Journal article
Participation Following Knee Replacement: The MOST Cohort Study
Physical therapy, Vol.93(11), pp.1467-1474
11/01/2013
DOI: 10.2522/ptj.20130109
PMCID: PMC3827713
PMID: 23813082
Abstract
BackgroundParticipation is an important, yet seldom studied, outcome after total knee replacement (TKR).ObjectiveThe purpose of this study was to investigate the extent and predictors of participation and participation restriction among people after TKR.Materials and MethodsThis study investigated the changes in pain, function, and participation scores (measured using a subscale of the Late-Life Function and Disability Instrument) from pre-TKR to ≥1 year post-TKR among a subsample of participants from the Multicenter Osteoarthritis Study (MOST) longitudinal cohort (MOST is funded by the National Institutes of Health). The proportions of individuals with participation restriction pre-TKR and ≥1 and ≥2 years post-TKR were calculated for all participants and for important demographic subgroups. The association between demographic and clinical factors and participation was estimated using linear regression. The association between demographic and clinical factors and participation restriction was estimated using logistic regression.ResultsThere were 292 individuals with outcome data ≥1 year post-TKR. Of these, 218 (75%) had data pre-TKR and ≥1 year post-TKR and 160 (55%) had data ≥2 years post-TKR. There were mean improvements in pain, function, and participation at ≥1 and 2 years. However, approximately 30% of the study sample had participation restriction pre-TKR and post-TKR, and the proportion decreased significantly only for those <65 years old. Non-whites had a higher proportion of participation restriction than any other subgroup (41% ≥1 year, 48% ≥2 years). Female sex and non-white race were associated with a worse participation score, and several demographic and modifiable factors were associated with participation restriction following TKR.LimitationsThe time between pre-TKR and post-TKR assessment varied across study participants, and data were not available on their rehabilitation utilization.ConclusionsAlthough there was a mean increase in participation ≥1 year following TKR, participation restriction was common. The likelihood of low participation was increased among women, non-whites, and those with depressive symptoms, severe pain in either knee, or worse pre-TKR function.
Details
- Title: Subtitle
- Participation Following Knee Replacement: The MOST Cohort Study
- Creators
- Jessica L Maxwell - J.L. Maxwell, PT, DPT, OCS, Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences: Sargent College, 635 Commonwealth Ave, Room 623, Boston University, Boston, MA 02215 (USA)Julie J Keysor - J.J. Keysor, PT, PhD, College of Health and Rehabilitation Sciences, Clinical Epidemiology Research and Training Unit, Boston University School of MedicineJingbo Niu - J. Niu, DSc, Clinical Epidemiology Research and Training Unit, Boston University School of MedicineJasvinder A Singh - J.A. Singh, MBBS, MPH, Birmingham Veterans Affairs Medical Center and Division of Rheumatology, Department of Medicine, University of Alabama–Birmingham, Birmingham, AlabamaBarton L Wise - B.L. Wise, MD, Department of Internal Medicine, Division of Rheumatology, Allergy and Clinical Immunology, School of Medicine, University of California–Davis, Davis, CaliforniaLaura Frey-Law - L. Frey-Law, PT, PhD, Department of Physical Therapy and Rehabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IowaMichael C Nevitt - M.C. Nevitt, PhD, MPH, Department of Epidemiology and Biostatistics, University of California–San Francisco, San Francisco, CaliforniaDavid T Felson - D.T. Felson, MD, MPH, Clinical Epidemiology Research and Training Unit, Boston University School of Medicine
- Resource Type
- Journal article
- Publication Details
- Physical therapy, Vol.93(11), pp.1467-1474
- DOI
- 10.2522/ptj.20130109
- PMID
- 23813082
- PMCID
- PMC3827713
- ISSN
- 0031-9023
- eISSN
- 1538-6724
- Language
- English
- Date published
- 11/01/2013
- Academic Unit
- Nursing; Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984047741102771
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