Association Between General Physical Exercise and Upper Extremity Disability

Hermanussen, Hugo (2015) Association Between General Physical Exercise and Upper Extremity Disability. thesis, Medicine.

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Abstract

Purpose Physical activity improves management of chronic conditions, maintenance of independence, psychological health and quality of life in the older population. It has also been shown to reduce cognitive function decline and mortality. Little is known about the influence of habitual participation in physical exercise on upper-extremity specific disability. Compliance with current physical activity guidelines among older adults is reported to be as low as 2.4% in certain populations, emphasizing the importance to assess whether an association between physical activity and upper extremity specific disability exists. An inverse association might encourage regular participation in physical activities among patients with upper extremity illness. This study tested the relationship between general physical exercise and upper-extremity disability in patients of advanced age with upper extremity illness in an urban academic hospital. Secondarily, we determined whether there was an association between pain intensity and physical exercise. Methods Between March 2015 and July 2015 completed a cohort of 111 patients at least 50 years of age, a cross-sectional survey consisting of a sociodemographic survey, three Patient- Reported Outcomes Measurement Information System (PROMIS) based computerized adaptive testing questionnaires (CAT) questionnaires, the Rapid Assessment of Physical Activity (RAPA) and a 14-item Mediterranean diet questionnaire. Descriptive statistics were used to interpret the data. Pain intensity was measured with an 11-point ordinal measure (0–10 numeric rating scale). Co-morbidity was measured with the Charlson Comorbidity Index (CCI). Factors that correlated with the PROMIS Upper-Extremity Physical Function and pain intensity were assessed in multivariable regression analysis after initial bivariate analysis. Results General physical activity correlated with PROMIS Upper-Extremity physical function and pain intensity (r= 0.28, p-value= 0.0027), but not after adjusting for confounding with other variables using multivariable regression. Factors independently associated with PROMIS Upper- Extremity physical function were sex, diagnosis and PROMIS Pain Interference, with the latter accounting for most of the observed variability (37%). Factors independently associated with pain intensity were years of education and PROMIS Pain Interference. Conclusions Our data suggest that general physical activity may not be as strongly or directly associated with symptom intensity and magnitude of disability compared to ineffective coping strategies. Interventions to lower pain interference (e.g. cognitive behavioral therapy) hold potential to reduce musculoskeletal symptom intensity and magnitude of disability.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor and Diercks, prof. dr. R.L. and Institution: UMCG, Orthopaedics department and Orthopaedic surgeon.
Supervisor name:	Second supervisor: and Ring, Prof. dr. David MD and Institution: Massachusetts General Hospital and Profession: Chief, Hand and Upper Extremity Service. Hand &
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1925

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