Phenotypic Classification and Functional Assessment in Knee Osteoarthritis Patients.

Current health sciences journal Pub Date : 2024-04-01 Epub Date: 2024-06-30 DOI:10.12865/CHSJ.50.02.16
Ovidiu-Florin Fugaru, Dumitru Rădulescu, Mircea-Sebastian Șerbănescu, Magdalena Rodica Trăistaru
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Abstract

The purpose of our study was the phenotypic classification of patients with osteoarthritis of the knee (KOA) and the dynamic assessment of functional status, monitored both numerically and in conformity with the International Classification of Functioning, Disability, and Health (ICF-basic set, shortened form). We conducted a prospective study in the Department of Physical Medicine and Rehabilitation, Filantropia Hospital, Craiova, from June of 2022 to November of 2023. In total, 100 patients with KOA were enlisted. Using data from the literature, physiotherapeutic examination, and results from paraclinical examinations, we classified studied patients into the five phenotypic categories: chronic pain (F1), local pathology with predominance of inflammatory mechanisms (F2), local pathology with predominance of metabolic mechanisms of bone and cartilage structures (F3), metabolic disorders (F4) and comorbidities (F5)-primarily chronic venous insufficiency in the lower limbs. We analyzed the values of generic qualifiers (at two evaluation time points) for the most significant elements of the core ICF set, abbreviated form, used in OAG, across each of the five phenotypes. Phenotypes F4 and F5 showed significant improvements across all evaluated functions, indicating increased efficacy in patients with comorbidities and metabolic diseases. Reduction in pain sensation, improvement in joint and muscle mobility, as well as enhancements in functions related to walking, dressing, and hand use, reflect an overall improvement in the quality of life for these patients.

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膝关节骨性关节炎患者的表型分类和功能评估
我们研究的目的是对膝关节骨性关节炎(KOA)患者进行表型分类,并根据《国际功能、残疾和健康分类》(ICF-基本集,简写本)对患者的功能状态进行动态评估。我们于 2022 年 6 月至 2023 年 11 月在克拉约瓦菲兰特罗比亚医院物理医学与康复科进行了一项前瞻性研究。共招募了 100 名 KOA 患者。通过文献资料、物理治疗检查和辅助检查结果,我们将研究对象分为五个表型类别:慢性疼痛(F1)、以炎症机制为主的局部病变(F2)、以骨和软骨结构代谢机制为主的局部病变(F3)、代谢紊乱(F4)和合并症(F5)--主要是下肢慢性静脉功能不全。我们分析了五种表型中每种表型中用于 OAG 的核心 ICF 集(缩写形式)最重要元素的通用限定词值(在两个评估时间点)。表型 F4 和 F5 在所有评估功能方面均有显著改善,表明对合并症和代谢性疾病患者的疗效有所提高。疼痛感的减轻、关节和肌肉活动度的改善,以及与行走、穿衣和手的使用有关的功能的增强,反映出这些患者的生活质量得到了全面提高。
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