A

Synopsis
On
PROPOSED TOPIC OF RESEARCH
For

The Degree of Doctor of Physical Therapy

In

Agile Institute of Rehabilitation Sciences

Bahawalpur.
Year: 2019
Assessment of Health Related Quality of
Life in Patients with Knee Osteoarthritis in
Bahawalpur.

Name of Supervisor:
Dr. Muhammad Kaleem
BSPT , PP-DPT (M.Phil)
Assistant Professor Agile Institute
Of Rehabilitation Sciences
Bahawalpur.

Submitted By:

Arslan Saeed

Rohaib Akhtar

Mohammad Arslan

Toqeer Zulfiqar
Introduction:
Osteoarthritis (OA) is the most common degenerative disease of

joints and a major health problem throughout the world. Osteoarthritis

affects all structures of a joint. Not only articular hyaline cartilage is lost,

but bony remodeling also occurs alongwith capsular stretching and

weakness of muscles around the joint. Although osteoarthritis can occur

at almost any joint, but it affects the knee joint with a high prevalence.

Patients with knee OA usually report limitations in their daily lives,

including basic tasks, work and leisure activities and these limitations

affect patients who were retired as well as those still working. Most of

the people affected by OA are older than 45 years. Osteoarthritis is also a

leading cause of impaired mobility in the elderly.1 According to a

research data from China, the overall prevalence of knee OA was about

13.8%, and there was a tendency of increased knee OA prevalence with

age, especially after 40 years old.2

Till now, there is no currently approved OA treatment plan capable

of slowing down OA-related structural progression or delaying the need

for total knee replacement.3 Thus current guidelines for management of

knee OA focuses on symptoms relief and functional improvements.4 The

final and ultimate goal of clinical treatment is to improve the health

condition and functional capacity of the patient. Health related quality of

life (HRQoL) is an important outcome measure for health condition and

evaluation of treatments in OA patients. Therefore, understanding the

concept of quality of life (QoL), symptoms and their relationship in

osteoarthritis patients is of importance.

Objectives:

The objective of the study is to evaluate the quality of life of a group of

patients with knee osteoarthritis of grade 3 according to the Kellgren and

Lawrence classification system and to assess the possible influencing factors

associated with QoL of knee OA patients.

Operational Definitions:

Knee Osteoarthritis:-

Knee osteoarthritis is a degenerative disease of joints and is a major

public health issue related to age, characterized by progressive loss of

articular cartilage resulting in knee pain, functional impairment, disability

and diminished patient's quality of life.5

Quality of life:-

QoL was defined as either the subjective perception of one’s own well-

being within socio-cultural context or as the satisfaction of desires and

pleasures and the accomplishment of the ideal to a standard of

perfection.6

Kellgren and Lawrence system for classification7:-

Changes seen on a plane radiograph.

Grade 0: No radiographic features of OA are present.

Grade 1: Doubtful joint space narrowing (JSN) and possible osteophytic

lipping.

Grade 2: Definite osteophytes and possible JSN on anteroposterior

weight-bearing radiograph.

Grade 3: Multiple osteophytes, definite JSN, sclerosis, possible bony

deformity.

Grade 4: Large osteophytes, marked JSN, severe sclerosis and definite

bony deformity.
Materials and methods:

Study Design: Descriptive cross-sectional study.

Setting: Physiotherapy outpatient department of Bahawal Victoria Hospital

Bahawalpur.

Sample Size: 100 patients suffering from knee osteoarthiritis.

Sampling Technique : Non-Probability Convenient sampling technique.

Sample Selection:

Inclusion Criteria:

. Willing Males and Females

. Knee OA

. Age 45 or above

Exclusion Criteria:

. Unwilling patients

. Age < 45 years

. Patients with other chronic diseases and musculoskeletal disorders

Data Collection Procedure:

All the subjects will be informed about the study. They have to sign a consent

form showing their willingness to participate in the study. All the participants
will be first assessed for knee OA of grade 3 according to the Kellgren and

Lawrence classification system. All participants fulfilling the criteria of

eligibility as per inclusion criteria will be included. Data will be collected by

the use of SF-36 questionnaire consists of 36 statements. A questionnaire will

be handed over to all the participants. All the variables of the questionnaire will

be explained to them. Filled questionnaire of their response of Quality of life

will b collected by the assessor .

Data Collection Instrument:

Questionnaire SF-36 attached as annexure

Data Analyzing Procedure:

Data will be analyzed using SPSS version 21 in department of community

medicine in Agile institute of rehabilitation sciences. Scoring of each question

(variable) in questionnaire will be done. Frequencies and percentages will be

calculated and will be presented in the form of tables and figures.

Key Words:

OA: Osteoarthritis.

BVH: Bahawal Victoria Hospital.

QoL: Quality of life.

HRQoL: Health related quality of life.

OPD: Outpatient Department

References:

1. Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific

medical conditions on the functional limitations of elders in the

Framingham Study. Am J Pub Health. 1994;84:351–58.

2. Zhang J, Song L, Liu G, et al. Risk factors for and prevalence of knee

osteoarthritis in the rural areas of Shanxi Province, North China:

COPCORD study. Rheumatol Int. 2013;33:2783–88.

3. Losina E, Daigle ME, Suter LG, et al. Disease-modifying drugs for knee

osteoarthritis: can they be cost-effective? Osteo Arth Cart. 2013;21:655-

67.

4. Hochberg MC, Altman RD, April KT, et al. American College of

Rheumatology 2012 recommendations for the use of nonpharmacologic

and pharmacologic therapies in osteoarthritis of the hand, hip, and

knee. Arthritis Care Res (Hoboken) 2012; 465–74.

5. Wang C, Iversen MD, McAlindon T, et al. Assessing the comparative

effectiveness of Tai Chi versus physical therapy for knee osteoarthritis:

design and rationale for a randomized trial. BMC Comple-ment Altern

Med. 2014;14:333.
6. The World Health Organization Quality of Life assessment (WHOQOL):

position paper from the World Health Organization. Soc Sci

Med. 1995;41:1403–09.

7. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis.

Ann. Rheum. Dis. 2000;16 (4): 494-502.