Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Jan 2013
Illness perceptions in the context of differing work participation outcomes: exploring the influence of significant others in persistent back pain.
Previous research has demonstrated that the significant others of individuals with persistent back pain may have important influences on work participation outcomes. The aim of this study was to extend previous research by including individuals who have remained in work despite persistent back pain in addition to those who had become incapacitated for work, along with their significant others. The purpose of this research was to explore whether the illness beliefs of significant others differed depending on their relative's working status, and to make some preliminary identification of how significant others may facilitate or hinder work participation for those with persistent back pain. ⋯ Significant others of employed individuals with back pain focused on the extent to which activity could still be undertaken despite back pain symptoms. Individuals out of work due to persistent back pain apparently self-limited their activity and were supported in their beliefs and behaviours by their significant others. To justify incapacity due to back pain, this group had seemingly become entrenched in a position whereby it was crucial that the individual with back pain was perceived as completely disabled. We suggest that significant others are clearly important, and potentially detrimental, sources of support to individuals with back pain. The inclusion of significant others in vocational rehabilitation programmes could potentially be a valuable way of mobilising readily accessible resources in a way that supports optimal functioning.
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Bmc Musculoskel Dis · Jan 2013
Smoking and primary total hip or knee replacement due to osteoarthritis in 54,288 elderly men and women.
The reported association of smoking with risk of undergoing a total joint replacement (TJR) due to osteoarthritis (OA) is not consistent. We evaluated the independent association between smoking and primary TJR in a large cohort. ⋯ The strengths of the inverse association between smoking and TJR, the temporal relationship of the association, together with the consistency in the findings warrant further investigation about the role of smoking in the pathogenesis of osteoarthritis causing TJR.
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Bmc Musculoskel Dis · Jan 2013
The six-minute walk test is an excellent predictor of functional ambulation after total knee arthroplasty.
The Six-minute walk (6 MW) and Timed-Up-and-Go (TUG) are short walk tests commonly used to evaluate functional recovery after total knee arthroplasty (TKA). However, little is known about walking capacity of TKA recipients over extended periods typical of everyday living and whether these short walk tests actually predict longer, more functional distances. Further, short walk tests only correlate moderately with patient-reported outcomes. The overarching aims of this study were to compare the performance of TKA recipients in an extended walk test to healthy age-matched controls and to determine the utility of this extended walk test as a research tool to evaluate longer term functional mobility in TKA recipients. ⋯ Though TKA recipients are able to walk for 30 minutes one year post-surgery, their performance falls significantly short of age-matched norms. The 30 MW test is strongly predicted by 6 MW test performance, thus providing strong construct validity for the use of the 6 MW test in the TKA population. Neither a short nor long walk test is a strong predictor of patient-reported function after TKA.
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Bmc Musculoskel Dis · Jan 2013
A patient and physician survey of fibromyalgia across Latin America and Europe.
Patients and physicians from three Latin American (LA) and six European countries were surveyed in order to describe differences in journey to diagnosis, impact, and management of fibromyalgia (FM). ⋯ Patient- and physician-rated disease perception and impact was often higher in LA than in Europe. Patient and physician perspective concerning FM impact and disruption were often misaligned within the same region. Our observations may be representative of cultural differences in stoicism, expression, beliefs, and attitudes to pain perception and management. Better understanding of these complexities could help targeted educational/training programs incorporating cultural differences, to improve chronic care.
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Bmc Musculoskel Dis · Jan 2013
Impact of age and comorbidity burden on mortality and major complications in older adults undergoing orthopaedic surgery: an analysis using the Japanese diagnosis procedure combination database.
The purpose of this study was to examine how complications in older adults undergoing orthopaedic surgery vary as a function of age, comorbidity, and type of surgical procedure. ⋯ Our data demonstrated that an increased comorbid burden as measured by Charlson comorbidity index has a greater impact on postoperative mortality and major complications than age in older adults undergoing orthopaedic surgery. After adjustment, mortality following lumbar arthrodesis or cervical laminoplasty was twice as high as that in TKA. Our findings suggest that an assessment of perioperative risks in elderly patients undergoing orthopaedic surgery should be stratified according to comorbidity burden and type of procedures, as well as by patient's age.