Prognosis of limitations in activities in osteoarthritis of the hip or knee: a 3-year cohort study.

van Dijk GM, Veenhof C, Spreeuwenberg P, Coene N, Burger BJ, van Schaardenburg D, van den Ende CH, Lankhorst GJ, Dekker J, on behalf of the CARPA Study Group. Prognosis of limitations in activities in osteoarthritis of the hip or knee: a 3-year cohort study. To describe the course of limitations in activities in elderly patients with osteoarthritis (OA) of the hip or knee over a follow-up period of 3 years, and to identify prognostic factors of the course of limitations in activities, focusing on body functions, comorbidity, and cognitive functioning. A longitudinal cohort study with 3 years of follow-up. Measurements were conducted annually. Statistical analyses included t tests, univariate regression analyses, and multivariate regression analyses. Rehabilitation centers and hospitals (Departments of Orthopedics, Rheumatology, and Rehabilitation) in The Netherlands. Patients (N=237) with hip or knee OA. Not applicable. Patient-perceived change, self-reported limitations in activities measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and observed limitations in activities (timed walking test). Prognostic factors: demographic data, clinical data, body function (pain, muscle strength, range of motion [ROM]), comorbidity, and cognitive functioning (cognitive decline, memory, attention). Self-reported limitations in activities measured by the WOMAC improved slightly after 3-year follow-up. In knee OA, reduced ROM at 1-year follow-up (beta=.120), increased pain at 1-year follow-up (beta=-.177), and higher morbidity count (beta=-.180) predicted worsening of self-reported limitations in activities. In hip OA, reduced ROM at 1-year follow-up (beta=.201 for hip external rotation and beta=.144 for knee extension), increased pain at 1-year follow-up (beta=-.134), higher morbidity count (beta=-.220), or the presence of moderate to severe cardiac disease (beta=-.214) and poorer cognitive functioning (beta=.181) predicted worsening of self-reported limitations in activities. Performance-based limitations in activities measured by the timed walking test did not change after 3 years of follow-up. In knee OA, decreased muscle strength at 1-year follow-up (beta=-.272) and higher morbidity count (beta=.199) predicted worsening of performance-based limitations in activities. In hip OA, better ROM (beta=.182), higher morbidity count (beta=.232), or the presence of moderate to severe cardiac and eye-ear-nose-throat disease (beta=.210 and beta=.188, respectively) and older age (beta=.355) predicted worsening of performance-based limitations in activities. Overall, at the group level, limitations in activities of patients with OA of the hip or knee recruited from hospitals and rehabilitation centers seem fairly stable during the first 3 years of follow-up. However, at the level of individual patients, considerable variation occurs. Prognostic factors for worsening of limitations in activities include increased pain, reduced ROM, and decreased muscle strength at 1-year follow-up; higher morbidity count; and to a lesser extent poor cognitive functioning.

van Dijk GM ，Veenhof C ，Spreeuwenberg P ，Coene N ，Burger BJ ，van Schaardenburg D ，van den Ende CH ，Lankhorst GJ ，Dekker J ，CARPA Study Group ... -  《-》

Limitations in activities in patients with osteoarthritis of the hip or knee: the relationship with body functions, comorbidity and cognitive functioning.

van Dijk GM ，Veenhof C ，Lankhorst GJ ，Dekker J ... -  《DISABILITY AND REHABILITATION》

Prognostic factors for the two-year course of activity limitations in early osteoarthritis of the hip and/or knee.

Holla JF ，Steultjens MP ，Roorda LD ，Heymans MW ，Ten Wolde S ，Dekker J ... -  《-》

The course of limitations in activities over 5 years in patients with knee and hip osteoarthritis with moderate functional limitations: risk factors for future functional decline.

To describe the course of limitations in activities over 5 years follow-up and identify predictors of future limitations in activities in elderly patients with osteoarthritis (OA) of the hip or knee with moderate functional limitations. A longitudinal cohort study with 5 years follow-up was conducted. Patients (n=288) were recruited at rehabilitation centers and hospitals. The main outcome measures were self-reported and performance-based limitations in activities. Prognostic factors were demographic and clinical data, body functions, comorbidity, cognitive functioning, avoidance of activity and social support. Measurements were conducted at baseline, 1, 2, 3 and 5 years follow-up. Both in patients with knee and hip OA, the course of limitations in activities remained fairly stable over a period of 5 years. Avoidance of activity, increased pain, more comorbidity, a higher age, a longer disease duration, a reduced muscle strength and range of joint motion at baseline predicted more future limitations in activities in patients with knee OA. In patients with hip OA, avoidance of activity, increased pain, more comorbidity, a higher age, a higher educational level and a reduced range of motion at baseline predicted more future limitations in activities. The course of limitations in activities remains fairly stable over a period of 5 years in elderly patients with hip or knee OA. However, at individual level there is considerable variation. Predictors of more future limitations in activities include avoidance of activity, increased pain, higher morbidity count, reduced range of motion, and a higher age.

Pisters MF ，Veenhof C ，van Dijk GM ，Heymans MW ，Twisk JW ，Dekker J ... -  《-》

Disability in end-stage knee osteoarthritis.

Kauppila AM ，Kyllonen E ，Mikkonen P ，Ohtonen P ，Laine V ，Siira P ，Niinimaki J ，Arokoski JP ... -  《DISABILITY AND REHABILITATION》