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Knee function, Physical Activity and Perceived Health after Meniscectomy in the Middle-aged

Ericsson, Ylva LU (2009) In Lund University, Faculty of Medicine Doctoral Dissertation Series 2009:100.
Abstract
The aim of this thesis was to explore the impact of meniscal injury and meniscectomy on joint and muscle function, physical activity and perceived health in middle-age subjects and to evaluate the effect of a functional exercise program.



Male and female post meniscectomy patients participated in Studies I-IV (n=45 in Studies I-III, n=99 in Study IV) and Study IV also included 94 controls. Outcome measures were thigh muscle strength, functional performance tests, femoral cartilage quality (assessed by dGEMRIC) and Body Mass Index (BMI) in addition to four questionnaires: the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Knee Self Efficacy Scale (K-SESABC), the Physical Activity Scale (PAS) and the MOS Short... (More)
The aim of this thesis was to explore the impact of meniscal injury and meniscectomy on joint and muscle function, physical activity and perceived health in middle-age subjects and to evaluate the effect of a functional exercise program.



Male and female post meniscectomy patients participated in Studies I-IV (n=45 in Studies I-III, n=99 in Study IV) and Study IV also included 94 controls. Outcome measures were thigh muscle strength, functional performance tests, femoral cartilage quality (assessed by dGEMRIC) and Body Mass Index (BMI) in addition to four questionnaires: the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Knee Self Efficacy Scale (K-SESABC), the Physical Activity Scale (PAS) and the MOS Short Form-36 (SF-36) health scale.

Studies I-II revealed that patients had less strength in the operated compared to the nonoperated leg (mean difference 9%) and the deficit was associated with symptoms and functional limitations (KOOS). Cartilage quality (dGEMRIC Index) in the medial compartment was 14% lower than in the lateral, and correlated positively with thigh muscle strength/BW and negatively with BMI. In study III, patients were randomized to a four- month functional exercise intervention or to no intervention. The exercise group tolerated the training well and improved in one-leg hop, hamstrings strength and quadriceps endurance. In study IV patients scored lower than controls in K-SES and in two SF-36 subscales. Only 46% of the patients had resumed their pre-injury PA level, although current PA did not differ between the groups. In the patient group, K-SES was associated with PAS (rs=0.42) and SF-36 (rs= 0.35-0.85). Female patients scored lower than male patients in K-SES and four SF-36 subscales.



In conclusion, patients were found to have considerable symptoms, functional limitations and lower self efficacy than controls 3-4 years after meniscectomy. Strong thigh muscles seem to be helpful for improving knee function and protecting knee cartilage, whereas high BMI appears to be harmful to the cartilage. Functional exercise training after meniscectomy could be a useful method for restoring knee function, thus helping patients to resume PA and maintain good health. (Less)
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author
supervisor
opponent
  • PT PhD Thomeé, Roland, Dept of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
physical activity, dGEMRIC, self efficacy of knee function, functional performance, muscle strength, meniscectomy, middle-aged, health-related quality of life, BMI, functional exercise
in
Lund University, Faculty of Medicine Doctoral Dissertation Series
volume
2009:100
pages
122 pages
publisher
Lund University
defense location
Medelhavet, Wallenberglaboratoriet, Universitetssjukhuset MAS
defense date
2009-11-20 13:00
ISSN
1652-8220
ISBN
978-91-86253-88-2
language
English
LU publication?
yes
id
84c364da-22b2-48af-98d7-b9a8696905ff (old id 1497441)
date added to LUP
2009-11-06 11:00:10
date last changed
2016-09-19 08:44:50
@phdthesis{84c364da-22b2-48af-98d7-b9a8696905ff,
  abstract     = {The aim of this thesis was to explore the impact of meniscal injury and meniscectomy on joint and muscle function, physical activity and perceived health in middle-age subjects and to evaluate the effect of a functional exercise program.<br/><br>
<br/><br>
Male and female post meniscectomy patients participated in Studies I-IV (n=45 in Studies I-III, n=99 in Study IV) and Study IV also included 94 controls. Outcome measures were thigh muscle strength, functional performance tests, femoral cartilage quality (assessed by dGEMRIC) and Body Mass Index (BMI) in addition to four questionnaires: the Knee Injury and Osteoarthritis Outcome Score (KOOS), the Knee Self Efficacy Scale (K-SESABC), the Physical Activity Scale (PAS) and the MOS Short Form-36 (SF-36) health scale. <br/><br>
Studies I-II revealed that patients had less strength in the operated compared to the nonoperated leg (mean difference 9%) and the deficit was associated with symptoms and functional limitations (KOOS). Cartilage quality (dGEMRIC Index) in the medial compartment was 14% lower than in the lateral, and correlated positively with thigh muscle strength/BW and negatively with BMI. In study III, patients were randomized to a four- month functional exercise intervention or to no intervention. The exercise group tolerated the training well and improved in one-leg hop, hamstrings strength and quadriceps endurance. In study IV patients scored lower than controls in K-SES and in two SF-36 subscales. Only 46% of the patients had resumed their pre-injury PA level, although current PA did not differ between the groups. In the patient group, K-SES was associated with PAS (rs=0.42) and SF-36 (rs= 0.35-0.85). Female patients scored lower than male patients in K-SES and four SF-36 subscales.<br/><br>
<br/><br>
In conclusion, patients were found to have considerable symptoms, functional limitations and lower self efficacy than controls 3-4 years after meniscectomy. Strong thigh muscles seem to be helpful for improving knee function and protecting knee cartilage, whereas high BMI appears to be harmful to the cartilage. Functional exercise training after meniscectomy could be a useful method for restoring knee function, thus helping patients to resume PA and maintain good health.},
  author       = {Ericsson, Ylva},
  isbn         = {978-91-86253-88-2},
  issn         = {1652-8220},
  keyword      = {physical activity,dGEMRIC,self efficacy of knee function,functional performance,muscle strength,meniscectomy,middle-aged,health-related quality of life,BMI,functional exercise},
  language     = {eng},
  pages        = {122},
  publisher    = {Lund University},
  school       = {Lund University},
  series       = {Lund University, Faculty of Medicine Doctoral Dissertation Series},
  title        = {Knee function, Physical Activity and Perceived Health after Meniscectomy in the Middle-aged},
  volume       = {2009:100},
  year         = {2009},
}