White DK, Keysor JJ, Lavalley MP, et
al, Boston University School of Medicine and other centers. Clinically important
improvement in function is common in people with or at high risk of knee OA:
the MOST study. J Rheumatol. 2010;37:1244-1251.
Meaningful improvement is common
among patients who have or are at risk for osteoarthritis (OA) of the knee 30
months after initial assessment. Improvements occur more frequently in persons
who do not have evidence of radiographic OA and in those who have fast walking
speeds.
To determine what factors might
influence or predict a patient’s level of activity after receiving a diagnosis
of OA, White and associates examined data from 1801 participants in the
longitudinal Multicenter Osteoarthritis Study (MOST). They used the Western
Ontario McMaster Universities Osteoarthritis Index (WOMAC) to identify minimal
clinically important (to the patient) improvement (MCII).
MOST patients who attained MCII had
several shared characteristics that set them apart from those with functional
limitations: a lower body mass index, less radiographic OA and knee pain, fewer
depressive symptoms, less medication use, faster walking speed, and stronger
knees. The strongest predictors of functionality were radiographic OA and
walking speed: persons with no radiographic OA were 40% to 50% more likely to
achieve MCII, and those who walked 1.0 m/s faster were twice as likely to
remain functional.
The authors noted that physicians
might consider predictors of functionality in trying to determine who may
benefit from therapeutic intervention.
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