How can we limit the impact of osteoarthritis on quality of life?

Edito of 2016/01/28

Regardless of location, osteoarthritis impacts upon the patient's quality of life. However, this impact can be limited by a series of measures that can be easily implemented (physical exercise and diet) even if they are not always easy to follow.

With a disease like osteoarthritis, any quality of life evaluation must assess how the patient perceives his/her pain, disability and, more generally, his/her health. Consequently, in this evaluation, preference is given to self-questionnaires, especially those which can be used to establish Lesquesne's index (a measure of pain and function) (hip and knee).

Medical publications that focus on quality of life assessments are essentially "before and after" surgery evaluations (total hip1 and knee2 replacements). They confirm the negative effects of osteoarthritis on quality of life (evaluation before surgery). Conversely, they highlight the positive effects of surgery in the "after" evaluation.

Not all patients with osteoarthritis are candidates for surgery (this is mainly reserved for the hip and knee). Nevertheless, they are not condemned to sit back and watch their quality of life deteriorate either. Three measures (apart from symptomatic treatments) can slow down this deterioration.

Physical activity is the first of these measures. It comprises 2 aspects: aerobic aspect (walking, cycling, swimming) and strengthening the muscles with physiotherapy taking a dominant role. To be effective, this physical activity must be regular, progressive and individualised (according to the physical capacity, taste and availability of the patient).

The second measure is weight monitoring. Any tendency to gain weight must be overcome regardless of which part of the body is affected by osteoarthritis (remember the links between obesity and digital osteoarthritis).

Articular economy is the third measure. This involves alleviating the pressure placed on joints when moving round (uneven terrain, stairs, etc.), adapting the home environment in line with the disability and using technical aids (walking sticks, orthoses and soles).

 

Références :

(1) Vogl M, Wilkesmann R, Lausmann C, Hunger M, Plötz W. The impact of
preoperative patient characteristics on health states after total hip replacement
and related satisfaction thresholds: a cohort study. Health Qual Life Outcomes
2014 Aug 7;12:108.

(2) Shan L, Shan B, Suzuki A, Nouh F, Saxena A. Intermediate and long-term quality
of life after total knee replacement: a systematic review and meta-analysis. J
Bone Joint Surg Am. 2015 Jan 21;97(2):156-68.

 

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