arthritis, activity, and remaining active as you age stacey schepens niemiec, phd otr/l 2/7/2014
TRANSCRIPT
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Arthritis, Activity, and Remaining Active as You Age
Stacey Schepens Niemiec, PhD OTR/L2/7/2014
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Arthritis in the US
Source: CDC, 2009
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Future of Arthritis
Source: CDC 2009
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Arthritis by Gender
Source: CDC 2009
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Arthritis and Limitations
Source: CDC 2009
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Arthritis
• Not a single disease• Different ages of onset• Different risk factors
© Adapted from MedicineNet, Inc.
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OA versus RA
• Autoimmune• Any joint, symmetrical• Any age• May advance, full-
blown, over weeks or months
• Prevalent in women
• Degenerative• Overused joints• Older adults and those
involved in physical work or sports
• Develops over time• Prevalent in women
Osteoarthritis Rheumatoid Arthritis
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OA and Symptoms
Pain
Stiffness
Fatigue
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OA and Fatigue
Fatigue↓ Mobility
↓ Physical Activity
↓ Quality of Life
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OA and Fatigability
ACTIVITY
FATIGUEFATIGABILITY
Fatigue experience Activity deficits
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Research Gaps in Fatigability
• Understanding OA symptoms within the context of daily activity
• Understanding how symptoms and activity change after participation in physical and mental activities
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Fatigability Studies
• In a study with older adults who engaged in physically fatiguing tasks, we found…
Schepens, Kratz, & Murphy, 2012
• Fatigue and activity levels and patterns were negatively affected on the task day
• Fatigue was lower for 3 days after the task day
• Pain remained consistent in levels and patterns
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Fatigability Studies
• In a study with older adults who engaged in mentally fatiguing tasks, we found…
Kratz, Schepens, & Murphy, 2013
• Pain was lower and fatigue was higher on the task day and the next day
• Pattern of fatigue and activity changed and persisted for 4 days
• No changes in activity levels
Picture : http://www.otsegocountycoa.org/techage.cfm
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What Exacerbates OA Symptoms?
• Paucity of causal research• Some theories:
Activity? Footwear? Weather?
Schepens, Kratz, Murphy, 2012; Kratz, Schepens, Murphy, 2013; Cited in: Hunter, Mcdougall, Keefe, 2008
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Non-pharmacological OA Management
Lorig, Gonzalez, & Laurent, 2006; Murphy, Lyden, Smith, Dong, & Koliba, 2010
Knowledge Staying active, staying safe
Self-monitoring
Activity pacing Relaxation Openness
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Acknowledgements• Dr. Schepens Niemiec is currently supported by (K12
HD055929) NIH – NCMRR and NINDS
• Fatigability studies were conducted at the Univ. of Michigan during Dr. Schepens Niemiec’s postdoctoral fellowship supported by NCMRR, NICHD, and NIH (5-T32-HD007422-17), and under the guidance of her mentor Susan Murphy, ScD OTR/L