Knee Problems in Young Adults

Abstract Obesity and physical inactivity have been identified as risk factors for knee pain in elderly populations. There has been an increase in the prevalence of obesity and physical inactivity in younger adults. Therefore, it is important to investigate whether they are risk factors for knee disorders among young adults. This thesis explored the epidemiology of knee problems in young adults. A literature review, using systematic methods, identified 19 studies reporting on the incidence of and/or risk factors for knee disorders in young adults. Knee disorder incidence varied across studies (0.07% to 42.0%), because of the different knee conditions and study populations (military and sports) investigated. There was conflicting evidence on whether obesity and physical activity were risk factors for knee disorders; and physical inactivity had not been investigated. A longitudinal study was undertaken to estimate the incidence of knee problems in young adults and explore whether physical activity, physical inactivity and obesity were risk factors. It was designed as a feasibility study to inform a large-scale cohort study in the general population. Three hundred and fourteen staff and students of the University of Central Lancashire, Preston campus were recruited and followed up for 12 months. Data was collected through self-report questionnaire and where possible direct measurement of weight and height was taken. Logistic regression was used to investigate any plausible relationship between knee problems and body mass index (BMI), physical inactivity, and physical activity levels. The mean (SD) age was 22 (5.2) years. There were more men (n=176, 56.1%) than woman (n=138, 43.9%). At baseline, the mean (SD) score for the Hopkins Symptoms Checklist-10 (mental distress) was 1.5 (0.4); mean (SD) BMI was 24.3 (4.1) and mean (SD) total hours spent sitting per day was 5.6 hours (2.6). Over half of the participants (n=165, 52.9%) reported low physical activity with similar proportions reporting moderate (n= 75, 24.0%), and high (n= 72, 23.1%) physical activity levels. The prevalence of knee problems was high (31.8% [95% CI 26.9% to 37.2%]); knee pain was the most prevalent symptom. Multivariate logistic regression analysis on cross- sectional data showed that high physical activity levels (OR 2.6 [95% CI 1.4-4.9]) and mental distress (OR 2.3 [95% CI 1.2-4.6]) were independent risk factors. Only 126 (40.1%) participants responded to the follow up at 12 months: 76.9% still had knee problems and 11.5% had a new knee problem. Knee problems are common in young adults. The study provided an estimate of incidence to inform the design of a large-scale population based study but attention needs to be paid to ensure lower attrition. The study suggests that more attention may need to be paid towards prevention of knee problems and that further work on the economic burden of knee problems among young adults is warranted. This is particularly important as there is increasing emphasis in public health policy on promoting physical activity

Knee problems are common in young adults and associated with physical activity and not obesity: the findings of a cross-sectional survey in a university cohort

Background: Obesity and sedentary behaviour, risk factors for knee osteoarthritis in middle-age, are increasing in younger adults. The objectives of this study were to estimate the prevalence of knee problems in young adults, to characterise these problems and explore the relationship with physical activity, physical inactivity and obesity. Methods: Presence of knee problems was collected through self-report questionnaire from staff and students of one university aged 18-39; direct measurement of weight and height was taken and activity measured using the International Physical Activity Questionnaire. Twelve-month prevalence of knee problems was estimated. Logistic regression was used to investigate the relationship between knee problems and physical activity levels, sitting time and body mass index. Results: The prevalence of knee problems was high (31.8% [95% CI 26.9% to 37.2%]) among the 314 participants; knee pain was the most common dominant symptom (65%). Only high physical activity levels (OR 2.6 [95% CI 1.4-4.9]) and mental distress (OR 2.3 [95% CI 1.2-4.6]) were independent risk factors for knee problems. Conclusions: Knee problems were common among young adults, who were staff and students of a university. With increasing obesity prevalence, populations are being encouraged to become more active. More attention may need to be paid towards prevention of knee problems in such programmes, and further research is warranted

Racism, Discrimination, and Harassment in Medical Schools in the UK: A Scoping Review

Background: Discrimination, racism, harassment, stereotyping, and bullying are a significant issue for medical students as they create a hostile environment with detrimental effect on student wellbeing and educational experience. Findings suggest that though prevalent, reporting of these experiences is rare and perceived as ineffective. Objectives: This scoping review aims to map the trends, types, and nature of discrimination, harassment, bullying, stereotyping, intimidation, and racism reports in undergraduate medical education in the UK since 2010 and to determine areas of focus for undertaking full systematic reviews in the future. Method: A search was conducted using the MEDLINE, AHMED, CINHL, and EMBASE electronic databases from 2010 up to February 2022 in English. Only primary research papers (e.g., cohort studies, cross-sectional studies, and case series) that report the words/phrases discrimination (including gender and racial), harassment (including verbal, sexual, academic, and physical), bullying, stereotype, intimidation, and racism within medical education in the UK after 2010, following the Equity Act 2010, were eligible for inclusion. Results: Five relevant articles relating to discrimination, harassment, bullying, stereotyping, intimidation, and racism in medical schools in the UK were included. Three themes were identified across these studies. Conclusions: The data suggest that there is a high prevalence rate of discrimination, harassment, and stereotyping being experienced by ethnic minority undergraduate medical students in the UK. There is underreporting due to perceived and structural barriers. The identified studies suggest that less progress has been made in these areas