Personalized rehabilitation program for older patients with osteoarthritis
https://doi.org/10.14412/1996-7012-2021-3-69-74
Abstract
Objective: to develop a personalized rehabilitation program for improving age-related resilience (AR), antioxidant status (AOS), the quality of life and reducing pain in elderly patients with osteoarthritis (OA).
Patients and methods. The program consisted of two parts. In the first part, we conducted a comparative study to assess the AR (Mahnach test), geriatric status, and AOS (amperometric flow-injection analysis) in 181 subjects in total, with coxarthrosis (n=92) and without it (n=89). The average age of patients in two groups was comparable: 72.1±1.1 and 71.9±1.1 years. Using factor analysis, we developed the personalized rehabilitation program based on the obtained data. The effectiveness of the program was evaluated in the second part of our work. We conducted an additional comparative study of changes in AR, AOS, severity of joint pain (by visual analogue scale, VAS) and quality of life (according to SF-36 questionnaire) in patients with coxarthrosis (n=114).
Results and discussion. Patients with coxarthrosis had significantly lower level of AR, total antioxidant, and antiradical activity, and a higher content of Schiff bases as compared to subjects without coxarthrosis (p<0.05). The program of rehabilitation, which included a course of treatment with Chondroquard, significantly improved AR, AOS, quality of life and reduced hip pain compared to the standard OA therapy (p<0.05).
Conclusion. The personalized rehabilitation program has a complex positive effect on pain, quality of life, AR and AOS in elderly patients with OA.
About the Authors
V. I. PanikarRussian Federation
8, Pobedy str., Belgorod 308015, Russia
E. I. Korshun
Russian Federation
Elena Igorevna Korshun
91, Volokolamsk highway, Moscow 125371, Russia
S. G. Anikin
Russian Federation
34A, Kashirskoe Shosse, Moscow 115522, Russian
O. V. Bochko
Russian Federation
91, Volokolamsk highway, Moscow 125371, Russia
E. A. Voronina
Russian Federation
19A, Kuznetsky Prospekt, Kemerovo 650000, Russia
M. V. Silyutina
Russian Federation
10, Studentskaya str., Voronezh 394036, Russia
E. S. Kravchenko
Russian Federation
25, Soboleva str., Yekaterinburg 620036, Russia
References
1. GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053): 1603-58. doi: 10.1016/S0140-6736(16)31460-X.
2. Balabanova RM, Dubinina TV, Demina AB, Krichevskaya OA. The incidence of diseases of the musculoskeletal system in the Russian Federation for 2015-2016. Nauchno-prakticheskaya revmatologiya, 2018;56(1):15-21. (In Russ.).
3. Kadam UT, Jordan K, Croft PR. Clinical comorbidity in patients with osteoarthritis: a case-control study of general practice consulters in England and Wales. Ann Rheum Dis. 2004 Apr;63(4):408-14. doi: 10.1136/ard.2003.007526.
4. Gabriel SE, Crowson CS, O'Fallon WM. Comorbidity in arthritis. J Rheumatol. 1999 Nov;26(11):2475-9.
5. Schellevis FG, van der Velden J, van de Lisdonk E, et al. Comorbidity of chronic diseases in general practice. J Clin Epidemiol. 1993 May;46(5):469-73. doi: 10.1016/0895-4356(93)90024-u.
6. Kovari E, Kaposi A, Bekes G, et al. Comorbidity clusters in generalized osteoarthritis among female patients: A crosssectional study. Semin Arthritis Rheum. 2020 Apr;50(2):183-91. doi: 10.1016/j.semarthrit.2019.09.001. Epub 2019 Sep 9.
7. Rusinova K, Guidet B. «Are you sure it's about 'age'?». Intensive Care Med. 2014 Jan; 40(1):114-6. doi: 10.1007/s00134-013-3147-x. Epub 2013 Nov 12.
8. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/ Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Care Res (Hoboken). 2020 Feb;72(2):149-62. doi: 10.1002/acr.24131. Epub 2020 Jan 6.
9. Bruyere O, Cooper C, Pelletier JP, et al. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting. Semin Arthritis Rheum. 2016 Feb;45(4 Suppl):S3-11. doi: 10.1016/j.semarthrit.2015.11.010. Epub 2015 Dec 2.
10. S∅reide K, Desserud KF. Emergency surgery in the elderly: the balance between function, frailty, fatality and futility. Scand J Trauma Resusc Emerg Med. 2015 Feb 3;23:10. doi: 10.1186/s13049-015-0099-x.
11. Il'nitskii AN, Potapov VN, Proshchaev KI, et al. Interaction of gerontological schools in the modern world: focus on ensuring individual and age-related viability. Vestnik Vserossiiskogo obshchestva spetsialistov po mediko-sotsial'noi ekspertize, reabilitatsii i reabilitatsionnoi industrii. 2020;(1):86-94. (In Russ.).
12. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2019 Apr;67(4):674- 94. doi: 10.1111/jgs.15767. Epub 2019 Jan 29.
13. Naumov AV, Moroz VI, Khovasova NO, et al. Chronic pain in patients over 60: a geriatric view. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2019;119(6):53-9. (In Russ.).
14. Voloshin VP, Eremin AV, Sankaranarayanan SA, et al. Study of the effectiveness of chondrogard (chondroitin sulfate) in patients with osteoarthritis. Trudnyi patsient 2015;(3): 29-32. (In Russ.).
15. Alekseeva LI, Anikin SG, Zaitseva EM, et al. Study of the efficacy, tolerability and safety of chondrogard in patients with osteoarthritis. Farmateka. 2013;(7):60-4. (In Russ.).
16. Alekseeva LI, Sharapova EP, Kashevarova NG, et al. Comparative study of the efficacy and safety of Chondroguard® during its combined (intra-articular and intramuscular) and intramuscular injection in patients with knee osteoarthritis. Sovremennaya revmatologiya = Modern Rheumatology Journal. 2018;12(2): 44-9. (In Russ.). doi: 10/14412/1996-7012-2018-2-44-49.
17. Walston J, Hadley EC, Ferrucci L, et al. Research agenda for frailty in older adults: toward a better understanding of physiology and etiology: summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults. J Am Geriatr Soc. 2006 Jun; 54(6):991-1001. doi: 10.1111/j.1532-5415.2006.00745.x.
18. Lippiello L, Woodward J, Karpman R, Hammad TA. In vivo chondroprotection and metabolic synergy of glucosamine and chondroitin sulfate. Clin Orthop Relat Res. 2000 Dec;(381):229-40. doi: 10.1097/00003086-200012000-00027.
19. Ronca F, Palmieri L, Panicucci P, Ronca G. Anti-inflammatory activity of chondroitin sulfate. Osteoarthritis Cartilage. 1998 May;6 Suppl A:14-21. doi: 10.1016/s1063-4584(98)80006-x.
20. Volpi N. Anti-inflammatory activity of chondroitin sulphate: new functions from an old natural macromolecule. Inflammopharmacology. 2011 Dec;19(6):299-306. doi: 10.1007/s10787-011-0098-0. Epub 2011 Nov 1.
21. Michel BA, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial. Arthritis Rheum. 2005 Mar;52(3):779-86. doi: 10.1002/art.20867.
22. Kahan A, Uebelhart D, De Vathaire F, et al. Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a twoyear, randomized, double-blind, placebocontrolled trial. Arthritis Rheum. 2009 Feb; 60(2):524-33. doi: 10.1002/art.24255.
23. Railhac JJ, Zaim M, Saurel AS, et al. Effect of 12 months treatment with chondroitin sulfate on cartilage volume in knee osteoarthritis patients: a randomized, doubleblind, placebo-controlled pilot study using MRI. Clin Rheumatol. 2012 Sep;31(9): 1347-57. doi: 10.1007/s10067-012-2022-4. Epub 2012 Jun 23.
24. Volpi N. Oral bioavailability of chondroitin sulfate (Condrosulf) and its constituents in healthy male volunteers. Osteoarthritis Cartilage. 2002 Oct;10(10): 768-77. doi: 10.1053/joca.2002.0824.
25. Torshin IYu, Lila AM, Naumov AV, et al. Meta-analysis of clinical studies of the effectiveness of treatment of osteoarthritis with Chondrogard. Pharmacoeconomics. Sovremennaya Farmakoekonomika i Farmakoepidemiologiya. 2020;13(4):388-99. (In Russ.).
Review
For citations:
Panikar VI, Korshun EI, Anikin SG, Bochko OV, Voronina EA, Silyutina MV, Kravchenko ES. Personalized rehabilitation program for older patients with osteoarthritis. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2021;15(3):69-74. (In Russ.) https://doi.org/10.14412/1996-7012-2021-3-69-74