Rheumatology 2000; 39: 955-961
© 2000 British Society for Rheumatology
Range of joint motion and disability in patients with osteoarthritis of the knee or hip
Netherlands Institute of Primary Health Care (NIVEL), Utrecht,
1 Institute for Research in Extramural Medicine, Vrije Universiteit, Amsterdam,
2 Netherlands Institute for Allied Health Professions (NPI), Amersfoort, The Netherlands and Faculty of Medicine and Pharmacology, Free University of Brussels, Brussels, Belgium and
3 Department of Rheumatology, Utrecht University Medical Centre, Utrecht, The Netherlands
Objective. To establish the relationships between the range of joint motion (ROM) and disability in patients with osteoarthritis (OA) of the knee or hip. Two related issues were addressed: (1) the inter-relationships between ROMs of joint actions, and (2) the relationship between ROM and disability.
Methods. Data on 198 patients with OA of the knee or hip were used. The ROM was assessed bilaterally for the hip and knee, using a goniometer. Disability was assessed using a self-reporting method (questionnaire) and an observational method. Correlation and factor analysis were used to establish the inter-relationships between the ROMs of joint actions. Correlation and multiple regression analyses were carried out to establish the relationships between ROM and disability.
Results. Close inter-relationships were found between the ROMs of the same joint action of the lateral and contralateral joints; inter-relationships between ROMs of different joint actions were substantially weaker. Low ROMs were associated with high levels of disability, both self-reported and observed. Some 25% of the variation in disability levels could be accounted for by differences in ROM. In both knee and hip OA patients, flexion of the knee and extension and external rotation of the hip were found to be most closely associated with disability.
Conclusion. Restricted joint mobility, especially in flexion of the knee and extension and external rotation of the hip, appears to be an important determinant of disability in patients with OA.
KEY WORDS: Osteoarthritis, Range of motion, Disability
Correspondence to: M. P. M. Steultjens, NIVEL, PO Box 1568, 3500 BN Utrecht, The Netherlands.
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