Abstract
This retrospective
study explored the correlation between osteoarthrosis severity and activity
limitation, and evaluated activity-enhancing nursing interventions in 50
patients with osteoarthrosis (January 2020-December 2023). Patients were
divided into intervention group (n=25) and control group (n=25). The control
group received routine nursing care, while the intervention group received
additional activity-enhancing nursing interventions including graded activity
training, assistive device guidance, and environmental modification advice.
Primary outcomes included the correlation between osteoarthrosis severity
(Kellgren-Lawrence grade) and activity limitation (WOMAC physical function
score), and the change in WOMAC physical function score at 8 weeks. Results
showed a significant positive correlation between Kellgren-Lawrence grade and
initial WOMAC physical function score (r=0.75, p<0.01). At 8 weeks, the
intervention group had a significantly greater reduction in WOMAC physical
function score compared to the control group (30.2±6.8 vs 15.6±5.9, p<0.01).
The intervention group also showed better performance in 6-Minute Walk Test
(6MWT) distance, Timed Up and Go (TUG) test time, and patient-reported activity
confidence (PAC) score (p<0.05 for all). Activity-enhancing nursing
interventions effectively improve activity ability in patients with
osteoarthrosis and reduce activity limitation.
Keywords: Osteoarthrosis; Larsen grade; Kellgren-lawrence grade;
WOMAC physical function
Introduction
Activity limitation is
a major disabling consequence of osteoarthrosis, with 60-70% of patients
reporting difficulty in daily activities such as walking, climbing stairs, and
dressing1. The degree of activity limitation is closely related
to osteoarthrosis severity, joint pain, muscle weakness, and psychological
factors, requiring comprehensive nursing interventions to improve functional
independence2. This study aims to explore the relationship between
osteoarthrosis and activity limitation, and evaluate the effect of
activity-enhancing nursing interventions, providing evidence for clinical
nursing practice3.
Methods
Study design and
participants
Retrospective analysis of 50 patients with
radiographically confirmed osteoarthrosis (knee: 35 cases, hip: 15 cases).
Inclusion criteria: age 50-80 years; Kellgren-Lawrence grade I-IV; presence of
activity limitation (WOMAC physical function score ≥20). Exclusion criteria:
severe cardiovascular diseases, musculoskeletal disorders other than
osteoarthrosis, and cognitive impairment.
Grouping & interventions
Control subgroups: Routine nursing care,
including health education, pain management, and basic mobility advice.
Intervention subgroups:
On the basis of routine nursing, activity-enhancing nursing interventions were
added:
• Graded activity training: Formulating individualized activity plans with progressive intensity and duration, starting from low-intensity activities (sitting to standing) and gradually transitioning to more complex activities (walking, stair climbing).
• Assistive device guidance: Assessing and recommending appropriate assistive devices (canes, walkers) to reduce joint load during activities, and training patients on correct usage.
• Environmental modification advice: Suggesting home modifications (installing handrails, raising toilet seats) to facilitate daily activities and reduce activity barriers.
• Activity confidence building: Using positive reinforcement and goal setting to enhance patients' confidence in performing activities.
Outcome measures
• Primary: Correlation between Kellgren-Lawrence grade and initial WOMAC physical function score; change in WOMAC physical function score (0-68, higher score indicates more severe activity limitation) at 8 weeks.
• Secondary: 6MWT distance (m), TUG test time (sec), and PAC score (0-10, higher score indicates higher activity confidence).
Statistical analysis
SPSS 26.0 software was
used for statistical analysis. Pearson correlation analysis was used to explore
the correlation between Kellgren-Lawrence grade and WOMAC physical function
score. Measurement data were expressed as mean ± standard deviation (x̄±s), and
independent sample t-test was used for comparison between groups. P<0.05 was
considered statistically significant.
Results
Relationship between osteoarthrosis severity and
activity limitation
There was a significant
positive correlation between Kellgren-Lawrence grade and initial WOMAC physical
function score (r=0.75, p<0.01) (Figure 1).
Baseline characteristics
There were no
significant differences in age, gender, affected joint, Kellgren-Lawrence
grade, and baseline outcome measures between the two groups (p>0.05), which
was comparable (Table 1).
Table 1: Comparison of baseline characteristics between the two groups
|
Characteristics |
Intervention Group (n=25) |
Control Group (n=25) |
p-value |
|
Age (years, x̄±s) |
64.8±8.5 |
65.5±7.9 |
0.76 |
|
Male gender, n(%) |
13(52.0) |
14(56.0) |
0.76 |
|
Affected joint (knee/hip) |
18(72.0)/7(28.0) |
17(68.0)/8(32.0) |
0.76 |
|
Kellgren-Lawrence grade (x̄±s) |
2.7±0.8 |
2.8±0.7 |
0.65 |
|
WOMAC physical function score (x̄±s) |
43.2±8.5 |
44.1±7.8 |
0.71 |
|
6MWT distance (m, x̄±s) |
278.5±52.6 |
272.3±49.8 |
0.63 |
|
TUG test time (sec, x̄±s) |
18.5±4.2 |
19.1±3.9 |
0.62 |
|
PAC score (x̄±s) |
4.3±1.2 |
4.1±1.3 |
0.61 |
Primary outcome
At 8 weeks, the WOMAC
physical function score in the intervention group was significantly lower than
that in the control group, and the reduction amplitude was significantly larger
(p<0.01) (Table 2).
Table 2: Comparison of WOMAC
physical function score between the two groups at different time points (x̄±s,
points)
|
Group |
n |
Baseline |
4 weeks |
8 weeks |
Reduction at 8 weeks |
|
Intervention Group |
25 |
43.2±8.5 |
30.5±7.2 |
13.0±6.3 |
30.2±6.8 |
|
Control Group |
25 |
44.1±7.8 |
36.2±6.9 |
28.5±6.1 |
15.6±5.9 |
|
p-value |
- |
0.71 |
0.002 |
<0.001 |
<0.001 |
At 8 weeks, the
intervention group showed significantly better performance in 6MWT, TUG test,
and higher PAC score compared to the control group (p<0.05) (Table 3).
Table 3: Comparison of
secondary outcomes between the two groups at 8 weeks (x̄±s)
|
Outcome Indicators |
Intervention Group (n=25) |
Control Group (n=25) |
p-value |
|
6MWT distance (m) |
432.6±68.5 |
338.5±62.8 |
<0.001 |
|
TUG test time (sec) |
10.2±2.3 |
16.1±3.2 |
<0.001 |
|
PAC score |
8.5±1.1 |
5.6±1.4 |
<0.001 |
Discussion
This study found a
significant positive correlation between osteoarthrosis severity and activity
limitation, which is consistent with previous studies4. The more severe
the osteoarthrosis, the greater the joint space narrowing, cartilage damage,
and pain, leading to decreased joint mobility and muscle strength, thereby
resulting in more severe activity limitation5.
The
activity-enhancing nursing interventions in this study achieved good results.
Graded activity training can gradually improve muscle strength and endurance
around the joint, enhance joint stability, and reduce activity limitation,
which is supported by relevant research6. Assistive device
guidance can effectively reduce joint load, improve balance during activities,
and increase patients' ability to perform daily activities7.
Environmental
modification advice can remove activity barriers in the home environment,
making it easier for patients to perform daily activities independently, which
is beneficial to improving their quality of life8. Activity
confidence building can enhance patients' self-efficacy, reduce their fear of
activities, and promote their active participation in activity training,
thereby improving activity ability9.
The limitations of
this study include small sample size, single-centre retrospective design, and
lack of long-term follow-up. Future studies with larger samples and longer
follow-up periods are needed to further verify the effectiveness of
activity-enhancing nursing interventions.
Conclusion
There is a significant positive
correlation between osteoarthrosis and activity limitation. Activity-enhancing
nursing interventions can effectively improve activity ability, reduce activity
limitation, and enhance activity confidence in patients with osteoarthrosis. It
is worthy of clinical promotion and application.
References