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Self-Reported Fatigue In Individuals With Knee Osteoarthritis

Bouzubar, Fawzi (2003) Self-Reported Fatigue In Individuals With Knee Osteoarthritis. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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PURPOSE: The purposes of this study were to: 1) describe the magnitude and dimensions of self-reported fatigue in individuals with knee OA and 2) determine the influence of quadriceps fatigue and cardiorespiratory endurance on self-reported fatigue in individuals with knee OA, after accounting for potential confounders such as age, sex, pain, depression, and anxiety. SUBJECTS: The sample consisted of 44 adults (75% female) with radiographically confirmed knee OA. METHODS: All subjects participated in two testing sessions using a dynamometer with a software program developed specifically for this study. During the first session, subjects completed the Multidimensional Assessment of Fatigue Scale (MAF), the WOMAC Osteoarthritis Index, the Center for Epidemiologic Studies Depression Scale (CES-D), and the Beck Anxiety Inventory Scale (BAI). A burst superimposition maximum isometric quadriceps torque test was performed to determine maximum voluntary isometric contraction (MVIC) torque that was used in the quadriceps fatigue test. In the first testing session, subjects also performed a submaximal cycle ergometer test to estimate VO2 max as a measure of cardiorespiratory endurance. Within 1 week of the first session, subjects returned for the quadriceps fatigue test in which they performed repeated submaximal contractions equal to 50% of their MVIC isometric torque output for 6 seconds followed by a 4-second rest period (duty cycle 60%). The contractions were continued until the subject could no longer generate the torque target for 3 successive contractions. During the sixth contraction and every minute thereafter, subjects were instructed to push with a maximum effort and the train of electrical stimuli was superimposed upon the maximal effort quadriceps contraction. Quadriceps fatigue was measured as the rate of decline of the MVIC torque output over the course of the test. ANALYSIS: Descriptive statistics were used to describe the magnitude and dimensions of fatigue. An independent samples t-test was used to compare fatigue in individuals with knee OA to the levels of fatigue reported by normal controls and individuals with rheumatoid arthritis. Hierarchical regression analysis was used to determine the influence of quadriceps fatigue and cardiorespiratory endurance self-reported fatigue. RESULTS: The mean global fatigue index score was 23.6 (SD = 10.4, range 1-40). Individuals with knee OA reported significantly higher fatigue than controls and significantly lower fatigue than RA patients (p < 0.05). Fatigue was reported to occur every day by 25% of the sample. Fatigue most often affected walking, doing household chores, shopping, and exercise. Fatigue was significantly associated with sex (r = .52, greater fatigue in females), pain (r = .62), depression (r = .47), anxiety (r = .54), and cardiorespiratory endurance (r = -.55) but not to quadriceps fatigue (r= .01). Hierarchical regression analyses revealed that adding quadriceps fatigue or cardiorespiratory endurance to the model after controlling for age, sex, pain, depression, and anxiety did not explain any additional variance in fatigue, (ÄR2 =.00). CONCLUSION: Fatigue is common in individuals with knee OA. Quadriceps fatigue is not related to self-reported fatigue. Cardiorespiratory endurance is related to self-reported fatigue, but not after controlling for age, sex, pain, depression, and anxiety. CLINICAL RELEVANCE: Management of fatigue in individuals with knee OA may require interventions to address psychosocial issues and/or cardiorespiratory endurance.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Bouzubar, Fawziffbst1@pitt.eduFFBST1
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairIrrgang, James Jirrgangjj@upmc.eduJIRRGANG
Committee MemberDelitto, Anthony
Committee MemberBaker, Carol E
Committee MemberFitzgerald, G. Kelley
Date: 17 November 2003
Date Type: Completion
Defense Date: 22 October 2003
Approval Date: 17 November 2003
Submission Date: 12 November 2003
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Institution: University of Pittsburgh
Schools and Programs: School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Cardiorespiratory Endurance; Quadriceps Fatigue; Fatigue; Knee Osteoarthritis
Other ID:, etd-11122003-135008
Date Deposited: 10 Nov 2011 20:04
Last Modified: 19 Dec 2016 14:37


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