L. Stitt

Bio: L. Stitt is an academic researcher from University of Western Ontario. The author has contributed to research in topics: Breast cancer & Cross-sectional study. The author has an hindex of 4, co-authored 6 publications receiving 6857 citations.

Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.

Abstract: Within the context of a double blind randomized controlled parallel trial of 2 nonsteroidal antiinflammatory drugs, we validated WOMAC, a new multidimensional, self-administered health status instrument for patients with osteoarthritis of the hip or knee. The pain, stiffness and physical function subscales fulfil conventional criteria for face, content and construct validity, reliability, responsiveness and relative efficiency. WOMAC is a disease-specific purpose built high performance instrument for evaluative research in osteoarthritis clinical trials.

Low back pain: prevalence and risk factors in an industrial setting.

Abstract: OBJECTIVE: To examine various factors associated with low back pain (LBP) in an industrial setting. METHODS: A cross sectional study was carried out among 1,562 employees of a large utilities corporation in Ontario using a self-administered questionnaire. Abdominal muscle strength was measured using a modified sphygmomanometer. Statistical analysis was carried out with Student's t test, chi-square test, and logistic regression analysis. RESULTS: Among 1,302 male employees the lifetime and point prevalence of LBP were 60% and 11%, respectively. Low back pain was significantly more prevalent among married employees, with more physically demanding jobs, regular lifting, poor general health, and past major illness. Abdominal muscle weakness was associated with current LBP. The mean time lost from work due to LBP over 5 years was 17 days. Sedentary workers developing LBP were more likely to require hospital admission. CONCLUSION: This study confirms the high prevalence of LBP in industry and identifies several risk factors.

Effect of therapeutic exercise and sleeping neck support on patients with chronic neck pain: a randomized clinical trial.

Abstract: OBJECTIVE: To investigate the effects of therapeutic exercises and sleeping neck support contoured pillows on patients with chronic neck pain. METHODS: Using a factorial design in a prospective clinical trial, participants were equally allocated at random to 4 treatment groups in the study: (1) placebo control, of hot or cold packs and massage; (2) sleeping neck support pillow and placebo; (3) active neck exercises and placebo; and (4) combined exercise and sleeping neck support pillow and placebo. Participants were treated by physical therapists over a 6 week period and assessed by masked independent assessors at 0, 3, 6, 12, 24 weeks, and 12 months, with the 12 week assessment being the primary decision time. The primary outcome measure was the Northwick Park Neck Pain Questionnaire (NPQ). RESULTS: For the 128/151 (85%) participants tested at 12 weeks, the NPQ descriptive statistics of count, mean (standard deviation) were: Initial: 128, 31.0 (11.3) at Week 12; All: 128, 18.5 (11.6); Control: 34, 18.6 (10.0); Pillow: 32, 21.5 (13.1); Active neck exercises: 29, 20.1 (11.6); and Combined: 33, 14.1 (10.6). Factorial analysis of variance showed that the main effects of Exercise (p = 0.146) and Pillow (p = 0.443) were not statistically significant; but the interaction of Exercise plus Pillow (p = 0.029) was statistically significant and clinically meaningful. CONCLUSION: Treatment by physiotherapists trained to teach both exercises and the use of a neck support pillow achieved the most favorable benefit for participants with chronic neck pain; either strategy alone was not more effective than a control regimen. Time was an important cofactor.

Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.

Abstract: Objective. To provide recommendations for the core outcome domains that should be considered by investigators conducting clinical trials of the efficacy and effectiveness of treatments for chronic pain. Development of a core set of outcome domains would facilitate comparison and pooling of d

Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure

Abstract: There is broad consensus that good outcome measures are needed to distinguish interventions that are effective from those that are not. This task requires standardized, patient- centered measures that can be administered at a low cost. We developed a questionnaire to assess short- and long-term patient-relevant outcomes following knee injury, based on the WOMAC Osteoarthritis Index, a literature review, an expert panel, and a pilot study. The Knee Injury and Osteoarthritis Outcome Score (KOOS) is self-administered and assesses five outcomes: pain, symptoms, activities of daily living, sport and recreation function, and knee-related quality of life. In this clinical study, the KOOS proved reliable, responsive to surgery and physical therapy, and valid for patients undergoing anterior cruciate ligament reconstruction. The KOOS meets basic criteria of outcome measures and can be used to evaluate the course of knee injury and treatment outcome.

The global burden of hip and knee osteoarthritis: estimates from the Global Burden of Disease 2010 study

Abstract: Objective To estimate the global burden of hip and knee osteoarthritis (OA) as part of the Global Burden of Disease 2010 study and to explore how the burden of hip and knee OA compares with other conditions. Methods Systematic reviews were conducted to source age-specific and sex-specific epidemiological data for hip and knee OA prevalence, incidence and mortality risk. The prevalence and incidence of symptomatic, radiographic and self-reported hip or knee OA were included. Three levels of severity were defined to derive disability weights (DWs) and severity distribution (proportion with mild, moderate and severe OA). The prevalence by country and region was multiplied by the severity distribution and the appropriate disability weight to calculate years of life lived with disability (YLDs). As there are no deaths directly attributed to OA, YLDs equate disability-adjusted life years (DALYs). Results Globally, of the 291 conditions, hip and knee OA was ranked as the 11th highest contributor to global disability and 38th highest in DALYs. The global age-standardised prevalence of knee OA was 3.8% (95% uncertainty interval (UI) 3.6% to 4.1%) and hip OA was 0.85% (95% UI 0.74% to 1.02%), with no discernible change from 1990 to 2010. Prevalence was higher in females than males. YLDs for hip and knee OA increased from 10.5 million in 1990 (0.42% of total DALYs) to 17.1 million in 2010 (0.69% of total DALYs). Conclusions Hip and knee OA is one of the leading causes of global disability. Methodological issues within this study make it highly likely that the real burden of OA has been underestimated. With the aging and increasing obesity of the world9s population, health professions need to prepare for a large increase in the demand for health services to treat hip and knee OA.