Article

OBJECTIVES: To identify factors that predicted incident use of assistive walking
devices (AWDs) and to explore whether AWD use was associated with changes in
osteoarthritis of the knee. DESIGN: Prospective cohort study. SETTING: Community.
PARTICIPANTS: Older adults (N=2639) in the Health, Aging and Body Composition
(Health ABC) Study including a subset of 874 patients with prevalent knee pain.
INTERVENTIONS: Not applicable. MAIN : Incident use of AWDs, mean
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain
scores, and the frequency of joint space narrowing on knee radiographs over a
3-year time period. RESULTS: AWD use was initiated by 9% of the entire Health ABC
cohort and 12% of the knee pain subset. Factors that predicted use in both groups
were age >/=73 (entire cohort: odds ratio [OR]=2.07; 95% confidence interval
[CI], 1.43-3.01; knee pain subset: OR=1.87; 95% CI, 1.16-3.03), black race
(entire cohort: OR=2.95; 95% CI, 2.09-4.16; knee pain subset: OR=3.21; 95% CI,
2.01-5.11), and lower balance ratios (entire cohort: OR=3.18; 95% CI, 2.21-4.59;
knee pain subset: OR=3.77; 95% CI, 2.34-6.07). Mean WOMAC pain scores decreased
slightly over time in both AWD and non-AWD users. Twenty percent of non-AWD users
and 28% of AWD users had radiographic progression in joint space narrowing of the
tibiofemoral joint in at least 1 knee. Fourteen percent of non-AWD users and 12%
of AWD users had radiographic progression in joint space narrowing in the
patellofemoral joint in at least 1 knee. CONCLUSIONS: AWDs are frequently used by
older adults. Knee pain and balance problems are significant reasons why older
adults initiate use of an AWD. In an exploratory analysis, there was no
consistent relation between the use or nonuse of an AWD and WOMAC pain scores or
knee joint space narrowing progression. Further studies of the relation of use of
AWDs to changes in knee osteoarthritis are needed.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS