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Modeling impairment: using the disablement process as a framework to evaluate determinants of hip and knee flexion
M J Lichtenstein1, R Dhanda, J E Cornell
1Division of Geriatrics and Gerontology, University of Texas Health Science Center at San Antonio 78284, USA. lichtenstei@uthscsa.edu
Aging (Milan, Italy)
|August 31, 2000
Summary
High body mass index (BMI) directly reduces hip and knee range of motion (ROM) in elders. Managing BMI is key for improving joint function and reducing disability from conditions like diabetes and arthritis.
Area of Science:
- Gerontology
- Biomedical Engineering
- Public Health
Background:
- Elderly individuals often have multiple interconnected health issues impacting daily function.
- The disablement process framework helps understand the progression from chronic disease to disability.
- Understanding factors affecting joint range of motion (ROM) is crucial for maintaining elder mobility.
Purpose of the Study:
- To investigate the inter-relationships between impairments affecting hip and knee flexion range of motion (ROM) in older adults.
- To identify key variables, particularly at the impairment level, that influence joint ROM.
- To examine the role of Body Mass Index (BMI) in relation to joint ROM and chronic conditions.
Main Methods:
- Utilized data from the San Antonio Longitudinal Study of Aging (n=647) including Mexican American and European American elders (aged 64-78).
- Assessed hip and knee ROM using inclinometer and goniometer, respectively.
- Employed structural equation modeling to analyze associations between BMI, pain, peripheral vascular disease, diabetes, arthritis, and joint ROM.
Main Results:
- Higher Body Mass Index (BMI) was a significant determinant of reduced hip and knee flexion range of motion (ROM).
- BMI was directly associated with prevalent diabetes and arthritis; these conditions did not independently affect ROM after BMI adjustment.
- BMI indirectly influenced knee ROM through pain and neurosensory impairments, and diabetes indirectly affected hip ROM via peripheral vascular disease.
Conclusions:
- Body Mass Index (BMI) is a primary direct factor influencing hip and knee range of motion (ROM) in older adults.
- The impact of diabetes and arthritis on physical disability may be partly mediated by BMI's effect on joint ROM.
- Interventions targeting BMI reduction may improve joint ROM and overall function in the elderly, suggesting BMI and ROM as key metrics for intervention success.