To explore the prevalence and impact of hip and/or knee pain in patients presenting for Pulmonary Rehabilitation

Abstract

Introduction: This study aimed to understand the prevalence and impact of hip and knee pain on Pulmonary Rehabilitation (PR) outcomes and completion rates. A secondary aim was to understand the change in self-reported hip and knee pain following PR.

Methods: Patients who attended PR (twice-weekly for 6-weeks) and who had hip/knee pain in the 4 weeks prior, completed an Oxford hip and/or knee score. A 1:1 propensity score match for age, gender, body mass index, sessions completed and Medical Research Council dyspnoea score was completed prior to group comparison for a PR cohort without hip/knee pain.

Results: 6.5% of PR patients reported pain: hip (27.8%), knee (41.3%) or hip and knee pain (30.9%). The mean (SD) Oxford score across all joints was 28.8 (8.5) indicating a moderate severity pre PR. 75 hip/knee pain participants provided sufficient data for pre PR matching and were propensity matched with those without hip/knee pain. Significant improvements were made in Oxford scores for the left hip, left knee and right knee but not the right hip following PR. There was no significant difference (p>0.05) between hip/knee pain and no pain groups for improvements in knee strength, walking tests or depression scores, both groups achieved within group significance (p<0.05). The majority of participants with hip/knee pain significantly improved for both physical outcomes and pain scores. There were no significant differences in completion rates between groups.

Conclusions: Overall we observed a reduction in pain and an increase in functional capacity in those attending PR with hip/knee pain. Pain did not impact the completion of PR and improvements were made regardless of severity.