8 results on '"DIONNE, CLERMONT E."'
Search Results
2. The impacts of pre-surgery wait for total knee replacement on pain, function and health-related quality of life six months after surgery.
- Author
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Desmeules F, Dionne CE, Belzile ÉL, Bourbonnais R, and Frémont P
- Subjects
- Cohort Studies, Female, Health Status, Humans, Male, National Health Programs, Prospective Studies, Quebec epidemiology, Surveys and Questionnaires, Arthroplasty, Replacement, Knee rehabilitation, Outcome Assessment, Health Care, Pain epidemiology, Quality of Life, Recovery of Function physiology, Waiting Lists
- Abstract
Objective: The purpose of the current study was to assess, in patients scheduled for primary total knee replacement (TKR), the effects of pre-surgery waiting time on pain and functional limitations related to the knee joint undergoing surgery, on health-related quality of life (HRQoL) and on contralateral knee pain 6 months after surgery., Method: A total of 141 patients scheduled for TKR were recruited from three hospitals in Quebec City, Canada, and followed up until 6 months after surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery waiting list and surgery, was considered in four categories (≤3, >3-6, >6-9, >9 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC). HRQoL was measured with the SF-36., Results: Mean pre-surgery waiting time was 184 (SD: 120.8) days. Six months after TKR, a significant difference was seen between the four groups of pre-surgery wait in terms of HRQoL SF-36 role physical [F(3, 136) = 2.74, P = 0.046] and contralateral knee WOMAC pain [F(3, 136) = 5.78, P = 0.0009] scores. Participants with the longest pre-surgery wait (>9 months) showed the worst scores 6 months after TKR., Conclusions: Longer pre-surgery waiting time had a negative clinically important impact on HRQoL and contralateral knee pain 6 months after surgery., (© 2010 Blackwell Publishing Ltd.)
- Published
- 2012
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3. The burden of wait for knee replacement surgery: effects on pain, function and health-related quality of life at the time of surgery.
- Author
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Desmeules F, Dionne CE, Belzile E, Bourbonnais R, and Frémont P
- Subjects
- Aged, Arthroplasty, Replacement, Knee statistics & numerical data, Canada, Disease Progression, Female, Health Services Accessibility statistics & numerical data, Humans, Knee Joint surgery, Longitudinal Studies, Male, Middle Aged, Osteoarthritis, Knee physiopathology, Osteoarthritis, Knee surgery, Pain Measurement, Prospective Studies, Time Factors, Waiting Lists, Arthroplasty, Replacement, Knee psychology, Osteoarthritis, Knee psychology, Pain psychology, Quality of Life psychology, Severity of Illness Index
- Abstract
Objective: To examine the change in pain and function related to the knee scheduled for surgery, change in health-related quality of life (HRQoL) and change in contralateral knee pain during pre-surgery wait up until time of surgery., Methods: One hundred and fifty-three patients scheduled for knee replacement were recruited from three hospitals in Québec City, Canada, and followed until surgery. Pre-surgery wait, defined as the time between enrolment on the pre-surgery wait list and surgery, was considered in five categories (< or =3, >3-6, >6-9, >9-12 and >12 months). Pain and functional limitations were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the medical outcomes study 36-item short form health survey., Results: Mean pre-surgery wait time was 183 (s.d. 121.9) days. Subjects having waited >9-12 months showed significant deterioration of the WOMAC pain (-9.9; 95% CI -19.2, -0.54) and function (-11.1; 95% CI -18.7, -3.4) scores. On the HRQoL SF-36 physical functioning scale, a significant deterioration was seen in subjects having waited >9-12 months (-11.3; 95% CI -18.4, -4.2) and >12 months (-7.1; 95% CI -12.9, -1.3). On the contralateral knee WOMAC pain score, a significant deterioration was observed in subjects having waited >6-9 months (-10.4; 95% CI -16.9, -3.9) and >12 months (-10.7; 95% CI -19.7, -1.7)., Conclusion: Pre-surgery wait time has a negative significant impact on pain, function and HRQoL at the time of surgery. The magnitude of deterioration seen in this study may be clinically important. The effects of this pre-surgery deterioration on post-surgery outcomes need to be investigated.
- Published
- 2010
- Full Text
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4. Waiting for total knee replacement surgery: factors associated with pain, stiffness, function and quality of life.
- Author
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Desmeules F, Dionne CE, Belzile E, Bourbonnais R, and Frémont P
- Subjects
- Aged, Arthroplasty, Replacement, Knee psychology, Canada epidemiology, Comorbidity, Disease Progression, Exercise Therapy methods, Exercise Therapy standards, Female, Health Services Accessibility statistics & numerical data, Health Surveys, Humans, Knee Joint physiopathology, Male, Middle Aged, Mobility Limitation, National Health Programs statistics & numerical data, Obesity epidemiology, Osteoarthritis, Knee psychology, Osteoarthritis, Knee surgery, Pain psychology, Pain rehabilitation, Quebec epidemiology, Range of Motion, Articular physiology, Severity of Illness Index, Stress, Psychological epidemiology, Time Factors, Walkers statistics & numerical data, Arthroplasty, Replacement, Knee statistics & numerical data, Disability Evaluation, Osteoarthritis, Knee epidemiology, Pain epidemiology, Quality of Life psychology, Waiting Lists
- Abstract
Background: Recent evidences show that education and rehabilitation while waiting for knee replacement have positive effects on the patients' health status. Identification of factors associated with worse pain, function and health-related quality of life (HRQoL) while waiting for surgery could help develop pre-surgery rehabilitation interventions that target specifically these factors and prioritize patients that may benefit the most from them. The objectives of this study were to measure pain, stiffness, function and HRQoL in patients at enrolment on waiting lists for knee replacement and to identify demographic, clinical, socioeconomic and psychosocial characteristics associated with these outcomes., Methods: This study is part of a broader study measuring the effects of pre-surgery wait in patients scheduled for knee replacement. From 02/2006 to 09/2007, 197 patients newly scheduled for total knee replacement were recruited from the waiting lists of three university hospitals in Quebec City, Canada. Pain, stiffness and function were measured with the Western Ontario and McMaster Osteoarthritis Index (WOMAC) and HRQoL was measured with the SF-36 Health Survey. Stepwise multiple regression analysis was used to assess the strength of the associations between the independent variables and the WOMAC and SF-36 scores., Results: The scores of all eight HRQoL physical and mental domains of the SF-36 were significantly lower than aged matched Canadian normative data (p < 0.05). Contralateral knee pain, higher psychological distress, higher body mass index (BMI) and the use of a walking aid were significantly associated with worse function (p < 0.05) and contributed to 22% of the variance of the WOMAC function score (multiple r = 0.47). A higher BMI, the use of a walking aid, contralateral knee pain and advanced age were significantly associated with worse physical function (p < 0.05) and contributed to 17% of the variance of the SF-36 HRQoL physical functioning score (multiple r = 0.41)., Conclusion: Patients waiting for knee replacement have poor function and HRQoL. Characteristics that were found to be associated with these outcomes could help develop pre-surgery rehabilitation program and prioritize patients that may benefit the most from them. Such programs could include interventions to reduce psychological distress, therapeutic exercises targeting both knees and weight loss management.
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- 2009
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5. Prevalence of musculoskeletal pain and associated factors in the Quebec working population.
- Author
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Leroux I, Dionne CE, Bourbonnais R, and Brisson C
- Subjects
- Adult, Female, Health Surveys, Humans, Logistic Models, Male, Middle Aged, Occupational Exposure, Prevalence, Psychology, Quebec epidemiology, Musculoskeletal System injuries, Pain epidemiology
- Abstract
Background: While the determinants of musculoskeletal pain are numerous, few studies conducted among workers have taken into account, altogether, physical factors, psychosocial factors (personal and work-related) and individual characteristics., Objectives: To estimate the 1-year prevalence of musculoskeletal pain in the Quebec working population by gender and anatomical site, and to determine which factors are associated with these prevalence figures., Methods: Data came from the 1998 Quebec Health Survey and included 9,496 individuals. One-year period prevalences for neck pain, back pain and pain in the upper and lower extremities were calculated for men and women. Logistic regression analyses were conducted to estimate the associations between individual, physical and psychosocial work factors, on one hand, and musculoskeletal pain in the four body regions, on the other hand., Results: For both genders back pain was the most frequent musculoskeletal symptom that had disturbed their activities during the past year. The largest difference between genders was observed for neck pain (women: 18%; men: 11%). Multivariate analyses indicated that physical and psychosocial work factors, as well as psychological variables, were associated with musculoskeletal pain in different body regions. Body mass index was associated only with pain in lower extremities for both genders., Conclusions: The results of this study suggest that interventions aimed at reducing musculoskeletal pain should take into account personal and work-related psychosocial variables, in addition to physical workload.
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- 2005
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6. A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients.
- Author
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Foldes-Busque, Guillaume, Dionne, Clermont E., Tremblay, Marie-Andrée, Turcotte, Stéphane, Fleet, Richard P., Archambault, Patrick M., and Denis, Isabelle
- Subjects
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EMERGENCY room visits , *QUALITY of life , *PATIENTS' attitudes , *HOSPITAL emergency services , *CHEST pain , *PROGNOSIS - Abstract
This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories. 672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit. Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories. Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention. • At the cohort level, the prognosis of ED patients with NCCP appears favorable. • Patients-centered analyses revealed an heterogenous prognosis of NCCP. • Over 40% of patients with NCCP experienced an unfavorable prognosis. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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7. Does back pain prevalence really decrease with increasing age? A systematic review.
- Author
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Dionne, Clermont E., Dunn, Kate M., and Croft, Peter R.
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BACKACHE , *PAIN , *AGE , *AGING , *EPIDEMIOLOGY - Abstract
Background: it is believed that the prevalence of back pain decreases around the middle of the sixth decade. However, back pain is still among the most commonly reported symptoms in the elderly and ostcoarthritis, disc degeneration, osteoporosis and spinal stenosis all increase with age. In light of this, it is difficult to understand why the prevalence of back pain would decrease with increasing age. Objective: this stud), aimed at summarising the scientific evidence on the trends of hack pain prevalence with age. Methods: population-based studies reporting the prevalence of back pain, including people aged 65 years and over, were systematically retrieved from several bibliographic databases. These were read and assessed by two reviewers, and papers retained ('good quality studies') were aggregated according to specific criteria. Results: good quality studies showed a large heterogeneity as to their methods and prevalence figures. No specific patterns were detected by country nor outcome measure, however, most studies that considered severe forms of back pain found an increase of prevalence with increasing age. The curvilinear association between age and back pain prevalence that is widely mentioned in the literature was found only for benign and mixed problems. Conclusions: the evidence concerning the association of back pain prevalence with age is more sparse than currently believed and this association seems to be modified by the severity of the problem. This knowledge could have important public health implications, as the proportion of older people will increase considerably in the coming years in most industrialised societies. [ABSTRACT FROM AUTHOR]
- Published
- 2006
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8. A clinical return-to-work rule for patients with back pain.
- Author
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Dionne, Clermont E., Bourbonnais, Renée, Frémont, Pierre, Rossignol, Michel, Stock, Susan R., and Larocque, Isabelle
- Subjects
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BACKACHE , *BACK diseases , *PAIN , *PRIMARY care , *MEDICAL care - Abstract
Abstract Background Tools for early identification of workers with back pain who are at high risk of adverse occupational outcome would help concentrate clinical attention on the patients who need it most, while helping reduce unnecessary interventions (and costs) among the others. This study was conducted to develop and validate clinical rules to predict the 2-year work disability status of people consulting for nonspecific back pain in primary care settings. Methods This was a 2-year prospective cohort study conducted in 7 primary care settings in the Quebec City area. The study enrolled 1007 workers (participation, 68.4% of potential participants expected to be eligible) aged 18-64 years who consulted for nonspecific back pain associated with at least 1 day's absence from work. The majority (86%) completed 5 telephone interviews documenting a large array of variables. Clinical information was abstracted from the medical files. The outcome measure was "return to work in good health" at 2 years, a variable that combined patients' occupational status, functional limitations and recurrences of work absence. Predictive models of 2-year outcome were developed with a recursive partitioning approach on a 40% random sample of our study subjects, then validated on the rest. Results The best predictive model included 7 baseline variables (patient's recovery expectations, radiating pain, previous back surgery, pain intensity, frequent change of position because of back pain, irritability and bad temper, and difficulty sleeping) and was particularly efficient at identifying patients with no adverse occupational outcome (negative predictive value 78%- 94%). Interpretation A clinical prediction rule accurately identified a large proportion of workers with back pain consulting in a primary care setting who were at a low risk of an adverse occupational outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
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