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Published in: Clinical Rheumatology 11/2007

01-11-2007 | Original Article

Osteoarthritis of the knee and hip: a comparison of factors associated with physical activity

Authors: Thomas Rosemann, Thomas Kuehlein, Gunter Laux, Joachim Szecsenyi

Published in: Clinical Rheumatology | Issue 11/2007

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Abstract

To assess factors associated with physical activity (PA) in a large sample of primary care patients, 1,250 outpatients from 75 general practices were approached consecutively. Of these, 1,021 (81.7%) returned short forms of the international physical activity questionnaire (IPAQ) and the arthritis impact measurement scale (AIMS2-SF). In addition, the patient health questionnaire (PHQ-9) was used to assess concomitant depression. A stepwise multiple linear regression analysis with the IPAQ score as dependent variable was performed separately for knee and hip patients. The impact of osteoarthritis (OA) on patients with an affected knee (594/58.2%) was more severe, as reflected in higher scores in the “symptom”, “lower body”, and “affect” scales of the AIMS2-SF (p < 0.01 for all). These patients were also less active than patients with OA to the hip (p = 0.02 for IPAQ score). Main predictors of PA [change in p(F) for all factors ≤0.001] in knee OA patients were physical limitation to the lower limb (R 2 = 0.180), social network (R 2 = 0.121), pain (R 2 = 0.111), body mass index (R 2 = 0.041), and age (R 2 = 0.032). Predictors for OA at the hip (427/41.8%) differed slightly [change in p(F) for all factors ≤0.003): physical limitation to the lower limb (R 2 = 0.162), pain (R 2 = 0.131), PHQ-9 score (R 2 = 0.092), social network (R 2 = 0.078), and disease duration (R 2 = 0.043). Our findings suggest that factors associated with PA differ depending on the localization of the OA. Our results may help to tailor future interventions more appropriately. Further research is needed to determine whether these tailored interventions will result in increased PA.
Literature
1.
go back to reference WHO (2002) Diet, nutrition, and the prevention of chronic diseases: WHO technical report series 916. World Health Organization, Geneva WHO (2002) Diet, nutrition, and the prevention of chronic diseases: WHO technical report series 916. World Health Organization, Geneva
2.
go back to reference Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656PubMed Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81(9):646–656PubMed
3.
go back to reference Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM et al (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133(8):635–646PubMed Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM et al (2000) Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med 133(8):635–646PubMed
4.
go back to reference Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF (1988) Obesity and knee osteoarthritis. The Framingham study. Ann Intern Med 109(1):18–24PubMed Felson DT, Anderson JJ, Naimark A, Walker AM, Meenan RF (1988) Obesity and knee osteoarthritis. The Framingham study. Ann Intern Med 109(1):18–24PubMed
5.
go back to reference O’Reilly SC, Jones A, Muir KR, Doherty M (1998) Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis 57(10):588–594PubMed O’Reilly SC, Jones A, Muir KR, Doherty M (1998) Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis 57(10):588–594PubMed
6.
go back to reference Warsi A, LaValley MP, Wang PS, Avorn J, Solomon DH (2003) Arthritis self-management education programs: a meta-analysis of the effect on pain and disability. Arthritis Rheum 48(8):2207–2213PubMedCrossRef Warsi A, LaValley MP, Wang PS, Avorn J, Solomon DH (2003) Arthritis self-management education programs: a meta-analysis of the effect on pain and disability. Arthritis Rheum 48(8):2207–2213PubMedCrossRef
7.
go back to reference Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L et al (2005) Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 143(6):427–438PubMed Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L et al (2005) Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 143(6):427–438PubMed
8.
go back to reference Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM (2002) Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 137(3):208–215PubMed Eden KB, Orleans CT, Mulrow CD, Pender NJ, Teutsch SM (2002) Does counseling by clinicians improve physical activity? A summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 137(3):208–215PubMed
9.
go back to reference van der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med 22(2):120–133PubMedCrossRef van der Bij AK, Laurant MG, Wensing M (2002) Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med 22(2):120–133PubMedCrossRef
10.
go back to reference Rosemann T, Korner T, Wensing M, Gensichen J, Muth C, Joos S et al (2005) Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339]. BMC Public Health 5:77PubMedCrossRef Rosemann T, Korner T, Wensing M, Gensichen J, Muth C, Joos S et al (2005) Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339]. BMC Public Health 5:77PubMedCrossRef
11.
go back to reference Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1991) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34(5):505–514PubMedCrossRef Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K et al (1991) The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 34(5):505–514PubMedCrossRef
12.
go back to reference Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 282(18):1737–1744PubMedCrossRef Spitzer RL, Kroenke K, Williams JB (1999) Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary care evaluation of mental disorders. Patient health questionnaire. JAMA 282(18):1737–1744PubMedCrossRef
13.
go back to reference Backenstrass M, Frank A, Joest K, Hingmann S, Mundt C, Kronmuller KT (2006) A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care. Compr Psychiatry 47(1):35–41PubMedCrossRef Backenstrass M, Frank A, Joest K, Hingmann S, Mundt C, Kronmuller KT (2006) A comparative study of nonspecific depressive symptoms and minor depression regarding functional impairment and associated characteristics in primary care. Compr Psychiatry 47(1):35–41PubMedCrossRef
14.
go back to reference Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613PubMedCrossRef Kroenke K, Spitzer RL, Williams JB (2001) The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 16(9):606–613PubMedCrossRef
15.
go back to reference Lowe B, Kroenke K, Herzog W, Grafe K (2004) Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9). J Affect Disord 81(1):61–66PubMedCrossRef Lowe B, Kroenke K, Herzog W, Grafe K (2004) Measuring depression outcome with a brief self-report instrument: sensitivity to change of the patient health questionnaire (PHQ-9). J Affect Disord 81(1):61–66PubMedCrossRef
16.
go back to reference Rosemann T, Korner T, Wensing M, Schneider A, Szecsenyi J (2005) Evaluation and cultural adaptation of a German version of the AIMS2-SF questionnaire (German AIMS2-SF). Rheumatology (Oxford) 44(9):1190–1195CrossRef Rosemann T, Korner T, Wensing M, Schneider A, Szecsenyi J (2005) Evaluation and cultural adaptation of a German version of the AIMS2-SF questionnaire (German AIMS2-SF). Rheumatology (Oxford) 44(9):1190–1195CrossRef
17.
go back to reference Guillemin F, Coste J, Pouchot J, Ghezail M, Bregeon C, Sany J (1997) The AIMS2-SF: a short form of the arthritis impact measurement scales 2. French Quality of Life in Rheumatology Group. Arthritis Rheum 40(7):1267–1274PubMed Guillemin F, Coste J, Pouchot J, Ghezail M, Bregeon C, Sany J (1997) The AIMS2-SF: a short form of the arthritis impact measurement scales 2. French Quality of Life in Rheumatology Group. Arthritis Rheum 40(7):1267–1274PubMed
18.
go back to reference Kellgren J, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502PubMedCrossRef Kellgren J, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16(4):494–502PubMedCrossRef
19.
go back to reference Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395PubMedCrossRef Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE et al (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35(8):1381–1395PubMedCrossRef
20.
go back to reference Rutten A, Abu-Omar K (2004) Prevalence of physical activity in the European Union. Soz Praventivmed 49(4):281–289PubMed Rutten A, Abu-Omar K (2004) Prevalence of physical activity in the European Union. Soz Praventivmed 49(4):281–289PubMed
21.
go back to reference Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C et al (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273(5):402–407PubMedCrossRef Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C et al (1995) Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273(5):402–407PubMedCrossRef
22.
go back to reference Hirata S, Ono R, Yamada M, Takikawa S, Nishiyama T, Hasuda K et al (2006) Ambulatory physical activity, disease severity, and employment status in adult women with osteoarthritis of the hip. J Rheumatol 33(5):939–945PubMed Hirata S, Ono R, Yamada M, Takikawa S, Nishiyama T, Hasuda K et al (2006) Ambulatory physical activity, disease severity, and employment status in adult women with osteoarthritis of the hip. J Rheumatol 33(5):939–945PubMed
23.
go back to reference Plotnikoff RC, Taylor LM, Wilson PM, Courneya KS, Sigal RJ, Birkett N et al (2006) Factors associated with physical activity in Canadian adults with diabetes. Med Sci Sports Exerc 38(8):1526–1534PubMedCrossRef Plotnikoff RC, Taylor LM, Wilson PM, Courneya KS, Sigal RJ, Birkett N et al (2006) Factors associated with physical activity in Canadian adults with diabetes. Med Sci Sports Exerc 38(8):1526–1534PubMedCrossRef
24.
go back to reference Shih M, Hootman JM, Kruger J, Helmick CG (2006) Physical activity in men and women with arthritis National Health Interview Survey, 2002. Am J Prev Med 30(5):385–393PubMedCrossRef Shih M, Hootman JM, Kruger J, Helmick CG (2006) Physical activity in men and women with arthritis National Health Interview Survey, 2002. Am J Prev Med 30(5):385–393PubMedCrossRef
25.
go back to reference Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ (1992) Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham study. Ann Intern Med 116(7):535–539PubMed Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ (1992) Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham study. Ann Intern Med 116(7):535–539PubMed
26.
go back to reference Plotnikoff RC, Mayhew A, Birkett N, Loucaides CA, Fodor G (2004) Age, gender, and urban–rural differences in the correlates of physical activity. Prev Med 39(6):1115–1125PubMedCrossRef Plotnikoff RC, Mayhew A, Birkett N, Loucaides CA, Fodor G (2004) Age, gender, and urban–rural differences in the correlates of physical activity. Prev Med 39(6):1115–1125PubMedCrossRef
27.
go back to reference Dieppe P (1995) Therapeutic targets in osteoarthritis. J Rheumatol Suppl 43:136–139PubMed Dieppe P (1995) Therapeutic targets in osteoarthritis. J Rheumatol Suppl 43:136–139PubMed
28.
go back to reference Roos E (2002) [Physical activity can influence the course of early arthritis. Both strength training and aerobic exercise provide pain relief and functional improvement]. Lakartidningen 99(45):4484–4489PubMed Roos E (2002) [Physical activity can influence the course of early arthritis. Both strength training and aerobic exercise provide pain relief and functional improvement]. Lakartidningen 99(45):4484–4489PubMed
29.
go back to reference Dieppe PA (2004) Relationship between symptoms and structural change in osteoarthritis. What are the important targets for osteoarthritis therapy? J Rheumatol Suppl 70:50–53PubMed Dieppe PA (2004) Relationship between symptoms and structural change in osteoarthritis. What are the important targets for osteoarthritis therapy? J Rheumatol Suppl 70:50–53PubMed
30.
go back to reference Hannan MT, Felson DT, Pincus T (2000) Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 27(6):1513–1517PubMed Hannan MT, Felson DT, Pincus T (2000) Analysis of the discordance between radiographic changes and knee pain in osteoarthritis of the knee. J Rheumatol 27(6):1513–1517PubMed
31.
go back to reference Garcia EL, Banegas JR, Perez-Regadera AG, Cabrera RH, Rodriguez-Artalejo F (2005) Social network and health-related quality of life in older adults: a population-based study in Spain. Qual Life Res 14(2):511–520PubMedCrossRef Garcia EL, Banegas JR, Perez-Regadera AG, Cabrera RH, Rodriguez-Artalejo F (2005) Social network and health-related quality of life in older adults: a population-based study in Spain. Qual Life Res 14(2):511–520PubMedCrossRef
32.
go back to reference Keefe FJ, Blumenthal J, Baucom D, Affleck G, Waugh R, Caldwell DS et al (2004) Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 110(3):539–549PubMedCrossRef Keefe FJ, Blumenthal J, Baucom D, Affleck G, Waugh R, Caldwell DS et al (2004) Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 110(3):539–549PubMedCrossRef
34.
go back to reference Roseman T, Backenstrass M, Rosemann A, Joest K, Szecsenyi J, Laux G (2006) Predictors of depression in a sample of 1021 primary care patients with osteoarthritis. Arthritis Care Res (in press) Roseman T, Backenstrass M, Rosemann A, Joest K, Szecsenyi J, Laux G (2006) Predictors of depression in a sample of 1021 primary care patients with osteoarthritis. Arthritis Care Res (in press)
35.
go back to reference Delahanty LM, Conroy MB, Nathan DM (2006) Psychological predictors of physical activity in the diabetes prevention program. J Am Diet Assoc 106(5):698–705PubMedCrossRef Delahanty LM, Conroy MB, Nathan DM (2006) Psychological predictors of physical activity in the diabetes prevention program. J Am Diet Assoc 106(5):698–705PubMedCrossRef
36.
go back to reference Bruce B, Fries JF, Lubeck DP (2005) Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14 year prospective, longitudinal study. Arthritis Res Ther 7(6):R1263–R1270PubMedCrossRef Bruce B, Fries JF, Lubeck DP (2005) Aerobic exercise and its impact on musculoskeletal pain in older adults: a 14 year prospective, longitudinal study. Arthritis Res Ther 7(6):R1263–R1270PubMedCrossRef
37.
go back to reference Parker CJ, Morgan K, Dewey ME (1997) Physical illness and disability among elderly people in England and Wales: the Medical Research Council Cognitive Function and Ageing study. The Analysis Group. J Epidemiol Community Health 51(5):494–501PubMedCrossRef Parker CJ, Morgan K, Dewey ME (1997) Physical illness and disability among elderly people in England and Wales: the Medical Research Council Cognitive Function and Ageing study. The Analysis Group. J Epidemiol Community Health 51(5):494–501PubMedCrossRef
38.
go back to reference Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D (2003) Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum 48(12):3359–3370PubMedCrossRef Sharma L, Cahue S, Song J, Hayes K, Pai YC, Dunlop D (2003) Physical functioning over three years in knee osteoarthritis: role of psychosocial, local mechanical, and neuromuscular factors. Arthritis Rheum 48(12):3359–3370PubMedCrossRef
39.
go back to reference Eberhardt KB, Fex E (1995) Functional impairment and disability in early rheumatoid arthritis-development over 5 years. J Rheumatol 226:1037–1042 Eberhardt KB, Fex E (1995) Functional impairment and disability in early rheumatoid arthritis-development over 5 years. J Rheumatol 226:1037–1042
40.
go back to reference Hazes JM (2003) Determinants of physical function in rheumatoid arthritis: association with the disease process. Rheumatology (Oxford) 42(Suppl 2):ii17–ii21 Hazes JM (2003) Determinants of physical function in rheumatoid arthritis: association with the disease process. Rheumatology (Oxford) 42(Suppl 2):ii17–ii21
41.
go back to reference Fransen M, McConnell S, Bell M (2003) Exercise for osteoarthritis of the hip or knee. Cochrane Database Syst Rev 3:CD004286PubMed Fransen M, McConnell S, Bell M (2003) Exercise for osteoarthritis of the hip or knee. Cochrane Database Syst Rev 3:CD004286PubMed
42.
go back to reference Elley CR, Kerse N, Arroll B, Robinson E (2003) Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ 326(7393):793PubMedCrossRef Elley CR, Kerse N, Arroll B, Robinson E (2003) Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ 326(7393):793PubMedCrossRef
Metadata
Title
Osteoarthritis of the knee and hip: a comparison of factors associated with physical activity
Authors
Thomas Rosemann
Thomas Kuehlein
Gunter Laux
Joachim Szecsenyi
Publication date
01-11-2007
Publisher
Springer-Verlag
Published in
Clinical Rheumatology / Issue 11/2007
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-007-0579-0

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