Title from PDF of title page (University of Missouri--Columbia, viewed on Feb 19, 2010). The entire thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file; a non-technical public abstract appears in the public.pdf file. Thesis advisor: Drs. Sheila Grant and James Cook. Includes bibliographical references.

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Experimental Surgery, Department of Surgery. Title from pdf file main screen (viewed on February 17, 2010). Includes bibliographical references.

With ageing population in Hong Kong, the prevalence of osteoarthritis is expected to be increasing. The most common type of osteoarthritis is osteoarthritis of knee. Osteoarthritis adversely affects physical activities, social activities and quality of life. It causes socioeconomic burdens and has become a more prominent public health issue in Hong Kong. Self-management of this irreversible health problem in the daily living is crucial to those elders suffering from osteoarthritis. However, no evidence-based guidelines on self-management education for elders with knee osteoarthritis have been formed. The objectives of this paper are to review literatures on the effectiveness of self-management program and to formulate evidence-based guidelines on self-management education for Chinese older adults with knee osteoarthritis. The literature review showed that self-management program was an effective measure to improve self-efficacy for self-management and to reduce pain among the elders with knee osteoarthritis. The assessment on the implementation potential of the self-management program showed that self-management program could be transferred to the community-dwelling Chinese elders with knee osteoarthritis and was found to be feasible for implementation in Elderly Health Centers in Hong Kong. The benefits of self-management program outweigh the costs for the implementation of such a program. The proposed self-management program would mainly provide the elders with the self-management skills, osteoarthritis related information and exercise practice in group sessions. There would also be follow-up telephone coaching. Guidelines for implementing the proposed self-management program are shown in this thesis. Implementation plan was formulated to propose communication strategies to initiate and sustain the implementation of the proposed self-management program. Pilot test was designed to test the feasibility of the program. Evaluation plan was developed to evaluate the effectiveness of the program in improving self-efficacy for self-management and reducing osteoarthritis pain for Chinese older adults with knee osteoarthritis. In sum, self-management program was found to be effective in improving self-efficacy for self-management and reducing pain among the elders with knee osteoarthritis. The guidelines on the proposed self-management program could support the evidence-based self-management education for Chinese older adults with knee osteoarthritis in Hong Kong. / published_or_final_version / Nursing Studies / Master / Master of Nursing

Given the percentage of African American women in the general U.S. population, the number of African American women with functional limitations and disabilities is disproportionate; although chronic conditions such as osteoarthritis may contribute to these disparities it is unclear what environmental factors may affect these outcomes in the women. Hence, the purpose of this study was to examine biological factors (age, body mass index, and waist circumference), psychosocial intra-individual factors (health care utilization, trust in health care providers, pain, pain beliefs, and depression), and cumulative extra-individual environmental factors (racial discrimination, stress from racial discrimination, and health care access) that may influence function and disability outcomes in African American women with osteoarthritis 50-80 years of age. The disablement process model combined with the cumulative inequality theory served as theoretical guides used for this study. This study was a non-experimental, descriptive correlational study. The study included a sample of 120 African American women with OA from Texas and New Mexico. Surveys were mailed to participants or distributed in person. The statistical analysis consisted of correlations, linear regressions, multiple regressions and hierarchical regressions. The significant predictors of function were BMI, pain severity and pain beliefs. Pain severity and pain beliefs predicted disability. Depression mediated the relationship between racial discrimination and disability. It was demonstrated that biological risk factors, intra-individual and extra-individual factors are related to disablement outcomes in this sample of African American women. This study can inform the development of future interventions designed to decrease the risk of functional limitations and disabilities in middle-aged and older African American women with osteoarthritis. / text

Osteoarthritis (OA) is a degenerative joint disorder and one of the leading causes of disability in elderly. Tai Chi is seen to be effective in relieving symptoms of OA knee joint. The main aim of this study is to design a Tai Chi program and a strength training program for the elderly with knee OA and to compare the effects of these programs on the range of motion, gait, pain and balance. 20 participants age 55 and over were divided into two groups (Tai Chi and Strength training) based on predetermined criteria. Both the groups showed improvement in WOMAC scores, balance and strength following Tai Chi and strength training intervention for 2 months.

This thesis examined the immediate biomechanical effects of valgus unloader brace application in participants with moderate medial compartment knee osteoarthritis during gait. Thirty-three individuals were prescribed a valgus unloader brace. 3D knee moments and angles were calculated during walking with and without the brace. Principal Component Analysis identified amplitude and temporal changes of the moment and angle waveforms during gait. Three groups were identified based on the change in knee adduction moment magnitude with brace application. Two-Way ANOVA tested for differences among groups and conditions in principal component scores, as well as discrete varus thrust values. There existed three subgroups of participants identified by different gait adaptations to brace application. The brace had temporal and magnitude effects on 3D kinetics and kinematics for the participant group. This study showed that the brace does not provide a consistent change to knee joint mechanics. These results have implications for brace prescription.

Objectives: To investigate differences between hip abductor muscle strength, hip and knee adduction moments and knee joint alignment in people with moderate/severe and mild medial compartment knee osteoarthritis (OA), and people without OA, and identify variables explaining variance in knee adduction moment in participants with OA. Background: It has been suggested that weakness of hip abductor muscles may lead to displacement of the centre of mass of body away from the stance limb during gait, resulting in increased knee adduction moment, a predictor of disease progression. Methods: Participants with medial compartment knee OA were divided into moderate/severe (n=23) and mild OA groups (n=15) based on radiographic grading. Control subjects were recruited to match participants in the moderate/severe group for age and gender (n=23). Hip abductor and adductor muscle isometric strength was measured using the Biodex dynamometer. Gait speed and hip and knee peak adduction moments and percentage of the stance phase where these occurred were obtained using a three dimensional motion analysis system and two force platforms. Knee alignment and severity of OA were measured from radiographs. Statistics: Univariate analysis of variance (ANOVA) was performed to determine group differences. Stepwise linear regression analysis was performed to identify the variables which contribute to variation in knee adduction moment. Results: Moderate/severe OA group participants had higher body mass index (BMI) than the mild OA and control group (p=0.01) and greater varus alignment compared to the control group (p<0.01). There was no difference between the mean hip abductor and adductor muscle strength and hip and knee adduction moments among the three groups. Peak hip (p=0.02) and knee adduction moments (p<0.05) occurred later in stance phase of gait in the moderate/severe OA group as compared to control group. Knee joint alignment (26%), hip abductor muscle isometric strength (20%), gait speed (16%) and hip adduction moment (11%) explained 73% of variance in the knee adduction moment in the participants with OA. Conclusion: Findings from this study do not support the theory that weakness of the hip abductor muscles contributes to higher knee adduction moments. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2008-03-03 21:47:07.309

Background and Purpose: Self-efficacy plays a major role in determining physical function during the earlier stages of the knee osteoarthritis (OA) and it may be a significant factor in the maintenance of physical function across the span of OA severity. This study examined the contribution of self-efficacy to objective and subjective measures of physical function at both maximal and sub-maximal levels. The relationship between self-efficacy and quality of life was also examined. Participants: Twenty community-dwelling adults with knee OA (age 69±14 years) were recruited for this study. Methods: Subjective maximal and sub-maximal performance were determined using the Maximal Activity Score (MAS) and Adjusted Activity Score (AAS) respectively of the Human Activity Profile. The objective measure of sub-maximal physical function was the 6-minute walk test (6MWT) while the Incremental Shuttle Walk Test (ISWT) was the maximal measure. Quality of life was determined using the Short Form Health Survey 36 (SF-36) and self-efficacy was measured using the Arthritis Self-Efficacy (ASE) scale. Disease severity was determined using the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). A stepwise multiple linear regression analysis was performed using each of 6MWT, ISWT, AAS and MAS as the dependent variable, and the WOMAC and ASE as independent variables. Results: Self-efficacy explained 44% of the variance in the 6MWT but only 16% in the ISWT. Self-efficacy explained approximately 30% of the variance in both the MAS and AAS. A moderate relationship was observed between self-efficacy and the Physical Component Score (PCS) (r=0.51) of health-related quality of life, but no relationship was observed with the Mental Component Score (MCS). Discussion and Conclusion: In mild to moderate knee OA, sub-maximal physical function was substantively influenced by an individual’s belief in his/her ability to perform a given task, but not so when the intensity of the activity approached maximal levels. This differential relationship between sub-maximal and maximal performance was not present using subjective reports of performance. These findings indicate that therapy utilizing training at sub-maximal levels in mild to moderate knee OA should focus on strategies for enhancing self-efficacy; whereas with training at relatively high intensities, less focus should be given to enhancing self-efficacy. / Thesis (Master, Rehabilitation Science) -- Queen's University, 2008-04-25 15:28:10.666

No description available.

SUMMARY Joint damages make a big part of orthopedic pathology and rheumatic diseases. One of the most often rheumatic diseases is osteoarthritis. Osteoarthritis is a difficult and widespread joint disease requiring special public health care attention and healing expenses and it has caused especially great interest of scientists in the world. Exercise therapy is an important part of complex treatment of osteoarthritis. However, information about exercise therapy frequency, duration, intensity and different exercises influence upon functional possibilities is still limited. Research purpose. To determine exercise therapy influence upon functional activity of patients with leg joints osteoarthritis. Goals. 1) To evaluate strength exercise therapy effect on clinical and functional data of patients with leg joint osteoarthritis. 2) To evaluate balance exercise therapy impact upon clinical and functional data of patients with leg joints osteoarthritis. 3) To compare strength and balance exercise therapy influence upon clinical and functional data of patients with leg joints osteoarthritis. 4) To determine pain intensity and functional data interrelation of patients with leg joints osteoarthritis. Research methods and organisation. Patients with leg joint osteoarthritis volunteered to participate in research. The participants were divided into two groups, each consisting of 15 persons. The two groups were homogenous by main data: sex, age, height, weight, diseases duration... [to full text]