Radiographic osteoarthritis of the knee classified by the Ahlbäck and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35–54 years with chronic knee pain Agility and Perturbation Training Techniques in Exercise Therapy for Reducing Pain and Improving Function in People With Knee Osteoarthritis: A Randomized Clinical Trial Multiple Psychological Factors Are Associated With Poorer Functioning in a Sample of Community-Dwelling Knee Osteoarthritis Patients Effectiveness of Periosteal Stimulation Therapy and Home Exercise Program in the Rehabilitation of Patients With Advanced Knee Osteoarthritis The effect of motor control and tactile acuity training on patients with non-specific low back pain and movement control impairment. The association between radiographic knee osteoarthritis and knee symptoms, function and quality of life 10–15 years after anterior cruciate ligament reconstruction Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol
OBJECTIVES To determine the prevalence of tibiofemoral radiographic knee osteoarthritis ( OA ) in people aged 35–54 years associated with chronic ( > 3 months ) knee pain  using two different radiographic grading systems . METHODS Population based postal survey in a r and om sample of inhabitants in a district in southern Sweden followed by  clinical examination and plain posteroanterior , weight bearing radiographical examination .  The Ahlbäck criteria ( focusing on joint space narrowing ) and the Kell- gren & Lawrence classification for knee OA were used for diagnosing tibiofemoral OA . RESULTS A question naire was sent to 2000 r and omly selected people aged 35–54 years . The response rate was 92.6 % . Fifteen per cent of these people reported chronic knee pain .  This group ( n=279 ) was offered a clinical and radiographic examination of the knee joint and 204 persons agreed to participate . According to the Kellgren & Lawrence classification 28 subjects had OA of the knee grade 2 or more and 16 grade 3 or more . Radiographically detected OA of the knee according to Ahlbäck was found in 20 cases . The minimum prevalence of radiological tibiofemoral knee OA with knee pain was thus 1.5 % for Kellgren & Lawrence grade 2 or more , 0.9 % for grade 3 or more , and 1.1 % according to the Ahlbäck classification . The agreement between the Kellgren & Lawrence grade s 2–3 versus Ahlbäck grade I as well as grade 3–4 versus Ahlbäck grade I – II was good ( κ 0.76 and 0.78 respectively ) . CONCLUSION The prevalence of radiographic tibiofemoral OA combined with  chronic knee pain in people aged 35–54 years was around 1 % as estimated by either the Kellgren & Lawrence or the Ahlbäck classifications systems . Prospect i ve follow up of this cohort should eluci date the significance of knee pain as a sign of developing OA Background Impairment-based exercise programs have yielded only small to moderate benefits in reducing pain and improving function in people with knee osteoarthritis ( OA ) . It has previously been proposed that adding agility and perturbation training to exercise programs for people with knee OA may improve treatment effects for pain and function . Objective The purpose of this study was to examine the effectiveness of adding agility and perturbation techniques to st and ard exercise therapy compared with the st and ard exercise program alone for people with knee OA . Design This was a single-blinded r and omized controlled trial . Setting The study was conducted in the outpatient physical therapy clinic of a large , university-based health center . Participants One hundred eighty-three people with knee OA ( 122 women , 61 men ) participated . Interventions Participants were r and omly assigned to either a group that received agility and perturbation training with st and ard exercise therapy or a group that received only the st and ard exercise program . Measurements The outcome measures were self-reported knee pain and function , self-reported knee instability , a performance-based measure of function , and global rating of change . Results Although both groups exhibited improvement in self-reported function and in the global rating of change at the 2- , 6- , and 12-month follow-up periods , there were no differences between groups on these outcomes . There was no reduction in knee pain or improvement in performance-based function in either group . Limitations It is possible that more-intense application of the interventions or application of the interventions to participants with knee OA who were at greater risk for falling may have yielded additive effects of the agility and perturbation training approach . Conclusions Both intervention groups exhibited improvement in self-reported function and the global rating of change . Our results , however , did not support an additive effect of agility and perturbation training with st and ard exercise therapy in our sample of individuals with knee OA . Further study is needed to determine whether there are subgroups of individuals who might achieve an added benefit with this approach Background Knee osteoarthritis ( OA ) is the most common type of arthritis and imposes a heavy burden on individual welfare among elderly people . There is preliminary evidence that psychological factors play a role in functional ability and pain in knee OA patients , particularly with respect to the surgery outcome . Less is known about psychological factors among community-dwelling patients with knee OA . Objectives We aim ed to determine which psychological factors are associated with pain and functional ability among community-dwelling knee OA patients using a comprehensive set of psychological question naires . Methods In the cross-sectional baseline setting of a prospect i ve , r and omized controlled intervention study , 111 patients aged from 35 to 75 years with clinical symptoms and radiographic grading of knee OA were included . They completed a comprehensive set of psychological question naires , including measures of re sources and coping , fear and catastrophizing , and distress . Results In cross-sectional comparisons , pain self-efficacy , fear of movement , pain catastrophizing , and elevated anxiety were associated with pain and a poorer functional ability . In logistic regression analysis , independent association was seen between pain self-efficacy and poorer functioning . Knee OA patients also reported elevated levels of anxiety . Conclusions The results reveal that both pain self-efficacy and negatively charged emotion and expectations toward pain are important factors when dealing with knee OA patients . Failure to consider these will probably contribute to prolonged disability and further pain . The results call for the routine assessment of multiple psychological factors in knee OA Background : Osteoarthritis ( OA ) of the knee is the most common form of joint disease . It is one of the major causes of impaired function that reduces quality of life in older people worldwide . Periosteal Stimulation Therapy ( PST ) with boosters in combination with home exercises may be a suitable treatment option for such patients . Objectives : To examine the effectiveness of PST with boosters in addition to a home-based exercise program as compared with Transcutaneous Electrical Nerve Stimulation ( TENS ) combined with the same home-based exercise program in the management of chronic pain and functional impairments associated with advanced knee OA . Design : The study was a r and omized controlled trial . Material s and Methods : Sixty patients with Kellgren-Lawrence grade 3 or 4 knee OA were r and omized to receive PST or TENS once a week for 10 weeks , followed by boosters for 6 months in addition to a home exercise program .  Visual Analogue Scale ( VAS ) and the Knee Injury and Osteoarthritis Outcome Score ( KOOS ) subscales were assessed at baseline , after the last PST session , and 6 months later . Results : Pain VAS and KOOS subscales were improved in both PST and TENS groups at 10 weeks and 6 months after intervention , with a statistically significant difference between the groups at both follow-up periods . Reduced pain VAS and increased KOOS subscales in the PST group were statistically significantly different from the TENS group during both follow-up periods . Conclusion : PST with boosters combined with a home exercise program was shown to be beneficial for improving subjective knee pain and functional performance of older patients with advanced knee OA BACKGROUND Movement control impairment is a clinical subgroup of non-specific low back pain which can be assessed reliably . There is a strong correlation between tactile acuity and movement control suggesting these two treatments might have additive effects . The first research aim was to determine if patients with a motor control impairment demonstrated improvement in outcome with combined tactile acuity and motor control training . The second aim was to determine if tactile acuity training enhanced the effect of motor control training . METHOD The primary study was a single-arm cohort study conducted in three physiotherapy practice s in the German-speaking part of Switzerl and . 40 patients ( 23 males and 17 females ) suffering from non-specific low back pain ( NSLBP ) and movement control impairment were treated . Patients were assessed at baseline and immediately post treatment . Treatment included exercises to lumbopelvic control and graphesthesia training to improve tactile acuity . Treatment effects were evaluated using the Rol and Morris disability question naire ( RMQ ) and the patient-specific functional scale ( PSFS ) . The performance on a set of six movement control tests and lumbar two-point discrimination were also assessed . The results of this cohort study were compared with a historic control group which was comparable with the primary study but included only motor control exercises . RESULTS All the outcomes improved significantly with the combined training ( RMQ - 2.2 pts . , PSFS - 2.8 pts . ; MCTB - 2.02 pts . & TPD - 17.07 mm ; all p < 0.05 ) . In comparison to the outcomes of the historic control , there was no significant differences in movement control , patient-specific functional complaints or disability between the groups . CONCLUSIONS The results of this study , based on a before and after intervention comparison , showed that outcome improved significantly following combined tactile acuity and motor control training . However , compared to an earlier study , the tactile acuity training did not have an additional effect to the results . The use of historical controls does not control for allocation bias and the results obtained here require verification in a r and omized controlled trial Background There are conflicting results in the literature regarding the association between radiographic knee osteoarthritis ( OA ) and symptoms and function in subjects with previous anterior cruciate ligament ( ACL ) reconstruction . Aim To investigate the associations between radiographic tibiofemoral knee OA and knee pain , symptoms , function and knee-related quality of life ( QOL ) 10–15 years after ACL reconstruction . Study design Cross-sectional study . Material and methods 258 subjects were consecutively included at the time of ACL reconstruction and followed up prospect ively . The authors included the Knee Injury and Osteoarthritis Outcome Score to evaluate knee pain , other symptoms ( symptoms ) , activities of daily living and sport and recreation ( Sport/Rec ) and QOL . The subjects underwent st and ing radiographs 10–15 years after the ACL reconstruction . The radiographs were grade d with the Kellgren and Lawrence ( K&L ) classification ( grade 0–4 ) . Results 210 subjects ( 81 % ) consented to participate in the 10–15-year follow-up . Radiographic knee OA ( K&L ≥ grade 2 ) was detected in 71 % , and 24 % showed moderate or severe radiographic knee OA ( K&L grade s 3 and 4 ) . No significant associations were detected between radiographic knee OA ( K&L grade ≥2 ) and pain , function or QOL , respectively , but subjects with radiographic knee OA showed significantly increased symptoms . Severe radiographic knee OA ( K&L grade 4 ) was significantly associated with more pain , symptoms , impaired Sport/Rec and reduced QOL . Conclusion Subjects with radiographic knee OA showed significantly more symptoms than those without OA , and subjects with severe radiographic knee OA had significantly more pain , impaired function and reduced quality of life than those without radiographic knee OA 10–15 years after ACL reconstruction Background Knee osteoarthritis ( OA ) is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability . Many people with knee OA also experience co-morbidities that further add to the OA burden . Uptake of and adherence to physical activity recommendations is suboptimal in this patient population , leading to poorer OA outcomes and greater impact of associated co-morbidities . This pragmatic r and omised controlled trial will investigate the clinical - and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA . Methods / Design 168 people with clinical ly diagnosed knee OA will be recruited from the community in metropolitan and regional areas and r and omly allocated to physiotherapy only , or physiotherapy plus nurse-delivered telephone coaching . Physiotherapy involves five treatment sessions over 6 months , incorporating a home exercise program of 4–6 exercises ( targeting knee extensor and hip abductor strength ) and advice to increase daily physical activity . Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia ( HCA ) Model of Health Change to provide behaviour change support . The telephone coaching intervention aims to maximise adherence to the physiotherapy program , as well as facilitate increased levels of participation in general physical activity . The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months . Secondary outcomes include physical activity levels , quality -of-life , and potential moderators and mediators of outcomes including self-efficacy , pain coping and depression . Relative cost-effectiveness will be determined from health service usage and outcome data . Follow-up assessment s will also occur at 12 and 18 months . Discussion The findings will help determine whether the addition of telephone coaching sessions can improve sustainability of outcomes from a physiotherapist-delivered physical activity intervention in people with knee OA.Trial Registration Australian New Zeal and Clinical Trials Registry reference :
Results The FreKAQ-J had acceptable internal consistency , unidimensionality , good test-retest reliability , and was functional on the category rating scale .
The FreKAQ-J was significantly correlated with pain in motion , disability , pain-related catastrophizing , fear of movement , and anxiety symptomatology .
Conclusions We developed FreKAQ-J by modifying the FreBAQ-J. The FreKAQ-J fits the Rasch measurement model well and is suitable for use in people with knee OA .
Background Recent systematic review s have demonstrated that pain associated with knee osteoarthritis ( OA ) is a complex phenomenon that involves various contributors .
People with knee OA exhibit symptoms of impaired body-perception , including reduced tactile acuity , impairments in limb laterality recognition , and de grade d proprioceptive acuity .
The Fremantle Back Awareness Question naire ( FreBAQ ) was developed to assess body-perception specific to the back in people with chronic low back pain .
The aim of this study was to develop and assess the psychometric properties of a knee-specific version of the FreBAQ-J ( FreKAQ-J ) , determine whether people with knee pain experience perceptual impairments and investigate the relationship between disturbed self-perception and clinical status .