SCREENING REPORT

Topic: Screening for the disability index in osteoarthritis patients

Background

Osteoarthritis is the degenerative changes in the articular cartilage and other joints structures; it may be secondary to an injury or disease in the majority of cases. Osteoarthritis develops in the middle- aged and elderly, it appears in the these joints which are most subjected to strain, either the weight bearing joints such as the hip and knee or those which according to the particular occupation are most used such as the spinal articulations of the Agricultural and manual worker or terminal interphalangeal joints of the of the hands of the gardener or cleaner (Joan E.Cash, 1965)

Though much discussion exists as the exact cause of the development of OA, it is likely that resistance of the joint surfaces reduced by the wear and tear of life. Direct trauma such as a fracture involving the articular surfaces and damaging the cartilage is often followed by the OA, faulty posture is a possible cause of degenerative changes because it upsets the mechanics of the joint, abnormal strain is, therefore, brought to bear cartilage and bone, as well as on joint capsules. For example OA of spine is secondary to structural kyphosis and scoliosis. Obesity is an important contributory factor to OA of the hip and knee (http://www.medicinet.com/osteoarthtis/article.htm)

Reasons for screening
During the past two weeks of my rural block at Elim hospital I have treated many patients with Osteoarthritis from Mbokota village, most of them they have already developed deformities secondary to OA, then as a result of this deformities the patients will end being disabled, that is why I have decided to screen for the disability index in OA patients of Mbhokota village.

Aim of the study

. To determine the functional abilities of patients with OA

Targeted population

All patients attending mbhokota clinic suffering from OA

Objectives

.To determine the functional abilities of patients suffering from OA.
.To determine how OA interferes with the patient`s ADL.
.To determine how pain affects patients with OA




Tools

A disability index questionnaire (Health assessment questionnaire from Stanford University school of Medicine) was used which was translated to Tsonga.

Method

Disability index questionnaires were distributed to the patients who were gathered in same place, the instructions were fully explained on how to complete the questionaire, those who were unable read and write we helped them on how to go about filling the questionairs.all the questionnaires were completed and collected at the very same day.

Significance of the study

The patients will be taught how to manage ADL`s with OA, also they will be shown how to do exercises and there will be less referral to the physiotherapy department

Results
Dressing and grooming
7(63, 6%) of the participants can dress themselves and tie shoe laces without difficulty, while 3(27, 3%) can dress themselves with some difficulty, 1(9, 1%) can dress with much difficulty and 0% were unable.
Standing
2(18, 2%) of the participants can stand from a chair without difficulty, 7(63.6%) can stand with some difficulty,2(18,2%) can stand from a chair with much difficulty while 0% were unable.
Eating
7(63, 6%) of the participants can lift a cup glass of water to the mouth without difficulty, 2(18, 2%) can lift the glass or a cup of water with some difficulty, 2(18, 2%) can with much difficulty, while o% were unable
Hygiene
7(63, 6%) of the participants can wash and dry their bodies without difficulty, 2(18, 2%) can with some difficulty, 2(18, 2%) can with much difficulty while 0% were unable
Walking
4(36, 4%) can walk on a flat ground without difficulties, 1(9%) can walk with some difficulties, 6(54, 5%) can walk with much difficulty, while 0% were unable.1(9,1%)can climb stairs without difficulty,2(18,2%)can climb stairs with some difficulties,3(27,3%) can climb with much difficulties while 5(45,5%)were unable to climb the stairs
Activities
0% of the participants can do chores and yard work without difficulty,0% of participants can with some difficulty,2(18,2%) can with much difficulty, while 9(81%) of them were unable to do chores and yard work



Pain
2(18, 2%) of the participants were affected by pain with the scale of up to 6/10, 3(27, 3%) were affected by pain up to scale of 5/10, 2(18, 2%) were affected up to the scale of 8/10, while 4(36, 4%) were affected up the scale of 7/10
In conclusion
There a few percentages of patients who had difficulties in in dressing grooming, reaching, eating, gripping, arising, and standing, but most of the patients have much difficulty in walking and climbing the stairs and we had higher percentage of those who were unable to do activities such as vacuuming and yard working with 81% and most of the patients with the percentage of 34% are affected by pain during ,this patients are at high risk of disability if they don`t adhere to the home programme and exercises .


Ethical considerations

A permission letter was written to the sister in charge of Mbhokota clinic and permission was granted, and also consent forms were distributed and signed by patients before the screening took place. The patients were allowed to withdraw at any time if they don’t want to continue with the screening
.
Recommendations

I recommended that the other groups of physiotherapy students should continue giving the patients education about OA, how to mage ADL`s, the importance of doing exercises and also give them pamphlets about OA
.
Acknowledgemements

.I acknowledges the sisters at Mbhokota clinic for making arrangements with the patients on our behalf and allowing us to use their venue for our tasks.
.I acknowledges the patients for trusting us and being cooperative through out our screening.
. I acknowledge our supervisor for arranging the transport to the clinic and helping us where we needed help.