The epidemiology of osteoarthritis of the knee in elderly patients living an urban area of Bangkok.

An epidemiological study of 392 elderly Thai patients with osteoarthritis (OA) of the knee, 86 males and 306 females, with a mean age of 67.8 years, was performed. The prevalence of knee OA was 34.5-45.6 per cent. Most of the patients had completed primary education and had sufficient income. More than half of the patients had pain in both knees, but many of the elderly people used neither knee supports nor walking aids (82.7 and 90.6%). Sixty-four per cent had no previous knowledge concerning the value of exercise. Sixty-five per cent of the patients had never used any pain medication. Three-fourths of the subjects evaluated themselves to have fair to good health. Sixty per cent presented with knee pain when climbing the stairs, and 64.8 per cent had a fair quality of life. Almost all the subjects had mild to moderately severe grade of OA and their X-ray findings were level II-III. The average quadriceps strength and six-minute walking distance were 12.95 +/- 5.51 kilograms and 363.69 +/- 99.34 meters respectively. The five factors that significantly correlated with walking ability were age, sex, the functional incapacity score, using walking aids and level of severity found on X-ray. Previous knowledge about knee exercise did not affect walking ability, but may have been due to the irregularity of the exercise schedule they performed. The elderly should be encouraged to exercise regularly in addition to receive knowledge about proper exercise.

The efficacy of a muscle exercise program to improve functional performance of the knee in patients with osteoarthritis.

Osteoarthritis (OA) is a common chronic and progressive degenerative joint condition. A major consequence of knee OA is physical disability; especially difficulty with activities requiring ambulation and transfer, which are necessary to maintain independence and a good quality of life. The purposes of this study were to determine the efficacy of a muscle exercise program along with education about knee care, and investigate the clinical factors which influence its therapeutic efficacy. A prospective study was carried out among elderly Thai people aged 60 years and over, living in an urban community of the Bangkok metropolitan area around Siriraj Hospital, between October 1997 and September 1999. The number of elderly people with osteoarthritis of the knee was 392 (male:female=86:306) with a mean age of 67.7+/-6 years. They were interviewed for demographic data and information about their symptoms. The range of the knee movement, quadriceps strength and the six-minute walking distance and a knee X-ray were evaluated. Group exercise was arranged twice a week for 8 weeks for the intervention group only. The results of the study revealed that the quadriceps strength in the intervention group had a tendency to increase and the walking distance was significantly improved especially in the first two months but there was a tendency to decline by the sixth and twelfth month after enrollment. On the other hand, there was no statistically significant difference of both important outcomes for the control group when assessed in the second month. The findings at the sixth and twelfth month after enrollment were that the quadriceps strength was slightly increased but the walking distance was decreased when compared with the initial assessment. An exercise frequency of 12 sessions in two months was sufficient to improve muscle strength and walking distance. Group exercise produces a significant improvement in strength and walking ability, especially in the first two months. Deterioration over time could be due to multiple factors, such as lack of regular exercise, lack of motivation, lack of family support or poor economic status, so we should encourage the elderly to exercise regularly.