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3. Predominant lifetime occupation and associations with painful and structural knee osteoarthritis: An international participant-level cohort collaboration

Author

Parsons, Camille M, Gates, Lucy S, Perry, Thomas, Nevitt, Michael, Felson, David, Sanchez-Santos, Maria T, Jones, Graeme, Golightly, Yvonne M, Allen, Kelli D, Callahan, Leigh F, White, Daniel K, Walker-Bone, Karen, Cooper, Cyrus, and Arden, Nigel K

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Chronic Pain, Pain Research, Aging, Arthritis, Osteoarthritis, Clinical Research, Aetiology, 2.1 Biological and endogenous factors, Musculoskeletal, Epidemiology, Harmonization, Knee, Occupation, Clinical sciences
Abstract

ObjectiveWith adults working to older ages, occupation is an important, yet less modifiable domain of physical activity to consider in the risk of knee osteoarthritis (OA). This study aimed to investigate the association between predominant lifetime occupation and prevalent knee OA.DesignParticipant-level data were used from five international community-based cohorts: Johnston County Osteoarthritis Project, the Hertfordshire Cohort Study, the Multicenter Osteoarthritis Study, the Tasmanian Cohort Study and Framingham Osteoarthritis Study. Self-reported predominant occupation was categorized into sedentary, light, light manual and heavy manual levels. Cross-sectional associations between predominant lifetime occupation and knee OA outcomes including prevalence of radiographic knee OA (RKOA), symptomatic RKOA and knee pain, were assessed using logistic regression, accounting for cohort clustering.ResultsData for 7391 participants were included. 24.7% reported sedentary lifetime occupation, 30.0% light, 35.9% light manual and 9.4% heavy manual. 43.3% presented with RKOA, 52.1% with knee pain and 29.0% with symptomatic RKOA. There was over a two-fold increase in the odds of having RKOA, knee pain and symptomatic RKOA in those whose with heavy manual compared to sedentary occupations ((odds ratio (OR): 2.14; 95% confidence interval (CI): 1.79, 2.58), (OR: 2.19; 95% CI: 1.78, 2.70), (OR: 2.41; 95% CI: 1.94, 2.99) respectively).ConclusionThis large international multi-cohort study demonstrated an association of heavy manual work with RKOA, symptomatic RKOA and knee pain. Measures that protect workers and are designed to reduce heavy manual related activities remain a priority to reduce the risk of knee OA.

Published
2020

12. The Web-Based Pain-at-Work Toolkit With Telephone Support for Employees With Chronic or Persistent Pain: Protocol for a Cluster Randomized Feasibility Trial

Author

Blake, Holly, primary, Chaplin, Wendy J, additional, Wainwright, Elaine, additional, Taylor, Gordon, additional, McNamee, Paul, additional, McWilliams, Daniel, additional, Abbott-Fleming, Victoria, additional, Holmes, Jain, additional, Fecowycz, Aaron, additional, Walsh, David Andrew, additional, and Walker-Bone, Karen, additional

Published
2023
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13. Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit

Author

Bechman, Katie, primary, Cook, Emma, additional, Alveyn, Edward, additional, Houssien, Abdullah, additional, Stevens, Martin, additional, Russell, Mark D, additional, Adas, Maryam, additional, Amlani-Hatcher, Paul, additional, Norton, Sam, additional, Lempp, Heidi, additional, Ledingham, Joanna, additional, Galloway, James, additional, and Walker-Bone, Karen, additional

Published
2023
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16. The effect on work presenteeism of job retention vocational rehabilitation compared to a written self-help work advice pack for employed people with inflammatory arthritis: protocol for a multi-centre randomised controlled trial (the WORKWELL trial)

Author

Hammond, Alison, Sutton, Chris, Cotterill, Sarah, Woodbridge, Sarah, O’Brien, Rachel, Radford, Kate, Forshaw, Denise, Verstappen, Suzanne, Jones, Cheryl, Marsden, Antonia, Eden, Martin, Prior, Yeliz, Culley, June, Holland, Paula, Walker-Bone, Karen, Hough, Yvonne, O’Neill, Terence W., Ching, Angela, and Parker, Jennifer

Published
2020
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22. Why did middle-aged and older people retire since the first COVID-19 lockdown? A qualitative study of participants from the Health and Employment After Fifty study.

Author

D'Angelo, Stefania, Bloom, Ilse, Ntani, Georgia, and Walker-Bone, Karen

Subjects
OLDER people, MIDDLE-aged persons, RETIREES, COVID-19 pandemic, STAY-at-home orders
Abstract

Background: Governments of Western countries need people to work to older ages, however the COVID-19 pandemic impacted the workforce by pushing older adults to retire. Socio-demographic factors that influence the decision to retire in the pre-pandemic period were, poor or good health, finances, marital status, and gender. The aim of this study was to explore aspects that contributed to the decision to retire among middle-aged and older people in England who retired during the COVID-19 pandemic. Methods: In September 2022 semi-structured interviews were conducted with a sample of participants from the Health and Employment After Fifty (HEAF) study who retired since March 2020. Consenting participants were purposively selected to achieve a wide spread of characteristics deemed important in the retirement process. Telephone interviews were conducted, audio-recorded, transcribed and then thematically analysed. Results: 24 interviews were conducted (10 men and 14 women, mean age 65 years). Six themes were identified: four of them were non-COVID-19 aspects while two can be interpreted as impact of COVID-19 on the workforce. Work-related factors were of major importance. A sense of appreciation and attachment in relation to their employer, and conversely high work demands and stress, as well as changes in work responsibilities and work practices since lockdown and/or perception of personal safety in the workplace during the pandemic influenced their retirement decision, as did physical and mental health issues. Another theme suggested that some participants felt they had reached the 'right' age and needed to spend more time with family. Having the financial capacity to retire was widely mentioned but was never the main factor. Conclusions: The decision to retire during the pandemic was multi-factorial although changes to work during lockdown were of great importance. Post-pandemic, our findings suggest that there are modifiable aspects of work, including appreciation and fair pay and work conditions, that employers and policy makers could encourage to retain their older workers. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Prevalence of, and risk factors for, musculoskeletal disorders of the neck and upper limbs

Author

Walker-Bone, Karen Elizabeth

Subjects
616, Soft tissue
Abstract

Neck and upper limb pain are common symptoms. However, such symptoms may arise from specific upper limb disorders such as rotator cuff tendinitis, lateral epicondylitis, or carpal tunnel syndrome, or as a result of more diffuse non-specific regional pains. Epidemiological research in this field had been hampered by the lack of an agreed system of classification until 1997 when a UK workshop derived consensus case definitions for most of these disorders. Working from these new criteria, the objectives of this thesis were to develop and test a workable examination protocol suitable for use in epidemiological research and then, using this new tool, to describe the prevalence, impact, risk factors and natural history of specific and non-specific upper limb disorders in the general population. Initial methodological work was performed in order to evaluate the repeatability and validity of the Southampton examination protocol. In two separate studies, among 88 hospital-based subjects and among 97 community-based subjects, the protocol was shown to have good repeatability and excellent validity against the gold standard. A cross-sectional survey of all 9698 working-aged adults registered with two general practices in Southampton was then undertaken. Every subject was mailed a questionnaire, enquiring about demography, risk factors and recent symptoms in the neck and upper limbs. All symptomatic respondents were invited to attend for interview and examination and upper limb symptoms were classified according to the National criteria. Additionally, a longitudinal study was undertaken of a cohort of 350 individuals identified cross-sectionally, who were re-contacted by postal questionnaire after an interval of 20 months. Every subject with persistent upper limb symptoms was invited to attend for repeat examination. The one-week prevalence of neck and upper limb pain lasting a day or longer in the past 7 days was 43%, and one-half of individuals reported functional disability as a result of their symptoms. Approximately one-third of those with pain were found to have specific upper limb disorders and specific disorders were associated with greater levels of disability than non-specific pain. Specific upper limb disorders tended to be associated with mechanical workplace exposures involving stress local to the site of that diagnosis, but non-specific pain was most strongly associated with prolonged abnormal neck posture. Neck and upper limb pain persisted in the majority of subjects (79%) at follow-up after 20 months. More importantly, specific disorders were observed to track within individuals so that those with specific disorders at baseline were considerably more likely to have specific disorders at follow-up.

Published
2002

24. P070 Results of a consensus process to determine the elements of a complex digital intervention for distal upper limb musculoskeletal disorders

Author

Brading, Lucy, primary, Kane, Kathleen, additional, McHugh, Gretl, additional, Dziedzic, Krysia, additional, Adams, Jo, additional, Chopra, Swati, additional, Swaithes, Laura, additional, Walker-Bone, Karen, additional, Macfarlane, Gary, additional, Conaghan, Philip, additional, and Kingsbury, Sarah, additional

Published
2023
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27. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases

Author

Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia; https://orcid.org/0000-0003-4953-3257, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina; https://orcid.org/0000-0002-9342-1861, Rodríguez-Carrio, Javier, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana I, Guillemin, Francis, Verstappen, Suzanne M M, Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia; https://orcid.org/0000-0003-4953-3257, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina; https://orcid.org/0000-0002-9342-1861, Rodríguez-Carrio, Javier, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana I, Guillemin, Francis, and Verstappen, Suzanne M M

Abstract

Objectives: A European League Against Rheumatism taskforce was convened to review the literature and develop recommendations on lifestyle behaviours for rheumatic and musculoskeletal diseases (RMDs). Methods: Six lifestyle exposures (exercise, diet, weight, alcohol, smoking, work participation) and seven RMDs (osteoarthritis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, systemic lupus erythematosus, systemic sclerosis, gout) were considered. The taskforce included health professionals in rheumatology, geriatricians, epidemiologists, public health experts, people with RMDs and exposure domain experts. Systematic reviews were conducted to gather available evidence, from which recommendations were developed. Results: Five overarching principles and 18 specific recommendations were defined based on available evidence. The overarching principles define the importance of a healthy lifestyle, how lifestyle modifications should be implemented, and their role in relation to medical treatments. Exercise recommendations highlight the safety and benefits of exercise on pain and disability, particularly among people with osteoarthritis and axial spondyloarthritis. The diet recommendations emphasise the importance of a healthy, balanced diet for people with RMDs. People with RMDs and health professionals should work together to achieve and maintain a healthy weight. Small amounts of alcohol are unlikely to negatively affect the outcomes of people with RMDs, although people with rheumatoid arthritis and gout may be at risk of flares after moderate alcohol consumption. Smokers should be supported to quit. Work participation may have benefits on RMD outcomes and should be discussed in consultations. Conclusions: These recommendations cover a range of lifestyle behaviours and can guide shared decision making between people with RMDs and health professionals when developing and monitoring treatment plans. Keywords: arthritis; epidemiology; patient reported outco

Published
2023

28. Determinants of international variation in the prevalence of disabling wrist and hand pain

Author

Coggon, David, Ntani, Georgia, Walker-Bone, Karen, Felli, Vanda E., Harari, Florencia, Barrero, Lope H., Felknor, Sarah A., Rojas, Marianela, Cattrell, Anna, Serra, Consol, Borchini, Rossana, Solidaki, Eleni, Merisalu, Eda, Habib, Rima R., Sadeghian, Farideh, Kadir, M. Masood, Peiris-John, Roshini J., Matsudaira, Ko, Nyantumbu-Mkhize, Busisiwe, Kelsall, Helen L., and Harcombe, Helen

Published
2019
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32. Function and employment after total hip replacement in older adults: a narrative review

Author

Zaballa Lasala, Elena, Dennison, Elaine, and Walker-Bone, Karen

Abstract

The burden of osteoarthritis (OA) has increased steadily due to an aging population, increasing life expectancy, obesity and lifestyle factors. Total hip replacement has become one of the most prevalent and successful operations globally and it is projected that demand will continue to grow as the incidence of OA continues to increase. Patients undergoing the operation expect much-improved function and pain relief but also increasingly need to return to work postoperatively, especially given the growing demand for the procedure and the encouragement of older people to continue working by most governments in the developed world. This review provides an overview of function and employment outcomes after hip arthroplasty. Despite the generally good success rate, some patients do not attain good functional outcomes and it is important that we develop ways to identify these patients preoperatively. We describe the effect of demographic, clinical and other factors on functional outcomes, as well as trajectories of physical function and pain recovery beyond the first few weeks after total hip replacement. Regarding employment outcomes, many people in work preoperatively are likely to resume to work after recovery; however, patients feel that they lack guidance from clinicians about returning to work postoperatively. Our review encompasses factors associated with return to work, timing of return to work, and potential temporary or permanent limitations that people might experience at work depending on type of employment.

Published
2023

36. Morbidities among older workers and work exit: The heaf cohort

Author

Walker-Bone, Karen, D'angelo, Stefania, Linaker, Catherine, Stevens, Martin J, Ntani, Georgia, Cooper, Cyrus, and Syddall, Holly Emma

Abstract

Background: Governments need people to work to older ages but the prevalence of chronic disease and comorbidity increases with age and impacts work ability.Aims: To investigate the effects of objective health diagnoses on exit from paid work amongst older workers.Methods: Health and Employment After Fifty (HEAF) is a population cohort of adults aged 50-64 years recruited from English GP practices which contribute to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about health and work at baseline and annually for 2-years: their responses were linked with their objective health diagnoses from the CPRD and data analysed using Cox regression.Results: Of 4888 HEAF participants ever in paid work, 580 (25%) men and 642(25%) women exited employment, 277 of them mainly or partly for a health reason (HRJL). Amongst HEAF participants who remained in work (n=3666) or who exited work but not for health reasons (n=945), there was a similar prevalence of background health conditions. In men and women, HRJL was associated with inflammatory arthritis, sleep disorders, common mental health conditions and musculoskeletal pain. There were however gender differences: widespread pain and lower limb osteoarthritis were associated with HRJL in women but hypertension and cardiovascular disease in men.Conclusions: Improved diagnosis and management of common conditions might be expected to increase working lives. Workplace wellbeing interventions targeting obesity and increasing mobility might contribute to extended working lives. Employers of predominantly female, as compared with male workforces may need different strategies to retain older workers.

Published
2022

37. Return to work and employment retention after uni-compartmental and total knee replacement: findings from the Clinical Outcomes in Arthroplasty study

Author

Zaballa Lasala, Elena, Ntani, Georgia, Harris, E. Clare, Arden, Nigel, Cooper, Cyrus, and Walker-Bone, Karen

Subjects
Orthopedics and Sports Medicine
Abstract

Background: little is known about ability to work after unicompartmental knee replacement (UKR) and total knee replacement (TKR), especially in physically-demanding occupations. This study described rates of return-to-work (RTW) and ability to sustain work by job after arthroplasty.Method: participants from The Clinical Outcomes in Arthroplasty Study (COASt) aged 18–65 were eligible if they underwent UKR or TKR and had at least 5 years’ follow-up post-operation. We posted a survey asking about pre-operative occupation, post-operative occupations and associated physical demands, and whether they had quit a job post-surgery due to difficulties with the operated knee (knee-related job loss (KRJL)). We fitted Cox Proportional Hazard Models to investigate the role of demanding physical activities on KRJL.Results: 251 people (143 UKR, 108 TKR) returned a questionnaire, of whom 101 UKR and 57 TKR worked post-operatively. Rates of RTW were highest amongst those in managerial and professional or technical roles, whichever operation they received. RTW was poorest amongst those in elementary occupations. In associate professional/technical occupations, RTW rates were better amongst UKR recipients. Amongst participants who returned to work, 17 reported KRJL (8.5% UKR and 16.7% TKR). Respondents were more likely to have KRJL if their job involved carrying/lifting ≥10 kg (HR:4.81, 95%CI 1.55–14.93) or climbing >30 flights of stairs (HR:4.03, 95%CI 1.36–11.98).Conclusions: knee arthroplasty recipients working pre-operatively mostly RTW. RTW may be more difficult after TKR than UKR. Jobs which involve lifting and climbing stairs may be particularly challenging. Surgeons offering knee arthroplasty should counsel patients about workability as well as risk of revision.

Published
2022

38. Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Gwinnutt, James M, primary, Wieczorek, Maud, additional, Rodríguez-Carrio, Javier, additional, Balanescu, Andra, additional, Bischoff-Ferrari, Heike A, additional, Boonen, Annelies, additional, Cavalli, Giulio, additional, de Souza, Savia, additional, de Thurah, Annette, additional, Dorner, Thomas E, additional, Moe, Rikke Helene, additional, Putrik, Polina, additional, Silva-Fernández, Lucía, additional, Stamm, Tanja, additional, Walker-Bone, Karen, additional, Welling, Joep, additional, Zlatković-Švenda, Mirjana, additional, Guillemin, Francis, additional, and Verstappen, Suzanne M M, additional

Published
2022
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39. Physical Activity and Diet in a Global Pandemic: An Investigation of the Impact of COVID-19 on Factors Relevant for Musculoskeletal Health at Two Different Stages of the Lifecourse

Author

Bevilacqua, Gregorio, primary, D’Angelo, Stefania, additional, Linaker, Cathy, additional, Paul, Alice, additional, Bloom, Ilse, additional, Zhang, Jean, additional, Laskou, Faidra, additional, Cooper, Cyrus, additional, Ward, Kate A., additional, Walker-Bone, Karen, additional, and Dennison, Elaine M., additional

Published
2022
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40. Smoking, alcohol consumption and disease-specific outcomes in rheumatic and musculoskeletal diseases (RMDs): systematic reviews informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Gwinnutt, James Martin; https://orcid.org/0000-0002-1435-8797, Ransay-Colle, Maxime, Balanescu, Andra, Bischoff-Ferrari, Heike, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas Ernst, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Silva-Fernández, Lucía, Stamm, Tanja A; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatkovic-Svenda, Mirjana; https://orcid.org/0000-0002-7123-140X, Verstappen, Suzanne MM, Guillemin, Francis; https://orcid.org/0000-0002-9860-7024, Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Gwinnutt, James Martin; https://orcid.org/0000-0002-1435-8797, Ransay-Colle, Maxime, Balanescu, Andra, Bischoff-Ferrari, Heike, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas Ernst, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Silva-Fernández, Lucía, Stamm, Tanja A; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatkovic-Svenda, Mirjana; https://orcid.org/0000-0002-7123-140X, Verstappen, Suzanne MM, and Guillemin, Francis; https://orcid.org/0000-0002-9860-7024

Abstract

Background: A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). The aim of this paper was to review the literature on the relationship between smoking and alcohol consumption with regard to RMD-specific outcomes. Methods: Two systematic reviews were conducted to identify systematic reviews and meta-analyses, published between 2013 and 2018, related to smoking and alcohol consumption in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), systemic sclerosis (SSc) and gout. Two additional systematic reviews were performed to identify original longitudinal studies on smoking and alcohol consumption and disease-specific outcomes. Results: Nine reviews and 65 original studies on smoking as well as two reviews and 14 original studies on alcohol consumption met the inclusion criteria. While most studies were moderate/poor quality, smoking was significantly associated with poorer outcomes: cardiovascular comorbidity; poorer response to RA treatment; higher disease activity and severity in early RA; axSpA radiographic progression. Results were heterogeneous for OA while there was limited evidence for PsA, SSc and gout. Available studies on alcohol mainly focused on RA, reporting a positive association between alcohol intake and radiographic progression. Five studies assessed alcohol consumption in gout, reporting a significant association between the number and type of alcoholic beverages and the occurrence of flares. Conclusion: Current literature supports that smoking has a negative impact on several RMD-specific outcomes and that moderate or high alcohol consumption is associated with increased risk of flares in RA and gout. Keywords: Epidemiology; Patient Reported Outcome Measures; Smoking

Published
2022

41. Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana; https://orcid.org/0000-0002-7123-140X, Guillemin, Francis; https://orcid.org/0000-0002-9860-7024, Verstappen, Suzanne M M, Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana; https://orcid.org/0000-0002-7123-140X, Guillemin, Francis; https://orcid.org/0000-0002-9860-7024, and Verstappen, Suzanne M M

Abstract

BackgroundA EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.MethodsSystematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).ResultsIn total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.ConclusionThe current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.

Published
2022

42. Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana I; https://orcid.org/0000-0002-7123-140X, Guillemin, Francis; https://orcid.org/0000-0002-9860-7024, Verstappen, Suzanne M M, Gwinnutt, James M; https://orcid.org/0000-0002-1435-8797, Wieczorek, Maud; https://orcid.org/0000-0002-4528-9923, Cavalli, Giulio; https://orcid.org/0000-0001-8728-3004, Balanescu, Andra, Bischoff-Ferrari, Heike A, Boonen, Annelies; https://orcid.org/0000-0003-0682-9533, de Souza, Savia, de Thurah, Annette; https://orcid.org/0000-0003-0103-4328, Dorner, Thomas E, Moe, Rikke Helene; https://orcid.org/0000-0001-7601-5346, Putrik, Polina, Rodríguez-Carrio, Javier; https://orcid.org/0000-0002-0011-5102, Silva-Fernández, Lucía, Stamm, Tanja; https://orcid.org/0000-0003-3073-7284, Walker-Bone, Karen, Welling, Joep, Zlatković-Švenda, Mirjana I; https://orcid.org/0000-0002-7123-140X, Guillemin, Francis; https://orcid.org/0000-0002-9860-7024, and Verstappen, Suzanne M M

Abstract

Background: A European League Against Rheumatism (EULAR) taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on the effects of physical exercise and body weight on disease-specific outcomes of people with RMDs. Methods: Three systematic reviews were conducted to summarise evidence related to exercise and weight in seven RMDs: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis and gout. Systematic reviews and original studies were included if they assessed exercise or weight in one of the above RMDs, and reported results regarding disease-specific outcomes (eg, pain, function, joint damage). Systematic reviews were only included if published between 2013-2018. Search strategies were implemented in the Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases. Results: 236 articles on exercise and 181 articles on weight were included. Exercise interventions resulted in improvements in outcomes such as pain and function across all the RMDs, although the size of the effect varied by RMD and intervention. Disease activity was not influenced by exercise, other than in axSpA. Increased body weight was associated with worse outcomes for the majority of RMDs and outcomes assessed. In general, study quality was moderate for the literature on exercise and body weight in RMDs, although there was large heterogeneity between studies. Conclusion: The current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs. Keywords: arthritis; epidemiology; patient reported outcome measures; physical therapy modalities

Published
2022

47. Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Gwinnutt, James M, primary, Wieczorek, Maud, additional, Cavalli, Giulio, additional, Balanescu, Andra, additional, Bischoff-Ferrari, Heike A, additional, Boonen, Annelies, additional, de Souza, Savia, additional, de Thurah, Annette, additional, Dorner, Thomas E, additional, Moe, Rikke Helene, additional, Putrik, Polina, additional, Rodríguez-Carrio, Javier, additional, Silva-Fernández, Lucía, additional, Stamm, Tanja, additional, Walker-Bone, Karen, additional, Welling, Joep, additional, Zlatković-Švenda, Mirjana I, additional, Guillemin, Francis, additional, and Verstappen, Suzanne M M, additional

Published
2022
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48. Smoking, alcohol consumption and disease-specific outcomes in rheumatic and musculoskeletal diseases (RMDs): systematic reviews informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

Author

Wieczorek, Maud, primary, Gwinnutt, James Martin, additional, Ransay-Colle, Maxime, additional, Balanescu, Andra, additional, Bischoff-Ferrari, Heike, additional, Boonen, Annelies, additional, Cavalli, Giulio, additional, de Souza, Savia, additional, de Thurah, Annette, additional, Dorner, Thomas Ernst, additional, Moe, Rikke Helene, additional, Putrik, Polina, additional, Rodríguez-Carrio, Javier, additional, Silva-Fernández, Lucía, additional, Stamm, Tanja A, additional, Walker-Bone, Karen, additional, Welling, Joep, additional, Zlatkovic-Svenda, Mirjana, additional, Verstappen, Suzanne MM, additional, and Guillemin, Francis, additional

Published
2022
Full Text
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