Journal article
Reasons for functional decline despite reductions in knee pain: the Multicenter Osteoarthritis Study
Physical therapy, Vol.91(12), pp.1849-1856
12/2011
DOI: 10.2522/ptj.20100385
PMCID: PMC3229048
PMID: 22003168
Abstract
The majority of interventions for knee osteoarthritis aim to reduce knee pain with the assumption that improvements in function will automatically follow. However, this assumption is not universally true, and a paradoxical decline in function is not uncommon following reduction in knee pain.
The purpose of this study was to examine what factors beyond knee pain are important for functional decline among people with reductions in knee pain.
This was an observational cohort study.
The Multicenter Osteoarthritis Study (MOST) is a National Institutes of Health-funded longitudinal study of people who have or are at high risk for knee osteoarthritis. This study included individuals who had a meaningful reduction in pain in either knee over 30 months, defined as a 41% decrease in visual analog scale pain score with an absolute decrease of ≥20/100. Meaningful decline in walking speed was defined as a decrease of 0.1 m/s during a 20-m walk. To examine the association of risk factors with meaningful decline in walking speed, risk ratios were calculated and adjusted for potential confounders.
Of the 465 people with a meaningful reduction in knee pain (mean [SD] age=63.3 [7.8] years, 67% female, 82% Caucasian, mean [SD] body mass index=31.3 [6.3] kg/m(2)), 20% had a meaningful decline in walking speed. Adjusting for confounders, participants with new comorbidity and those with widespread pain had 1.8 and 1.7 times the risk of decline compared with their counterparts with no comorbidity or widespread pain (adjusted risk ratio=1.8 [95% confidence interval=1.1-3.0] and 1.7 [95% confidence interval=1.1-2.8], respectively).
Generalizability is limited to people with a reduction in knee pain.
Reductions in knee pain are not always accompanied by improvements in walking speed. Health providers should consider that the onset of new comorbidity and presence of widespread pain may increase the risk of functional decline despite a reduction in knee pain.
Details
- Title: Subtitle
- Reasons for functional decline despite reductions in knee pain: the Multicenter Osteoarthritis Study
- Creators
- Daniel K White - Department of Physical Therapy and Athletic Training, College of Health and Rehabilitation Sciences, Sargent College, Boston University, 685 Commonwealth Avenue, Boston, MA 02115, USA. dwtbn@bu.eduDavid T FelsonJingbo NiuMichael C NevittCora E LewisJames C TornerTuhina Neogi
- Resource Type
- Journal article
- Publication Details
- Physical therapy, Vol.91(12), pp.1849-1856
- DOI
- 10.2522/ptj.20100385
- PMID
- 22003168
- PMCID
- PMC3229048
- NLM abbreviation
- Phys Ther
- ISSN
- 0031-9023
- eISSN
- 1538-6724
- Publisher
- United States
- Grant note
- U01 AG018947 / NIA NIH HHS U01 AG018832 / NIA NIH HHS AR47785 / NIAMS NIH HHS AR007598 / NIAMS NIH HHS U01 AG019069 / NIA NIH HHS AR47885 / NIAMS NIH HHS P60 AR047785 / NIAMS NIH HHS AG18820 / NIA NIH HHS K23 AR055127 / NIAMS NIH HHS T32 AR007598 / NIAMS NIH HHS P30-AG031679 / NIA NIH HHS K23AR055127 / NIAMS NIH HHS AG19069 / NIA NIH HHS P30 AG031679 / NIA NIH HHS AG18947 / NIA NIH HHS AG18832 / NIA NIH HHS U01 AG018820 / NIA NIH HHS
- Language
- English
- Date published
- 12/2011
- Academic Unit
- Epidemiology; Surgery; Injury Prevention Research Center; Neurosurgery
- Record Identifier
- 9983996080102771
Metrics
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