Physical activity level and health-related quality of life in adults with multiple osteochondromas: a Dutch cross-sectional study

Abstract

Multiple Osteochondromas (MO) can significantly impact physical functioning, yet evidence on how MO affects physical activity levels (PAL) and health-related quality of life (HRQOL) remains limited. This study aimed to: (1) characterize the PAL and physical and mental HRQOL of adult patients with MO and compare them with healthy subjects (2) explore whether illness-related symptoms, sociodemographic and psychological factors are associated with patients' PAL and HRQOL. This cross-sectional study used a survey consisting of sociodemographic data and validated questionnaires on the PAL (Baecke Physical Activity Questionnaire) and HRQOL (SF-36). The PAL, physical and mental HRQOL were compared with reference scores of healthy subjects using a one-sample t-test. An a-priori defined theoretical framework (ICF-model) was used to select explanatory variables, including several psychological factors, for the multiple linear regression models of the dependent variables PAL and HRQOL. 342 patients (42.6% males) with a mean age of 41.8 ± 16.3 completed the survey. Mean PAL scores were 7.2 ± 1.7, physical HRQOL 41.7 ± 11.1 and mental HRQOL 49.1 ± 10.5. Except for mental HRQOL, these scores were lower than healthy subjects (p < 0.001). The final regression model for the PAL contained six factors (R² = 0.221, p < 0.001) showing the strongest association with having a job and malignant degeneration. Fourteen variables, including pain-related disability and number of surgical procedures, explained physical HRQOL (R² = 0.731, p < 0.001). For mental HRQOL, eight factors remained in the model (R² = 0.618, p < 0.001) with anxiety explaining the most unique variance (9.4%). MO patients reported significantly lower PAL and physical HRQOL than healthy controls. This study provides insight in several factors associated with the PAL and HRQOL in MO which could be used to optimize patients' treatment.

Keywords: Exercise; Multiple Hereditary Exostoses; Multiple osteochondromas; Physical activity; Quality of life.

Fig. 1

ICF model of the a priori selected explanatory variables for the dependent variables: the physical activity level (BPAQ) and physical and mental health-related quality of life (SF-36). ^aWere not included in the regression model with the physical activity level (BPAQ) as dependent variable. The PDI measures disability at the activities level, equal to the ICF-level of the BPAQ. HRQOL, measured at the participation level, is assumed to be affected by the activities level and not the other way around. Abbreviations: DN4 douleur neuropathique en 4 questions, NRS numeric rating scale, CIS checklist individual strength, PDI pain disability index, PCS pain catastrophizing scale, SF-36 short form-36, BPAQ Baecke Physical Activity Questionnaire, HADS Hospital Anxiety and Depression Scale, FABQ Fear-Avoidance Beliefs Questionnaire, BMI Body Mass Index.