Obesity and disability in the symptomatic Irish knee osteoarthritis population.

BACKGROUND: Osteoarthritis (OA) of the knee is a common disorder with significant social and financial implications. Obesity is the strongest modifiable risk factor of knee OA. There is little data on obesity in Irish knee OA populations and its relationship to other measures of disease severity. AIMS: In Beaumont Hospital, we have been collecting data on patients presenting with knee OA as part of a screening process for potential candidates for therapeutic exercise intervention studies. Here, we present data on the first 96 candidates screened during this process. RESULTS: The mean body mass index (BMI) of the group fell within the obese range (31); indeed, only 21% had a normal BMI. The vast majority of our patients had severe self-reported disability. In contrast, the distribution of radiographic severity of knee OA was more even. There was no significant relationship between radiographic severity and disability. BMI did predict disability but had a weak correlation. Radiographic severity did not correlate with BMI. CONCLUSION: Irish patients with knee OA referred for physiotherapy were very disabled, significantly obese and represent a challenging cohort of patients to treat.

Measuring patient satisfaction with exercise therapy for knee osteoarthritis: evaluating the utility of the physiotherapy outpatient survey.

OBJECTIVES: To assess patient satisfaction with exercise for knee osteoarthritis (OA). METHODS: A convenience sample of 27 patients recruited to a randomized controlled trial (RCT) comparing open kinetic chain and closed kinetic chain exercises for knee OA were reassessed at nine months post-randomization. Clinical outcomes included self-report and physical performance measures of function and pain severity. Patients also completed the Physiotherapy Outpatient Survey (POPS), which is a multi-dimensional measure of patient satisfaction with physiotherapy. RESULTS: There was no significant difference in satisfaction between the two intervention groups. Overall mean satisfaction for the entire cohort was 4.07 of a maximum score of 5 (standard deviation (SD) = 0.52). Lower levels of satisfaction with outcome (mean = 3.56, SD = 0.8) were reported compared with other domains of expectations, communication, organization and the therapist (mean = 3.79-4.49; SDs = 0.42-0.92). Both intervention groups improved from baseline on clinical outcomes of pain, self-report function and walking distance, with no significant differences between the two groups. CONCLUSIONS: High levels of satisfaction were reported in this subsample of knee OA patients participating in an RCT evaluating the effects of different exercise approaches for knee OA. Satisfaction varied depending on the satisfaction domain, with lower satisfaction with outcome compared with other aspects of care. The POPS questionnaire can be used to measure the multi-dimensional aspects of satisfaction with physiotherapy.