of the American College of Rheumatology. The VAS, Timed Up and Go Test (TUGT), WOMAC and the SF-8 Index, respectively measured reported perceived pain, physical function, quality of life and health status in the study groups. BMI, pulse and blood pressure were also recorded to further monitor the effects of the interventions. A comparable number of scores were obtained over six weeks of bi-weekly ballet exercise classes (intervention group = IG), and nine weeks of two-weekly exercise classes at the Midros Clinic (comparison group = CG). Descriptive statistics were used to analyse the demographic information and inferential statistics were used to determine the associations for parametric data; a two tailed p-value was calculated; the 95% CI was calculated using the approximation of Katz. The p-value was classified as significant if p<0.05. Results: The demographics and baseline measurements of the IG and CG were comparable. A series of five exercise classes (over nine weeks) had a significantly beneficial effect on BMI and systolic BP, perceived and actual physical function, and QOL, whereas a series of 12 ballet exercise classes ( over six weeks) had a significant positive effect on BMI and diastolic BP, perceived pain, perceived physical function, and QOL. The comparison of responses to the outcome measures by male and female participants demonstrated that, contrary to findings in the reviewed literature, females held more positive perceptions than males on their perceived severity of joint pain and function, physical and mental health, and well being. A series of the existing exercise classes of Midros Clinic brought about more significant changes than a program of ballet exercise classes in the research parameters measured, despite exercise classes taking place much less frequently than the ballet classes. Conclusion: Although both interventions were found to both bring about positive changes in older persons with OA, a series of ballet exercises classes did not result in better outcomes than the currently existing Midros Clinic group exercise classes. The results of the current study demonstrate that exercise interventions are found to be the most beneficial in improving the quality of life of OA sufferers.
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Wang, Ping. "A pilot study to develop and validate a traditional Chinese medicine (TCM) questionnaire a health status instrument for TCM assessment in patients with Osteoarthritis (OA) of the hip or knee : a thesis submitted to Auckland University of Technology in partial fulfilment of the degree of Master of Health Science, December 2004." Full thesis. Abstract, 2004. http://puka2.aut.ac.nz/ait/theses/WangP.pdf.
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Webb, Michelle Lynn. "Analysis of Osteoarthritis on Appendicular Joint Surfaces in Known Age and Sex Samples from the Terry and Spitalfields Collections." Digital Archive @ GSU, 2010. http://digitalarchive.gsu.edu/anthro_theses/44.
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Arthritis is one of the most common manifestations of aging and is the single largest cause of disability in the UK, US, Australia, and Canada among people age 30 years and older. Osteoarthritis of appendicular joint surfaces exhibits alterations of bony tissue in and around the joint surface. The degree to which osteoarthritis of articular surfaces occurs as a function of age and sex can be resolved with cemetery populations of known individuals, such as the Terry (19-20th century) and Spitalfields (17-18th century) collections upon which I report (n = 322; 162 males and 160 females). Using the five point scoring system 0-4 of lipping from the Chicago Standards Guide I ask whether (1) age has an influence on the accumulation of OA; (2) sex differences are present in patterns of OA; and (3) population origin is responsible for explaining intensity of OA.
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Unevik, Erik. "The influence of educational attainment and immigration status on outcomes of a national self-management program for hip and knee osteoarthritis – results on 22 741 patients from the BOA register." Thesis, Stockholms universitet, Institutionen för folkhälsovetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-163480.
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Background: Supervised exercise and delivered education are first step treatment for knee, hip and hand osteoarthritis (OA) according to international guidelines. It is uncertain whether OA outcomes from participation in the Swedish self-management program “Better management of Osteoarthritis (BOA)” differs for participants with different sociodemographic background. The aim of this master thesis was thus to assess to what extent there were differences by level of education and immigration status among participants in the self-management program in terms of Health, Health-related quality of life, Mobility, Health-related behaviours and Adherence to the self-management program, measured at baseline, three and 12 months. Methods: Analysis of covariance (ANCOVA), logistic and multinomial regression was used to analyse outcomes for 22 741 participants. Results: For most adjusted outcomes, there were sociodemographic inequalities at all measurement points. However, there were no educational differences in mobility and attitude to physical activity at baseline, but at the follow-ups such inequalities emerged. Conversely, the willingness to undergo joint surgery differed by immigration status at baseline, but not at the follow-ups, and immigrants were more adherent towards the self-management program than domestic born participants. Conclusion: These results are pioneer findings showing that it exists sociodemographic differences related to OA treatment.
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Salmon, Jean-Hugues. "La prise en charge de l'arthrose des membres inférieurs ; aspect de santé publique." Thesis, Reims, 2019. http://www.theses.fr/2019REIMM201.
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L’arthrose est la maladie articulaire la plus fréquente pouvant être responsable d’une perte d’autonomie et d’un handicap fonctionnel majeur. Du fait du vieillissement de la population et de la prévalence de l’obésité, le nombre de personnes ayant une arthrose des membres inférieurs va augmenter dans les années à venir et entrainer une explosion des dépenses de santé. La cohorte « Knee and Hip OsteoArthritis Long-term Assessment » (KHOALA) est une cohorte française multicentrique représentative de patients atteints d’arthrose symptomatique de hanche et/ou de genou.Les objectifs de ce projet étaient d’établir une revue de la littérature sur les conséquences économiques de l'arthrose de hanche et/ou du genou. Puis à partir de la cohorte KHOALA, nous avons décrit la consommation de soins ; identifié les facteurs associés aux trajectoires d'utilisation des ressources de santé et estimé les coûts annuels totaux. Enfin nous avons réalisé une analyse systématique de la littérature sur les analyses coût-efficacité des anti-arthrosiques d’action lente et de l’acide hyaluronique intra articulaire dans l’arthrose de genoux.La revue systématique a objectivé une hétérogénéité des couts totaux par patient (de 0,7 à 12 k€/an). Les données de KHOALA ont démontré que la majorité des patients consultait son médecin généraliste et une minorité de patients consultait un spécialiste. Le seul facteur clinique indépendant prédictif des consultations des professionnels de la santé était l'état de santé mentale. Le coût total annuel moyen par patient sur la période d'étude de 5 ans était de 2180 ± 5 305 €. En France, les coûts médians pourraient atteindre 2 milliards € / an (IQR 0,7–4,3)Osteoarthritis is the most common joint disease that can be responsible for a loss of autonomy and a major functional disability. With the aging of the population and the prevalence of obesity, the number of people with lower limb osteoarthritis will increase in the coming years and lead to an explosion of health spending. The "Knee and Hip OsteoArthritis Long-term Assessment" cohort (KHOALA) is a representative French multicenter cohort of patients with symptomatic hip and / or knee osteoarthritis.The aims of this thesis were to provide an overview of the economic consequences of hip and knee osteoarthritis worldwide. Then from the KHOALA cohort, we described health care resources use in the KHOALA cohort, we identified factors associated with trajectories of healthcare use and we estimated the annual total costs. Finally, we conducted a systematic review of the literature on the cost effectiveness of intra-articular hyaluronic acid and disease-modifying osteoarthritis drugs used in the treatment of knee OA.The systematic review showed a heterogeneity of the total costs per patient (from 0.7 to 12 k € / year). KHOALA data showed that primary care physicians have a central role in osteoarthritis care, mental health state was the only independent predictive factor of healthcare professional consultations. The mean annual total cost per patient over 5 years was 2180 ± 5,305 €. In France, median annual total costs would be approximately 2 billion €/year (IQR 0.7-4.3)
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Ornetti, Paul. "Validation transculturelle des critères d'évaluation rapportés par le patient dans l'arthrose des membres inférieurs." Phd thesis, Université de Bourgogne, 2010. http://tel.archives-ouvertes.fr/tel-00589347.
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Dans les pathologies ostéo-articulaires, les critères d'évaluation rapportés par les patients (Patient-Reported Outcomes ou PROs) sont désormais les critères de jugement incontournables, réclamés par les autorités sanitaires et les organismes de régulation. La validation de leurs propriétés psychométriques et leur adaptation transculturelle sont donc indispensables pour pouvoir les utiliser dans les essais thérapeutiques internationaux. Ce processus complexe de validation transculturelle permet d'élaborer une version du PRO dans le langage cible qui prenne en considération tous les spécificités socioculturelles et les équivalences linguistiques.Ce travail de thèse a comme problématique la validation transculturelle des PROs spécifiquement développés pour les pathologies du genou et de la hanche. Après avoir explicité les recommandations publiées dans ce domaine puis avoir réalisé une revue de la littérature de la qualité méthodologique des auto-questionnaires disponibles pour ces pathologies articulaires, nous avons entrepris les validations transculturelles du questionnaire KOOS (ou Knee injury and Osteoarthritis Outcome Score), du questionnaire HOOS (ou Hip disability and Osteoarthritis Outcome Score) et de leurs formes réduites (KOOS-PS et HOOS-PS pour Physical function Short form). Ces auto-questionnaires, développés en langue anglaise au cours de la dernière décennie, permettent d'évaluer de manière globale (symptômes, retentissement fonctionnel dans les activités quotidiennes et sportives, qualité de vie) des pathologies du genou ou de la hanche, aussi bien traumatiques que dégénératives. Après traduction et adaptation française selon les recommandations internationales, les versions françaises du KOOS, du HOOS, du KOOS-PS et du HOOS-PS ont ensuite été validées de manière prospective dans des cohortes françaises bi-centriques de patients arthrosiques suivis en milieu rhumatologique et orthopédique. Les résultats de ces travaux, publiés sous la forme de trois articles originaux, démontrent que les propriétés psychométriques des versions françaises de ces questionnaires sont satisfaisantes quelle que soit la sévérité de l'arthrose, en terme de faisabilité, de cohérence interne, de reproductibilité, de validité et de sensibilité au changement (après mise en place de prothèse totale ou viscosupplémentation par acide hyaluronique). Ces PROs capturent des concepts supplémentaires pertinents, comme le retentissement sur les activités sportives ou la qualité de vie, et permettent avec le même outil de mesure le suivi longitudinal de patients, depuis l'atteinte traumatique jusqu'à l'arthrose. Ils améliorent ainsi l'évaluation globale des pathologies du genou et de la hanche. La validation exhaustive, y compris transculturelle, permet à ce jour de considérer les questionnaires KOOS et le HOOS comme des PROS de référence. A ce titre, leur utilisation dans les essais thérapeutiques internationaux doit être encouragée.
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Wieczorek, Maud. "Facteurs pronostiques de l’évolution de la santé perçue dans l’arthrose symptomatique de hanche et de genou : analyses de la cohorte KHOALA." Thesis, Université de Lorraine, 2019. http://www.theses.fr/2019LORR0182.
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L’arthrose des membres inférieurs (MI) représente un problème de santé publique en raison de sa forte prévalence et de ses conséquences en termes d’altération de la qualité de vie. Malgré cela, ses conséquences sur la qualité de vie et les facteurs pronostiques de son évolution restent mal connus. Les objectifs de cette thèse étaient donc de décrire l’évolution et les types de progression des sujets atteints d’arthrose des MI sur 5 ans en termes de santé perçue et d’identifier les facteurs pronostiques de cette évolution. Dans une première partie, nous avons réalisé et publié une revue systématique sur l’utilisation de l’analyse de trajectoires de critères de jugement cliniques pour définir des phénotypes d’évolution dans l’arthrose des MI. La multiplicité des facteurs étudiés dans les différentes études ne nous a pas permis de réaliser une synthèse quantitative de leurs rôles pronostiques. Malgré cette hétérogénéité, nous avons pu observer que les facteurs pronostiques de l’évolution de la douleur et de la fonction physique (FP) n’étaient pas identiques. Dans une seconde partie, nous avons donc modélisé simultanément l’évolution de ces 2 dimensions de la santé perçue pour mieux comprendre l'expérience globale des patients au cours de l’évolution de leur maladie et les interrelations entre ces 2 concepts. Dans cette étude, nous avons utilisé les données de la cohorte française KHOALA. Nous avons pu mettre en évidence le rôle pronostique de l’intensité de l’activité physique (AP) pratiquée mais pas celui de sa durée hebdomadaire. Dans une seconde étude, des associations entre l’intensité et le type d’AP et une trajectoire particulière de FP et entre la durée hebdomadaire de l’AP et une trajectoire de santé mentale ont pu être mises en évidence. D’après ces résultats, nous avons pu faire l’hypothèse que l’association entre les composantes de l’AP mesurées à l’inclusion et la FP des patients à 5 ans pouvait être médiée par la composition corporelle à 3 ans. Dans cette dernière partie, nous n’avons pas mis en évidence le rôle médiateur des variables relatives à la composition corporelle dans cette relation. En conclusion, notre travail de thèse a permis de synthétiser la littérature concernant la variabilité de l’arthrose des MI. Nous avons pu mettre en évidence l’existence de différents phénotypes au sein de notre population d’étude française et identifier des caractéristiques pronostiques de l’appartenance à une trajectoire de symptômes sévèresKnee and hip osteoarthritis (OA) is a public health problem because of its high prevalence, its consequences in terms of impaired quality of life and disability. Despite this, knowledge about its clinical evolution, its consequences on quality of life and the prognostic factors for its evolution remain limited. The objectives of this thesis were therefore to describe the evolution and types of progression of subjects with hip and/or knee OA over 5 years in terms of self-perceived health and to identify the prognostic factors of the evolution of these patients. In a first part, we conducted and published a systematic literature review on the use of trajectory analysis of clinical outcomes to define phenotypes in lower-limb OA. The multiplicity of factors examined in the different studies did not allow us to perform a quantitative synthesis of their respective prognostic roles. Despite this heterogeneity, we could observe that the prognostic factors of the course of pain and physical function (PF) were not exactly identical. In a second part, we therefore simultaneously modelled the evolution of these 2 dimensions of perceived health to better understand the patients' overall experience during the course of their disease and the interrelationships between these 2 concepts. To do this, we used data from the French KHOALA cohort. We highlighted the prognostic role of the physical activity (PA) intensity but we did not highlight the prognostic role of its weekly duration. In a second study, the prognostic roles of the intensity and type of PA on belonging to a particular PF trajectory and the weekly duration of the PA on belonging to a mental health trajectory could be highlighted. Based on these results, we hypothesized that the association between the baseline PA components and PF at 5 years could be mediated by body composition variables at 3 years. In this last part, the causal mediation analysis did not reveal a mediating role of body composition variables in this relationship. In conclusion, our thesis work synthesized the literature on the variability of lower-limb OA and the existence of distinct longitudinal phenotypes. We highlighted the existence of different phenotypes in our French study population and identify predictive characteristics of belonging to a severe symptom trajectory
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Robin, Joshua B. "A paleopathological assessment of osteoarthritis in the lower appendicular joints of individuals from the Kellis 2 cemetery in the Dakhleh Oasis, Egypt." Master's thesis, University of Central Florida, 2011. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/4703.
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Osteoarthritis (OA) is a degenerative pathological condition of the appendicular joints which affects the cartilage and underlying bone. OA is relatively common in both the archaeological and clinical context, and a significant amount of research has been conducted on this osteological condition. The purpose of this thesis is to assess the incidence, demographic prevalence, and general severity of hip and knee OA in a Roman-Christian period (50 A.D-450 A.D) population sample from the Dakhleh Oasis, Egypt. The bioarchaeological sample originates from the Kellis 2 cemetery which is associated with the ancient town of Kellis. The town of Kellis is believed to have been a prosperous economic hub in Egypt, located in the Western Sahara Desert approximately 250 kilometers west of the Nile. The skeletal samples (n=135, 83 females and 51 males) was visually assessed for the osteological characteristics of OA in the hips and the knees. Joint surfaces of the hip include the acetabulum and femoral head. Joint surfaces of the knee include lateral/medial tibio-femoral compartments and the patellofemoral compartment. The ages of the individuals assessed in this study range from 19-72 years, and have been divided into five age categories which were then cross-tabulated with sex and OA incidence in order to determine demographic prevalence of OA. Findings indicate that age is a significant etiological factor of OA prevalence for both males and females. Males are afflicted by the disease significantly more than females in the hips (F: (L) 3.6%, (R) 5.9% and M: (L) 13.7%, (R) 13.7%) and also slightly more affected in the knees(F: (L) 17.5%, (R) 18.3% and M: (L) 22.9%, (R)21.3%). The acetabulum tends to be more arthritic than the femoral head for both males and females. Femoral condyles tend to be more arthritic than tibial condyles for both males and females.; The patello-femoral compartment tends to be the most arthritic part of the knee while the medial condyles of both tibiae exhibit virtually no OA (with the exception of one individual). The joint surface observed with the highest OA prevalence is the femoral surface of the patella (F: (L) 17.5%, (R) 15.9% and M: (L) 21.3%, (R) 21.3%). The highest prevalence of OA by joint complex is observed on the left knee in males (22.9%), and the lowest prevalence of OA is observed on the left hip of females (3.6%). Both hip and knee joints have higher prevalence of unilateral OA manifestation than bilateral. Isotopic and archaeological evidence indicates that the individuals at Kellis maintained an agricultural subsistence regime, and that the males within the population may have been highly mobile migrating to and from the Dakhleh Oasis. Subsistence agriculture has its necessary physical demands which may have been a contributory factor to OA rates. Males show higher OA rates than females throughout the joints of the legs. Sexual dimorphism of OA for the hips is suggestive of sexual divisions of labor. OA of the knees lacks sexual dimorphism therefore the knee joint complex of males and females were likely subjected to similar levels of mechanical loading. It can be concluded based on the OA data that males and females exhibit similar activity, or biomechanical stress levels in the knee joint complexes. Males exhibit significantly higher pathological manifestation of OA in the hip joint complexes, indicative of higher levels of mechanical loading in the hip joint complex which can theoretically be attributed to sexual divisions of labor or perhaps terrestrial mobility.ID: 030646221; System requirements: World Wide Web browser and PDF reader.; Mode of access: World Wide Web.; Thesis (M.A.)--University of Central Florida, 2011.; Includes bibliographical references.
M.A.
Masters
Anthropology
Sciences
Anthropology
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Olsson, Vilma, and Frida Danarp. "Rörelserädsla och self-efficacy för fysisk träning innan och efter deltagande i artrosskola : En icke-experimentell longitudinell enkätstudie." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-53988.
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Sammanfattning Bakgrund: Vanligt vid artros är låg aktivitetsnivå. I behandlingsprogrammet artrosskola är fysisk träning en intervention. Predicerande faktorer för om beteendet fysisk träning kommer utföras är self-efficacy samt rörelserädsla. Syfte: Syftet var att studera variablerna rörelserädsla och self-efficacy för fysisk träning hos personer med höft- och eller knäartros innan och efter deltagande i artrosskola samt korrelationen avseende skillnaden mellan för- och eftermätning för variablerna. Metod: En icke-experimentell longitudinell enkätstudie med två mätpunkter för ett urval om 22 personer deltog i studien. Mätinstrumenten var Tampaskalan för kinesiofobi- svensk version (TSK-SV) och self-efficacy för fysisk träning skalan (S-ESES). Dataanalysen utfördes med Wilcoxons tecken rangtest samt Spearmans rangkorrelationstest. Resultat: Signifikant skillnad mellan skattad TSK-SV förelåg före respektive efter deltagande i artrosskola (p=0,049). Effektstorleken värderades som medelstor. Ingen signifikant skillnad förelåg mellan skattad S-ESES innan och efter deltagande i artrosskola (p=0,116). Effektstorleken värderades som liten. Lågt signifikant samband förelåg mellan skillnader mellan för- och eftermätning gällande self-efficacy för fysisk träning och rörelserädsla. Slutsats: Resultatet visade på en minskad rörelserädsla och en korrelation mellan förändringarna gällande variablerna. Vidare studier med artrosskola som en kontrollerad oberoende variabel krävs för att möjliggöra kausala slutsatser gällande artrosskolans inverkan på variablerna.Abstract Background: Common in osteoarthritis are low activity level. Self-management is a rehabilitation program that includes physical exercise. Self-efficacy and fear of movement can determine if physical activity will be performed. Aim: The aim of the study was to examine the variables fear of movement and self-efficacy for physical exercise for people with hip-and or knee osteoarthritis before and after participation in self-management program, and to investigate the correlation between the pre-post differences in the variables. Methods: Non-experimental longitudinal questionnaire survey with two measurement points. 22 participants participated. Measurements used were Tampa scale for the kinesiophobia-Swedish version (TSK-SV) and Swedish version of the Exercise Self-efficacy scale (S-ESES). Wilcoxon's tecken-rank test and Spearman's rank correlation test were used to analyze data. Results: A significant difference between estimated TSK-SV before and after the intervention (p=0,049), medium effect size. No significant difference between estimated S-ESES before and after the intervention (p=0,116), small effect size. Difference between the measuring points showed low correlation between fear of movement and self-efficacy for exercise. Conclusion: Fear of movement decreased and there was a correlation between the difference of the variables. Future studies require a controlled independent variable to enable causal conclusion between the interventions impact on the variables.
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Parsons, Gail Elizabeth. "Exploring the experiences of osteoarthritic patients awaiting hip and knee arthroplasty : informing and evaluating the effectivess of a health maintenance intervention." Thesis, University of the West of England, Bristol, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.573501.
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ABSTRACT Name: Gail Elizabeth Parsons Date: August, 2011 Title of thesis: Exploring The Experiences of Osteoarthritic Patients Awaiting Hip And Knee Arthroplasty: Informing and evaluating the effectiveness of a health maintenance intervention. Aim of the study To explore the lived experiences of patients with severe osteoarthritis of the hip and knee joint whilst awaiting primary joint replacement surgery. To utilise findings from interviews and evidence-based literature to develop a health maintenance clinic (HMC) intervention, followed by its evaluation. Methodology A mixed method design was adopted: an exploratory approach incorporating descriptive phenomenology consisting of unstructured interviews with participants awaiting their hip or knee replacement surgery, followed by a randomised control trial (RCT) to compare the existing preoperative assessment service with a health maintenance clinic intervention. Setting and sample A purposeful sample of 6 people with osteoarthritis awaiting joint replacement were interviewed. In addition, a sample of 250 people (mean age 73 years) were recruited via an orthopaedic out-patient department for the RCT following referral to the waiting list for hip or knee replacement surgery. Outcome measures The Western Ontario and McMaster Osteoarthritis Index (WOMAC) tool was used at the time of referral to waiting list and again during the preoperative assessment appointment. The Hospital Patient Satisfaction Index (HP SI) was administered at the preoperative assessment appointment. Number of surgery postponements was also recorded. Results Six themes emerged from the interview data: living and coping with pain; not being able to walk and move around; coping with every day activities; how others see me; help, advice and support whilst awaiting surgery; effect upon family, friends and helpers. The RCT revealed; no significant difference between the total WOMAC scores between the two groups. Participants attending the HMC (experimental group) were significantly more satisfied with their care. There was no relationship between satisfaction and WOMAC scores. There was a significant difference in the number of postponements of surgery between groups, with a greater proportion of participants proceeding to surgery in the experimental group. Conclusion The interview data generated new knowledge of the experiences, concerns and symptoms of individuals waiting for primary hip and knee replacement surgery. Health maintenance provision 'tailored' to the individual was revolutionary at the time of the study. Patient satisfaction was significantly high and the number of postponements of surgery was significantly less for those attending the clinic.
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Abraham, Ajay Matthew. "Lifecourse influences on osteoarthritis of the knees, hips and hands as defined by musculoskeletal ultrasound." Thesis, University of Newcastle upon Tyne, 2013. http://hdl.handle.net/10443/2271.
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Aims: There has been very little lifecourse research looking at the risk of osteoarthritis (OA). A lifecourse analysis of risk factors for knee, hip and hand OA (defined using features on ultrasound) acting at different stages of life, including early life factors, was performed among members of the Newcastle Thousand Families birth cohort. Methods: Potential risk factors for OA (including birth weight, breast feeding data and socioeconomic status) have been collected prospectively in this birth cohort of subjects aged 63 (born in May-June 1947) and an a priori conceptual framework was developed. Subjects had both knees, hips and the dominant hand scanned with ultrasound. These data were analysed in relation to a range of factors from across the lifecourse using logistic and linear regression models. Results: Among 316 participants, duration of exclusive breast feeding showed a significant inverse association with knee osteophytes while BMI and total hip bone mineral density at age 50 increased the risk of knee osteophytes. The univariate effect of social class at birth on knee osteophytes was found to be mediated by its subsequent effect on breast feeding and total hip bone mineral density. The multivariate model for hip OA had three risk factors; BMI, physical activity and pack years of smoking at age 50. Smoking at age 50 and increased infections in childhood appeared to confer protection from hand OA. Conclusions: This is the first study to perform a lifecourse analysis of OA risk using prospectively collected data. The majority of the risk of OA at the three joint sites seemed to occur through factors acting in adulthood. However, breast feeding protected subjects from knee OA while infections in childhood decreased hand OA risk. These results suggest that modification of OA risk factors acting in adulthood would probably be more beneficial than intervening in early life.
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Sled, ELIZABETH. "Measurement Reliability and Effect of Hip Strengthening Exercises in Knee Osteoarthritis." Thesis, 2008. http://hdl.handle.net/1974/1479.
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The progression of knee osteoarthritis (OA), the most common cause of physical disability in older adults, is influenced by muscular and biomechanical factors. Reliability of muscular and biomechanical measures, including knee muscle strength and limb alignment, is critical. Furthermore, conservative interventions that slow the course of OA disease progression and prevent disability are urgently needed. The objectives of this thesis were to: 1) investigate the reliability of measures of knee muscle strength and alignment in persons with knee OA, and 2) determine the influence of an exercise intervention targeting hip muscles on knee joint loading in those with medial knee OA.
In the first study reliability of knee muscle strength measures was evaluated within one testing session in 40 persons with knee OA. Isometric and isokinetic peak torque values for the quadriceps and hamstring muscles demonstrated high degrees of intra-session reliability.
Reliability of lower limb alignment measures was determined following a bone landmark-based approach with use of a computer program. Excellent reliability coefficients were found which compared favorably with reliability of manual measures from schematics of limb deformities drawn with AutoCAD® software. When the computer method was applied to 100 full-limb radiographs of persons with or at risk for knee OA, alignment measures demonstrated high inter- and intra-reader reliability.
Hip muscle weakness may influence loading of the medial knee compartment. Hip abductor strength was evaluated in 40 individuals with medial compartment knee OA in comparison to a control group of 40 healthy older adults. The effect of an 8-week home-based hip abductor strengthening program on the knee adduction moment was also assessed in this group with knee OA, compared with the control group which received no intervention. Following the exercise program the OA group demonstrated improvements in hip abductor strength and functional performance on a sit-to-stand task. There were no changes in the knee adduction moment. Thus, hip muscle strengthening did not influence joint loading, but may improve function in persons with knee OA.
Results from this thesis provide increased understanding of knee OA, from muscular and biomechanical perspectives, in the areas of measurement reliability and exercise intervention.Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2008-09-25 01:29:13.675
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Ching-YunLiang and 梁瀞云. "Assessment of the Effect of Teriparatide on Joint Space Narrowing in Patients with Knee or Hip Osteoarthritis." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/02338224726537054893.
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Weigl, Martin [Verfasser]. "Long-term outcome in patients with osteoarthritis of the hip or knee after comprehensive rehabilitation : a prospective 2 year follow-up study / vorgelegt von Martin Weigl." 2002. http://d-nb.info/965808335/34.
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Doiron-Cadrin, Patrick. "Plausibilité de l’effet d’un programme de télé-préréadaptation, supervisée ou en personne, comparés à un groupe témoin chez des participants en attente d’une arthroplastie totale de la hanche ou du genou : essai pilote randomisé en simple aveugle." Thèse, 2017. http://hdl.handle.net/1866/20795.
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