Challenges faced by patients with Osteoarthritis of the Hip and Knee in using their Bathrooms in Lusaka, Zambia

Introduction: People with Osteoarthritis (OA) of the hip and knee have difficulties in performing basic activities of daily living. These problems arise from disturbed biomechanics, pain and loss of range of motion. Both pain and stiffness prevent deep knee flexion, a movement that is important in the use of both the toilet and the bathing facilities. The aim of this study was to determine the challenges faced by patients with osteoarthritis of the hip and knee in using their bathrooms in Lusaka, Zambia. Methods: A cross sectional, descriptive quantitative study was done. The study was conducted at the University Teaching Hospital in the Department of Physiotherapy. Fifty six participants with hip or knee osteoarthritis were recruited in the study. Portions of the ICF were used to determine the level of difficulty in using both the bathtub for bathing and the toilet. A visual analogue scale and manual goniometer were used to measure the intensity of pain and range of motion respectively. Data were analysed using SPSS version 25.0. Chi Square test was used to determine if there was a relationship between severity of pain and the ranges of motion in the hip and knee at the significance level of 0.05. Results: Participants in this study had a mean age of 53.39 years (SD=9.210). Majority were females (79%) and 21% males. The participants had mild problems with (52%, n=29) followed by moderate problems with bathing (32%, n=18). More than half of the participants had moderate problems (55% while a few (7%) had severe problems with toileting. During bathing and toileting, 80% and 62% of the participants experienced moderate to severe pain in the knee and hip respectively. There were significant associations between the severity of pain and the ranges of motion in hip flexion, hip extension and knee flexion (P = 0.01, 0.001 and 0.02). Conclusion: Patients with OA of the knee and the hip have moderate to severe challenges with bathing and toileting. Pain may be the main factor contributing to the challenges in bathing and toileting. Physiotherapy needs to take the bathing and toileting facilities into account when managing patients with OA of the knee and hip.