Combined knee osteoarthritis and diabetes is associated with reduced muscle strength, physical inactivity, and poorer quality of life
DOI:
https://doi.org/10.2340/jrm.v56.39986Keywords:
Physical activity, Getriatic, Physical Performance, Psychological Status, Pain, Non-communicable DiseaseAbstract
Objective: This study delves into the intriguing connection between knee osteoarthritis and diabetes in Malaysia. Specifically, the exacerbation of knee osteoarthritis in the presence of diabetes in terms of symptoms, physical performance, physical activity, psychological status, social participation, and quality of life was discussed.
Design: This cross-sectional study recruited adults aged 50 and above by convenient sampling and grouped them into: knee osteoarthritis-diabetes-, knee osteoarthritis+diabetes-, knee osteoarthritis-diabetes+, and knee osteoarthritis+diabetes+.
Subjects/Patients: Of 436 recruited participants, 261 (59.8%) participants reported knee osteoarthritis.
Methods: Handgrip strength, Timed Up and Go test, 6 Meter Walk Test, and 5 Times Sit to Stand Test were measured using standardized procedures. Six questionnaires were administered for the remaining parameters.
Results: Across groups, there were significant differences: 6 Meter Walk Test (p = 0.024), Timed Up and Go test (p = 0.020), and 5 Times Sit to Stand Test (p < 0.001), quality of life (p = 0.009), and physical activity (p = 0.036). Knee osteoarthritis+diabetes+ was independently associated with reduced handgrip strength, 5 Times Sit to Stand Test, quality of life, and physical inactivity after adjustment. Knee osteoarthritis+diabetes- was independently associated with reduced Timed Up and Go test and social isolation.
Conclusion: The findings revealed the diabetic knee osteoarthritis subgroup’s unique physical and psychosocial features of reduced muscle strength and physical inactivity. Future studies should investigate whether managing metabolic factors, and enhancing physical activity and strength exercises, can reduce knee osteoarthritis symptoms and disease severity.
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References
Allen KD, Thoma LM, Golightly YM. Epidemiology of osteoarthritis. Osteoarthritis Cartilage 2022; 30: 184-195.
https://doi.org/10.1016/j.joca.2021.04.020 DOI: https://doi.org/10.1016/j.joca.2021.04.020
Veerapen K, Wigley RD, Valkenburg H. Musculoskeletal pain in Malaysia: a COPCORD survey. J Rheumatol 2007; 34: 207-213
Mat S, Jaafar MH, Ng CT, Sockalingam S, Raja J, Kamaruzzaman SB, et al. Ethnic differences in the prevalence, socioeconomic and health related risk factors of knee pain and osteoar-thritis symptoms in older Malaysians. PLoS One 2019; 14: e0225075.
https://doi.org/10.1371/journal.pone.0225075 DOI: https://doi.org/10.1371/journal.pone.0225075
Dell'Isola A, Allan R, Smith SL, Marreiros SSP, Steultjens M. Identification of clinical phenotypes in knee osteoarthritis: a systematic review of the literature. BMC Musculoskelet Disord 2016; 17: 425.
https://doi.org/10.1186/s12891-016-1286-2 DOI: https://doi.org/10.1186/s12891-016-1286-2
Eitner A, Culvenor AG, Wirth W, Schaible H-G, Eckstein F. Impact of diabetes mellitus on knee osteoarthritis pain and physical and mental status: data from the Osteoarthritis Initia-tive. Arthritis Care Res (Hoboken) 2021; 73: 540-548.
https://doi.org/10.1002/acr.24173 DOI: https://doi.org/10.1002/acr.24173
Schett G, Kleyer A, Perricone C, Sahinbegovic E, Iagnocco A, Zwerina J, et al. Diabetes is an independent predictor for severe osteoarthritis: results from a longitudinal cohort study. Diabetes Care 2013; 36: 403-409.
https://doi.org/10.2337/dc12-0924 DOI: https://doi.org/10.2337/dc12-0924
Laiguillon MC, Courties A, Houard X, Auclair M, Sautet A, Capeau J, et al. Characterization of diabetic osteoarthritic cartilage and role of high glucose environment on chondrocyte activation: toward pathophysiological delineation of diabetes mellitus-related osteoar-thritis. Osteoarthritis Cartilage 2015; 23: 1513-1522.
https://doi.org/10.1016/j.joca.2015.04.026 DOI: https://doi.org/10.1016/j.joca.2015.04.026
Louati K, Vidal C, Berenbaum F, Sellam J. Association between diabetes mellitus and osteoar-thritis: systematic literature review and meta-analysis. RMD Open 2015; 1: e000077.
https://doi.org/10.1136/rmdopen-2015-000077 DOI: https://doi.org/10.1136/rmdopen-2015-000077
Zaharia OP, Pesta DH, Bobrov P, Kupriyanova Y, Herder C, Karusheva Y, et al. Reduced muscle strength is associated with insulin resistance in type 2 diabetes patients with osteoar-thritis. J Clin Endocrinol Metab 2021; 106: 1062-1073.
https://doi.org/10.1210/clinem/dgaa912 DOI: https://doi.org/10.1210/clinem/dgaa912
Fujita R, Ota S, Yamamoto Y, Kataoka A, Warashina H, Inoue T, et al. Effect of diabetes mellitus on physical activity in patients with knee osteoarthritis: a cross-sectional study. J Orthop Surg 2023; 31: 10225536231197726.
https://doi.org/10.1177/10225536231197726 DOI: https://doi.org/10.1177/10225536231197726
Wallis JA, Taylor NF, Bunzli S, Shields N. Experience of living with knee osteoarthritis: a systematic review of qualitative studies. BMJ Open 2019; 9: e030060.
https://doi.org/10.1136/bmjopen-2019-030060 DOI: https://doi.org/10.1136/bmjopen-2019-030060
Mat S, Kamaruzzaman SB, Chin A-V, Tan MP. Impact of knee pain on fear of falling, changes in instrumental activities of daily living, and falls among Malaysians age 55 years and above. Front Public Health 2020; 8: 571196.
https://doi.org/10.3389/fpubh.2020.571196 DOI: https://doi.org/10.3389/fpubh.2020.571196
Losina E, Silva GS, Smith KC, Collins JE, Hunter DJ, Shrestha S, et al. Quality-adjusted life-years lost due to physical inactivity in a US population with osteoarthritis. Arthritis Care Res (Hoboken) 2020; 72: 1349-1357.
https://doi.org/10.1002/acr.24035 DOI: https://doi.org/10.1002/acr.24035
Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis: classification of osteoarthritis of the knee. Arthritis Rheum 1986; 29: 1039-1049.
https://doi.org/10.1002/art.1780290816 DOI: https://doi.org/10.1002/art.1780290816
American Diabetes A. 2. Classification and diagnosis of diabetes: standards of medical care in diabetes-2021. Diabetes Care 2020; 44: S15-S33.
https://doi.org/10.2337/dc21-S002 DOI: https://doi.org/10.2337/dc21-S002
Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS): from joint injury to osteoarthritis. Health Qual Life Outcomes 2003; 1: 64.
https://doi.org/10.1186/1477-7525-1-64 DOI: https://doi.org/10.1186/1477-7525-1-64
Bohannon RW. Grip strength: an indispensable biomarker for older adults. Clin Interv Aging 2019; 14: 1681-1691.
https://doi.org/10.2147/CIA.S194543 DOI: https://doi.org/10.2147/CIA.S194543
Chen L-K, Woo J, Assantachai P, Auyeung T-W, Chou M-Y, Iijima K, et al. Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc 2020; 21: 300-307.e302.
https://doi.org/10.1016/j.jamda.2019.12.012 DOI: https://doi.org/10.1016/j.jamda.2019.12.012
Bauer K, Lau T, Schwille-Kiuntke J, Schild S, Hauner H, Stengel A, et al. Conventional weight loss interventions across the different BMI obesity classes: a systematic review and quantitative comparative analysis. Eur Eat Disord Rev 2020; 28: 492-512.
https://doi.org/10.1002/erv.2741 DOI: https://doi.org/10.1002/erv.2741
Samah ZA, Singh DKA, Murukesu RR, Shahar S, Nordin NAM, Omar MA, et al. Discriminative and predictive ability of physical performance measures in identifying fall risk among older adults. Sains Malays 2018; 47: 2769-2776.
https://doi.org/10.17576/jsm-2018-4711-19 DOI: https://doi.org/10.17576/jsm-2018-4711-19
Kim HJ, Park I, Lee HJ, Lee O. The reliability and validity of gait speed with different walking pace and distances against general health, physical function, and chronic disease in aged adults. J Exerc Nutrition Biochem 2016; 20: 46-50.
https://doi.org/10.20463/jenb.2016.09.20.3.7 DOI: https://doi.org/10.20463/jenb.2016.09.20.3.7
Bohannon RW, Williams Andrews A. Normal walking speed: a descriptive meta-analysis. Physiotherapy 2011; 97: 182-189.
https://doi.org/10.1016/j.physio.2010.12.004 DOI: https://doi.org/10.1016/j.physio.2010.12.004
Tapanya W, Sangkarit N, Amput P, Konsanit S. Lower extremity muscle strength equation of older adults assessed by Five Time Sit to Stand Test (FTSST). Hong Kong Physiother J 2023; 44: 1-10.
https://doi.org/10.1142/S1013702523500099 DOI: https://doi.org/10.1142/S1013702523500099
Whitney SL, Wrisley DM, Marchetti GF, Gee MA, Redfern MS, Furman JM. Clinical measurement of sit-to-stand performance in people with balance disorders: validity of data for the five-times-sit-to-stand test. Phys Ther 2005; 85: 1034-1045.
https://doi.org/10.1093/ptj/85.10.1034 DOI: https://doi.org/10.1093/ptj/85.10.1034
Kim M, Won CW. Cut points of chair stand test for poor physical function and its association with adverse health outcomes in community-dwelling older adults: a cross- sectional and longitudinal study. J Am Med Dir Assoc 2022; 23: 1375-1382.e1373.
https://doi.org/10.1016/j.jamda.2021.11.007 DOI: https://doi.org/10.1016/j.jamda.2021.11.007
Ipaq Research Committee. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ)-short and long forms. 2005. Available from: https://www.ipaq.ki.se/scoring
Osman A, Wong JL, Bagge CL, Freedenthal S, Gutierrez PM, Lozano G. The Depression Anxiety Stress Scales-21 (DASS-21): further examination of dimensions, scale reliability, and correlates. J Clin Psychol 2012; 68: 1322-1338.
https://doi.org/10.1002/jclp.21908 DOI: https://doi.org/10.1002/jclp.21908
Ross W, George P, Thomas E, Helen H, Peter RC. The Keele Assessment of Participation: a new instrument to measure participation restriction in population studies. Combined quali-tative and quantitative examination of its psychometric properties. Qual Life Res 2005; 14: 1889-1899.
https://doi.org/10.1007/s11136-005-4325-2 DOI: https://doi.org/10.1007/s11136-005-4325-2
Lubben J, Blozik E, Gillmann G, Iliffe S, von Renteln Kruse W, Beck JC, et al. Performance of an abbreviated version of the Lubben Social Network Scale among three European commu-nity-dwelling older adult populations. Gerontologist 2006; 46: 503-513.
https://doi.org/10.1093/geront/46.4.503 DOI: https://doi.org/10.1093/geront/46.4.503
Pérez-Rojo G, Martín N, Noriega C, López J. Psychometric properties of the CASP-12 in a Spanish older community dwelling sample. Aging Ment Health 2018; 22: 700-708.
https://doi.org/10.1080/13607863.2017.1292208 DOI: https://doi.org/10.1080/13607863.2017.1292208
Miksch A, Hermann K, Rölz A, Joos S, Szecsenyi J, Ose D, et al. Additional impact of concomitant hypertension and osteoarthritis on quality of life among patients with type 2 diabetes in primary care in Germany: a cross-sectional survey. Health Qual Life Outcomes 2009; 7: 19.
https://doi.org/10.1186/1477-7525-7-19 DOI: https://doi.org/10.1186/1477-7525-7-19
Vitaloni M, Botto-van Bemden A, Sciortino Contreras RM, Scotton D, Bibas M, Quintero M, et al. Global management of patients with knee osteoarthritis begins with quality of life as-sessment: a systematic review. BMC Musculoskelet Disord 2019; 20: 493.
https://doi.org/10.1186/s12891-019-2895-3 DOI: https://doi.org/10.1186/s12891-019-2895-3
Atukorala I, Hunter DJ. A review of quality-of-life in elderly osteoarthritis. Expert Rev Pharmaco econ Outcomes Res 2023; 23: 365-381.
https://doi.org/10.1080/14737167.2023.2181791 DOI: https://doi.org/10.1080/14737167.2023.2181791
Brown GC, Brown MM, Sharma S, Brown H, Gozum M, Denton P. Quality of life associated with diabetes mellitus in an adult population. J Diabetes Complications 2000; 14: 18-24.
https://doi.org/10.1016/S1056-8727(00)00061-1 DOI: https://doi.org/10.1016/S1056-8727(00)00061-1
Wen L, Shin M-H, Kang J-H, Yim Y-R, Kim J-E, Lee J-W, et al. Association between grip strength and hand and knee radiographic osteoarthritis in Korean adults: data from the Dong-gu study. PLoS One 2017; 12: e0185343.
https://doi.org/10.1371/journal.pone.0185343 DOI: https://doi.org/10.1371/journal.pone.0185343
Gundmi S, Maiya AG, Bhat AK, Ravishankar N, Hande MH, Rajagopal KV. Hand dysfunction in type 2 diabetes mellitus: systematic review with meta-analysis. Ann Phys Rehabil Med 2018; 61: 99-104.
https://doi.org/10.1016/j.rehab.2017.12.006 DOI: https://doi.org/10.1016/j.rehab.2017.12.006
Vancampfort D, Stubbs B, Firth J, Koyanagi A. Handgrip strength, chronic physical conditions and physical multimorbidity in middle-aged and older adults in six low- and middle income countries. Eur J Intern Med 2019; 61: 96-102.
https://doi.org/10.1016/j.ejim.2018.11.007 DOI: https://doi.org/10.1016/j.ejim.2018.11.007
Strollo SE, Caserotti P, Ward RE, Glynn NW, Goodpaster BH, Strotmeyer ES. A review of the relationship between leg power and selected chronic disease in older adults. J Nutr He-alth Aging 2015; 19: 240-248.
https://doi.org/10.1007/s12603-014-0528-y DOI: https://doi.org/10.1007/s12603-014-0528-y
Vaz MM, Costa GC, Reis JG, Junior WM, Albuquerque de Paula FJ, Abreu DC. Postural control and functional strength in patients with type 2 diabetes mellitus with and without pe-ripheral neuropathy. Arch Phys Med Rehabil 2013; 94: 2465-2470.
https://doi.org/10.1016/j.apmr.2013.06.007 DOI: https://doi.org/10.1016/j.apmr.2013.06.007
Tiwari D, Talley SA, Alsalaheen B, Goldberg A. Strength of association between the Five-Times-Sit-to-Stand Test and balance, knee extensor strength and lower limb power in commu-nity-dwelling older adults. Int J Ther Rehabil 2019; 26: 1-10.
https://doi.org/10.12968/ijtr.2018.0001 DOI: https://doi.org/10.12968/ijtr.2018.0001
Leenders M, Verdijk LB, van der Hoeven L, Adam JJ, van Kranenburg J, Nilwik R, et al. Patients with type 2 diabetes show a greater decline in muscle mass, muscle strength, and functional capacity with aging. J Am Med Dir Assoc 2013; 14: 585-592.
https://doi.org/10.1016/j.jamda.2013.02.006 DOI: https://doi.org/10.1016/j.jamda.2013.02.006
Alenazi AM, Alshehri MM, Alqahtani BA, Alanazi AD, Bindawas SM. Combined diabetes and arthritis are associated with declined gait speed. Clin Rheumatol 2021; 40: 1593-1598.
https://doi.org/10.1007/s10067-020-05370-3 DOI: https://doi.org/10.1007/s10067-020-05370-3
Xu Y, Tong GYY, Lee JY-C. Investigation on the association between diabetes distress and productivity among patients with uncontrolled type 2 diabetes mellitus in the primary healthcare institutions. Prim Care Diabetes 2020; 14: 538-544.
https://doi.org/10.1016/j.pcd.2020.04.004 DOI: https://doi.org/10.1016/j.pcd.2020.04.004
Lauren KK, Esther W, Crystal M, Ian S, Jane S, Alanna W, et al. 'It's a Dance Between Managing Both': a qualitative study exploring perspectives of persons with knee osteoarthritis and type 2 diabetes mellitus on the impact of osteoarthritis on diabetes management and daily life. BMJ Open 2022; 12: e061472.
https://doi.org/10.1136/bmjopen-2022-061472 DOI: https://doi.org/10.1136/bmjopen-2022-061472
Cleven L, Krell-Roesch J, Nigg CR, Woll A. The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a syste-matic review of longitudinal studies published after 2012. BMC Public Health 2020; 20: 726.
https://doi.org/10.1186/s12889-020-08715-4 DOI: https://doi.org/10.1186/s12889-020-08715-4
Grace HL, Michael JR, Timothy EM, Chantel P, Michael TS, Matthew SH, et al. Increased risk of incident knee osteoarthritis in those with greater work-related physical activity. Occup Environ Med 2022; 79: 543.
https://doi.org/10.1136/oemed-2022-108212 DOI: https://doi.org/10.1136/oemed-2022-108212
Ida S, Murata K. Social isolation of older adults with diabetes. Gerontol Geriatr Med 2022; 8: 23337214221116232.
https://doi.org/10.1177/23337214221116232 DOI: https://doi.org/10.1177/23337214221116232
Lebrec J, Ascher-Svanum H, Chen Y-F, Reed C, Kahle-Wrobleski K, Hake AM, et al. Effect of diabetes on caregiver burden in an observational study of individuals with Alzheimer's disease. BMC Geriatr 2016; 16: 93.
https://doi.org/10.1186/s12877-016-0264-8 DOI: https://doi.org/10.1186/s12877-016-0264-8
Li W, Yin H, Liu Q, Chen Y, Liang Y, Zhou H, et al. Associations among depression, hemoglobin A1c level, and prognosis in patients with coronary artery disease: a prospective study. Front Psychiatry 2022; 13.
https://doi.org/10.3389/fpsyt.2022.815196 DOI: https://doi.org/10.3389/fpsyt.2022.815196
Kaur G, Tee GH, Ariaratnam S, Krishnapillai AS, China K. Depression, anxiety and stress symptoms among diabetics in Malaysia: a cross sectional study in an urban primary care setting. BMC Fam Pract 2013; 14: 69.
https://doi.org/10.1186/1471-2296-14-69 DOI: https://doi.org/10.1186/1471-2296-14-69
Najafi F, Moradinazar M, Hamzeh B, Rezaeian S. The reliability of self-reporting chronic diseases: how reliable is the result of population-based cohort studies. J Prev Med Hyg 2019; 60: E349-e353.
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