يعرض 1 - 10 نتائج من 62 نتيجة بحث عن '"Katz, Jeffrey N."', وقت الاستعلام: 0.87s تنقيح النتائج
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    دورية أكاديمية
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    دورية أكاديمية
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    دورية أكاديمية

    المساهمون: national institutes of health

    المصدر: BMC Musculoskeletal Disorders ; volume 23, issue 1 ; ISSN 1471-2474

    مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

    الوصف: Background Knee osteoarthritis (OA) is among the most common and disabling persistent pain conditions, with increasing prevalence and impact around the globe. In the U.S., the rising prevalence of knee OA has been paralleled by an increase in annual rates of total knee arthroplasty (TKA), a surgical treatment option for late-stage knee OA. While TKA outcomes are generally good, post-operative trajectories of pain and functional status vary substantially; a significant minority of patients report ongoing pain and impaired function following TKA. A number of studies have identified sets of biopsychosocial risk factors for poor post-TKA outcomes (e.g., comorbidities, negative affect, sensory sensitivity), but few prospective studies have systematically evaluated the unique and combined influence of a broad array of factors. Methods This multi-site longitudinal cohort study investigated predictors of 6-month pain and functional outcomes following TKA. A wide spectrum of relevant biopsychosocial predictors was assessed preoperatively by medical history, patient-reported questionnaire, functional testing, and quantitative sensory testing in 248 patients undergoing TKA, and subsequently examined for their predictive capacity. Results The majority of patients had mild or no pain at 6 months, and minimal pain-related impairment, but approximately 30% reported pain intensity ratings of 3/10 or higher. Reporting greater pain severity and dysfunction at 6 months post-TKA was predicted by higher preoperative levels of negative affect, prior pain history, opioid use, and disrupted sleep. Interestingly, lower levels of resilience-related “positive” psychosocial characteristics (i.e., lower agreeableness, lower social support) were among the strongest, most consistent predictors of poor outcomes in multivariable linear regression models. Maladaptive profiles of pain modulation (e.g., elevated temporal summation of pain), while not robust unique predictors, interacted with psychosocial risk factors such that the TKA ...

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    دورية أكاديمية
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    دورية أكاديمية
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    دورية أكاديمية

    المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases

    المصدر: BMC Musculoskeletal Disorders ; volume 20, issue 1 ; ISSN 1471-2474

    مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

    الوصف: Background Knee osteoarthritis (OA) is prevalent and often associated with meniscal tear. Physical therapy (PT) and exercise regimens are often used to treat OA or meniscal tear, but, to date, few programs have been designed specifically for conservative treatment of meniscal tear with concomitant knee OA. Clinical care and research would be enhanced by a standardized, evidence–based, conservative treatment program and the ability to study the effects of the contextual factors associated with interventions for patients with painful, degenerative meniscal tears in the setting of OA. This paper describes the process of developing both a PT intervention and a home exercise program for a randomized controlled clinical trial that will compare the effectiveness of these interventions for patients with knee pain, meniscal tear and concomitant OA. Methods This paper describes the process utilized by an interdisciplinary team of physical therapists, physicians, and researchers to develop and refine a standardized in-clinic PT intervention, and a standardized home exercise program to be carried out without PT supervision. The process was guided in part by Medical Research Council guidance on intervention development. Results The investigators achieved agreement on an in-clinic PT intervention that included manual therapy, stretching, strengthening, and neuromuscular functional training addressing major impairments in range of motion, musculotendinous length, muscle strength and neuromotor control in the major muscle groups associated with improving knee function. The investigators additionally achieved agreement on a progressive, protocol-based home exercise program (HEP) that addressed the same major muscle groups. The HEP was designed to allow patients to perform and progress the exercises without PT supervision, utilizing minimal equipment and a variety of methods for instruction. Discussion This multi-faceted in-clinic PT program and standardized HEP provide templates for in-clinic and home-based care for ...

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    دورية أكاديمية

    المساهمون: National Institutes of Health

    المصدر: BMC Musculoskeletal Disorders ; volume 19, issue 1 ; ISSN 1471-2474

    مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

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    دورية أكاديمية
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    دورية أكاديمية

    المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases

    المصدر: BMC Musculoskeletal Disorders ; volume 19, issue 1 ; ISSN 1471-2474

    مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

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    دورية أكاديمية

    المساهمون: National Institutes of Health

    المصدر: BMC Musculoskeletal Disorders ; volume 18, issue 1 ; ISSN 1471-2474

    مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

    الوصف: Background Arthroscopic surgery is a common treatment for knee osteoarthritis (OA), particularly for symptomatic meniscal tear. Many patients with knee OA who have arthroscopies go on to have total knee arthroplasty (TKA). Several individual studies have investigated the interval between knee arthroscopy and TKA. Our objective was to summarize published literature on the risk of TKA following knee arthroscopy, the duration between arthroscopy and TKA, and risk factors for TKA following knee arthroscopy. Methods We searched PubMed, Embase, and Web of Science for English language manuscripts reporting TKA following arthroscopy for knee OA. We identified 511 manuscripts, of which 20 met the inclusion criteria and were used for analysis. We compared the cumulative incidence of TKA following arthroscopy in each study arm, stratifying by type of data source (registry vs. clinical), and whether the study was limited to older patients (≥ 50) or those with more severe radiographic OA. We estimated cumulative incidence of TKA following arthroscopy by dividing the number of TKAs among persons who underwent arthroscopy by the number of persons who underwent arthroscopy. Annual incidence was calculated by dividing cumulative incidence by the mean years of follow-up. Results Overall, the annual incidence of TKA after arthroscopic surgery for OA was 2.46% (95% CI 1.68–3.25%). We calculated the annual incidence of TKA following arthroscopy in four separate groups defined by data source (registry vs. clinical cohort) and whether the sample was selected for disease progression (either age or OA severity). In unselected registry studies the annual TKA incidence was 1.99% (95% CI 1.03–2.96%), compared to 3.89% (95% CI 0.69–7.09%) in registry studies of older patients. In unselected clinical cohorts the annual incidence was 2.02% (95% CI 0.67–3.36%), while in clinical cohorts with more severe OA the annual incidence was 3.36% (95% CI 1.38–5.34%). The mean and median duration between arthroscopy and TKA (years) were 3.4 and ...