Effect of Proper Use of Cane and Physical Therapy Management to Reverse Hamstrings Tightness and Abductors Weakness Due to Improper Use in Knee and Hip OA Patients
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Abstract
Background: Osteoarthritis (OA) is a degenerative joint disease that significantly impairs mobility and quality of life, particularly among the elderly. The use of canes, when applied correctly, can alleviate joint stress, reduce pain, and improve functional mobility. However, improper use can exacerbate symptoms such as hamstring tightness and abductor weakness.
Objective: To investigate the effects of targeted physical therapy and proper cane usage on pain reduction, enhanced range of motion, and improved gait parameters in patients with knee and hip OA.
Methods: This quasi-experimental study enrolled 40 participants aged 40-80 years with diagnosed knee and hip OA from public and private healthcare facilities in Faisalabad. Participants received education on proper cane use and engaged in a physical therapy program consisting of exercises for stretching hamstrings and strengthening abductors, three times a week. Outcomes measured included WOMAC pain scores, hip and knee range of motion (ROM) via goniometry, Trendelenburg test duration for abductor strength, and gait parameters (stride length and cadence). Data were analyzed using SPSS version 25, employing the Wilcoxon signed-rank test to evaluate pre- and post-intervention changes.
Results: Significant improvements were noted post-intervention with the WOMAC pain score decreasing from a mean of 6.2 ± 1.5 to 3.1 ± 1.3 (p < 0.001). Hip extension increased from 20 ± 5 degrees to 30 ± 6 degrees (p < 0.001), and knee flexion improved from 90 ± 10 degrees to 110 ± 9 degrees (p < 0.001). Trendelenburg test duration improved from 10 ± 2 seconds to 25 ± 5 seconds (p < 0.001), and gait parameters showed an increase in stride length from 0.8 m ± 0.1 to 1.0 m ± 0.1 (p < 0.001) and cadence from 90 steps/min to 100 steps/min (p < 0.001).
Conclusion: Proper cane use combined with a structured physical therapy regimen significantly reduces pain and improves both joint mobility and gait dynamics in patients with knee and hip osteoarthritis. These interventions are crucial for enhancing quality of life and mobility in OA patients.
Keywords: Osteoarthritis, Cane Usage, Physical Therapy, Gait Parameters, Range Of Motion, WOMAC Pain Score, Knee Osteoarthritis, Hip Osteoarthritis, Trendelenburg Test, Mobility Aids.
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References
van Delft MA, Huizinga TW. An Overview of Autoantibodies in Rheumatoid Arthritis. J Autoimmun. 2020;110:102392.
Figus FA, Piga M, Azzolin I, McConnell R, Iagnocco A. Rheumatoid Arthritis: Extra-Articular Manifestations and Comorbidities. Autoimmun Rev. 2021;20(4):102776.
Pisaniello HL, Whittle SL, Lester S, Menz F, Metcalf R, McWilliams L, et al. Using the Derived 28-Joint Disease Activity Score Patient-Reported Components (DAS28-P) Index as a Discriminatory Measure of Response to Disease-Modifying Anti-Rheumatic Drug Therapy in Early Rheumatoid Arthritis. BMC Rheumatol. 2022;6(1):67.
Papakonstantinou D. Work Disability and Rheumatoid Arthritis: Predictive Factors. Work. 2021;69(4):1293-304.
Radu A-F, Bungau SG. Management of Rheumatoid Arthritis: An Overview. Cells. 2021;10(11):2857.
Mollard E, Michaud K. Self-Management of Rheumatoid Arthritis: Mobile Applications. Curr Rheumatol Rep. 2021;23:1-8.
Nagy G, Roodenrijs NM, Welsing PM, Kedves M, Hamar A, van der Goes MC, et al. EULAR Points to Consider for the Management of Difficult-to-Treat Rheumatoid Arthritis. Ann Rheum Dis. 2022;81(1):20-33.
Bolton D. A Revitalized Biopsychosocial Model: Core Theory, Research Paradigms, and Clinical Implications. Psychol Med. 2023:1-8.
Karunamuni N, Imayama I, Goonetilleke D. Pathways to Well-Being: Untangling the Causal Relationships Among Biopsychosocial Variables. Soc Sci Med. 2021;272:112846.
Savalescu J, Davies LW, Roache R, Davies W, Loebel JP. Psychiatry Reborn: Biopsychosocial Psychiatry in Modern Medicine: International Perspectives. 2020.
Frazier LD. The Past, Present, and Future of the Biopsychosocial Model: A Review of The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments by Derek Bolton and Grant Gillett. New Ideas Psychol. 2020;57:100755.
Chau SYL, Leung MHA, Tang WK. The Association of Disease Activity with Depression and Sleep Quality in Patients with Rheumatoid Arthritis in Hong Kong. Int J Rheum Dis. 2023;26:2543-50.
Machin A, Babatunde OO, Haththotuwa R, Scott IC, Blagojevic-Bucknall M, Corp N, et al. The Association Between Anxiety and Disease Activity and Quality of Life in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Clin Rheumatol. 2020;39:1471-82.
Moudi S, Heidari B, Yousefghahari B, Gholami R, Gholinia H, Babaei M. The Prevalence and Correlation of Depression and Anxiety with Disease Activity in Rheumatoid Arthritis. Reumatologia. 2023;61:86-91.
Xiang S, Wang R, Hua L, Song J, Qian S-H, Jin Y-B, et al. Assessment of Bidirectional Relationships Between Mental Illness and Rheumatoid Arthritis: A Two-Sample Mendelian Randomization Study. J Clin Med. 2023;12.
Thiele GM, Duryee MJ, Anderson DR, Klassen LW, Mohring SM, Young KA, et al. Malondialdehyde-Acetaldehyde Adducts and Anti-Malondialdehyde-Acetaldehyde Antibodies in Rheumatoid Arthritis. Arthritis Rheumatol. 2015;67(3):645-55.
Hart PC, Rajab IM, Alebraheem M, Potempa LA. C-Reactive Protein and Cancer—Diagnostic and Therapeutic Insights. Front Immunol. 2020;11:595835.
Matcham F, Rayner L, Steer S, Hotopf M. The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology. 2013 Dec 1;52(12):2136-48.
DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of internal medicine. 2000 Jul 24;160(14):2101-7.
Treharne GJ, Kitas GD, Lyons AC, Booth DA. Well-being in rheumatoid