VanSwearingen JM, Brach JS, Hicks G; Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA. jessievs@pitt.edu.

An incongruence of pathology and symptoms in persons with osteoarthritis (OA) has made documenting clinical status, disease progression and response to intervention difficult. PURPOSE: To determine the relation of pathology, impair-ment and disability in women with knee OA. SUBJECTS: Thirty five women participating in a study of a disease modifying drug volunteered to participate. The women were a mean age of 55.9, SD, 5.4, range, 47.5-65.2 years; and all women were of a height and weight that placed them in the upper tertile of body mass index. METHODS: Pathology of the knee was determined from the Kellgren & Lawrence Grade for the standing AP radiograph. Impairment was determined using self-reported pain during gait. Disability was determined by performance-based measures of gait characteristics using the GaitMat II, and self-reported using the WOMAC, disease-specific disability index, and the SF36, health-related quality of life (HRQL) measure. DATA ANALYSES: Bivariate correlations between pathology, impairment, and performance-based and self-reported disability, and regression analyses to describe the relation of pathology, impairment, disability, and HRQL were performed. RESULTS: Pathology was not related to the other measures. Pain was related to gait disability, stride length, r=-.41, p=.02, but not to self-reported disability. Disability (gait speed and stride length) were related to SF-36, physical role function subscale (r=-.43, r=-.44, p=.01, respectively), and gait speed was related to the SF 36 bodily pain subscale (r=-.41, p=.02). No relation was found between the WOMAC and SF-36 measures. Regression analysis, indicated impairment (pain) and performance-based disability (stride length) contributed to self-reported physical role function for the women with osteoarthritis of the knee (R²=.32, df=1,30; p=.01). CONCLUSION: Measures of impairment (pain) and disability (gait characteristics), and not pathology (radiograph) were related to reported disability and HRQL in women with OA of the knee. Impairment and disability impacted self-reported physical role function and not physical function. FUNDING SOURCE: (The project was partially funded by the CMRF, University of Pittsburgh Medical Center.)

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