Abstract
This retrospective
study explored the relationship between osteoarthrosis severity and joint
stiffness and evaluated stiffness-alleviating nursing interventions in 30
patients with osteoarthrosis. Patients were divided into intervention group
(n=15) and control group (n=15). The control group received routine nursing
care, while the intervention group received additional stiffness-alleviating
nursing interventions including structured range-of-motion exercises, thermal
therapy and activity pacing. Primary outcomes included the correlation between
osteoarthrosis severity (Kellgren-Lawrence grade) and stiffness duration
(morning stiffness and total daily stiffness time) and the change in total
daily stiffness time at 4 weeks. Results showed a significant positive
correlation between Kellgren-Lawrence grade and initial total daily stiffness
time (r=0.72, p<0.01). At 4 weeks, the intervention group had a
significantly greater reduction in total daily stiffness time compared to the
control group (56.8±11.5 mins vs 24.3±9.8 mins, p<0.01). The intervention
group also showed better improvement in joint range of motion (ROM), Lequesne
Index and Functional Impairment Questionnaire (FIQ) score (p<0.05 for all).
Stiffness-alleviating nursing interventions effectively reduce joint stiffness
in patients with osteoarthrosis and improve functional status.
Keywords: Osteoarthrosis; Lequesne index; Kellgren-Lawrence
grade; Functional impairment questionnaire
Introduction
Joint stiffness is a
cardinal symptom of osteoarthrosis, affecting 70-80% of patients and
significantly impairing daily activities1. The pathophysiological link involves articular
cartilage degradation, synovial inflammation and altered joint biomechanics,
which restrict mobility and prolong stiffness duration2. This study investigates the osteoarthrosis-stiffness
association and evaluates targeted nursing interventions, addressing the lack
of stiffness-specific care protocols3.
Methods
Study design and
participants
Retrospective analysis of 30 patients with
radiographically confirmed osteoarthrosis (knee: 22 cases, hip: 8 cases).
Inclusion criteria: age 50-80 years; Kellgren-Lawrence grade I-IV; morning
stiffness ≥30 mins or total daily stiffness ≥2 hrs. Exclusion criteria:
inflammatory arthritis, joint contractures and neurological disorders affecting
mobility.
Grouping & interventions
Control group: Routine care (pain
assessment, general mobility advice).
Intervention group: Added
stiffness-alleviating interventions: Structured ROM exercises:
Gentle stretching
sequences (3 sets/day) with progressive intensity, focusing on affected joints.
Thermal therapy protocol: Warm compresses (40-42°C) for 15 mins
pre-exercise, cold compresses post-activity. Activity pacing guidance:
Scheduling activities during low-stiffness periods, with rest breaks to prevent
stiffness exacerbation.
Self-management training: Teaching patients to
recognize early stiffness signs and perform preventive exercises. Primary:
Correlation between Kellgren-Lawrence grade and initial stiffness duration
(morning stiffness in mins; total daily stiffness time in mins); change in
total daily stiffness time at 4 weeks. Secondary: Joint ROM (degrees),
Lequesne Index, FIQ score (0-100, higher=worse).
Statistical analysis
SPSS 26.0 used for
Pearson correlation, independent t-tests and paired t-tests. p<0.05 was
significant.
Results
Osteoarthrosis-stiffness relationship and baseline
data
Significant positive
correlation between Kellgren-Lawrence grade and initial total daily stiffness
time (r=0.72, p<0.01). No significant differences in baseline
characteristics between groups (Table 1).
Table 1: Baseline
Characteristics
|
Characteristics |
Intervention Group (n=15) |
Control Group (n=15) |
p-value |
|
Age (years, x̄±s) |
63.2±8.5 |
64.1±7.9 |
0.76 |
|
Male gender, n(%) |
8(53.3) |
9(60.0) |
0.73 |
|
Affected joint (knee/hip) |
13/2 |
9/6 |
0.15 |
|
Kellgren-Lawrence grade (x̄±s) |
2.6±0.8 |
2.7±0.7 |
0.68 |
|
Morning stiffness (mins, x̄±s) |
45.2±12.3 |
47.1±11.8 |
0.69 |
|
Total daily stiffness time (mins, x̄±s) |
88.5±19.2 |
91.3±18.6 |
0.65 |
|
ROM (degrees, x̄±s) |
67.3±13.2 |
65.8±12.9 |
0.74 |
Discussion
This study confirms
a strong correlation between osteoarthrosis severity and joint stiffness,
consistent with mechanisms involving cartilage loss and synovial thickening4.
Stiffness-alleviating interventions addressed key factors: ROM exercises
prevented adhesions5, thermal therapy enhanced tissue
extensibility6 and activity pacing minimized stiffness triggers7. The significant
reduction in stiffness translated to improved function, highlighting stiffness
management as a critical nursing target8.
Limitations include
small sample size and short follow-up. Future studies should explore long-term
efficacy and biomarkers of stiffness.
Conclusion
Osteoarthrosis severity
correlates significantly with joint stiffness. Stiffness-alleviating nursing
interventions effectively reduce stiffness and improve function, warranting
integration into clinical practice.
References