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Deng Y, Tang Z, Yang Z, Chai Q, Lu W, Cai Y, Luo Y, Zhou Y. Comparing the effects of aquatic-based exercise and land-based exercise on balance in older adults: a systematic review and meta-analysis. Eur Rev Aging Phys Act 2024; 21:13. [PMID: 38764039 PMCID: PMC11102618 DOI: 10.1186/s11556-024-00349-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/10/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND Balance plays a crucial role in the daily activities of older adults. Aquatic-based exercises (AE) are widely conducted as an alternative to land-based exercises (LE). Previous studies have compared AE and LE as effective ways to improve balance and have yielded inconsistent results. Therefore, this review aimed to compare the effects of AE and LE on balance function in older adults. METHODS Electronic databases, including PubMed, Web of Science, Scopus, and Embase, were searched. Randomized controlled trials published from January 2003 to June 2023 were included following predetermined criteria. Data extraction was carried out by two independent reviewers. Data synthesis was conducted using RevMan 5.3 software. The fixed-effect model or random-effect model was chosen based on the results of the heterogeneity test. Meta-analysis for the effect sizes of balance outcomes was calculated as standardized mean difference (SMD) with 95% confidence intervals (CI). The quality of the included studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. This review was registered at PROSPERO CRD42023429557. RESULTS A total of 29 studies involving 1486 older adults (with an average age of 66.2 years) were included. Meta-analysis results indicated that AE could improve balance ability based on two tests: the Berg balance scale (BBS: SMD = 1.13, 95% CI 0.25 to 2.00, p = 0.01, I2 = 94%) and the 30-s chair stand test (30 CST: SMD = 2.02, 95% CI 0.50 to 3.54, p = 0.009, I2 = 96%). However, there were no significant differences between the AE group and the LE group in terms of the 6-min walking test (6 MWT: SMD = 0.13, 95% CI -0.16 to 0.43, p = 0.38, I2 = 62%) and time up to go test (TUGT: SMD = 0.44, 95% CI -0.44 to 0.91, p = 0.07, I2 = 85%). Older adults with different health conditions have different gains in different balance measurements after AE intervention and LE intervention. CONCLUSIONS Although this was influenced by participant health status, transfer effects, sample size, and other factors, AE offers better benefits than LE for improving balance function in older adults.
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Affiliation(s)
- Ying Deng
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Zheng Tang
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Zhengting Yang
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Qi Chai
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Wenting Lu
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yunshi Cai
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yiting Luo
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yongzhao Zhou
- Sichuan University, West China Hospital, Chengdu, 610041, Sichuan, China.
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Ng N, Parkinson L, Brown WJ, Moorin R, Peeters GMEEG. Lifestyle behaviour changes associated with osteoarthritis: a prospective cohort study. Sci Rep 2024; 14:6242. [PMID: 38485979 PMCID: PMC10940587 DOI: 10.1038/s41598-024-54810-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 02/16/2024] [Indexed: 03/18/2024] Open
Abstract
The aim of this prospective cohort study was to compare changes in lifestyle behaviours over nine years in women who were and were not diagnosed with osteoarthritis (OA). Data were from the 1945-51 cohort of the Australian Longitudinal Study on Women's Health (aged 50-55 in 2001) who completed written surveys in 2001, 2004, 2007 and 2010. The sample included 610 women who were, and 3810 women who were not diagnosed with OA between 2004 and 2007. Descriptive statistics were used to assess changes in lifestyle behaviours (weight, sitting time, physical activity, alcohol and smoking) in the two groups, over three survey intervals: from 2001-2004 (prior to diagnosis); from 2004-2007 (around diagnosis); and from 2007-2010 (following diagnosis). Compared with women without OA (28%), a greater proportion of women with OA (38%) made at least one positive lifestyle change (p < 0.001). These included losing > 5 kg (9.8% vs. 14.4%, p < 0.001), and reducing sitting time by an hour (29.5% vs. 39.1%, p < 0.001) following diagnosis. However, women with OA also made negative lifestyle changes (35% vs. 29%, p < 0.001), for example, gaining > 5 kg around the time of diagnosis (21.4% vs. 14.5%, p < 0.001) and increasing sitting time by an hour following diagnosis (38.4% vs. 32.3%, p = 0.003). More women with OA also started smoking following diagnosis (8.9% vs. 0.8%, p < 0.001). While some women made positive changes in lifestyle behaviours during and following OA diagnosis, others made negative changes. Consistent support from clinicians for managing OA symptoms may enable patients to make more positive changes in lifestyle behaviours.
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Affiliation(s)
- Norman Ng
- School of Human Movement and Nutrition Science (#26B), The University of Queensland, Blair Drive, St Lucia Campus, Brisbane, QLD, 4072, Australia.
| | | | - Wendy J Brown
- School of Human Movement and Nutrition Science (#26B), The University of Queensland, Blair Drive, St Lucia Campus, Brisbane, QLD, 4072, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Rachael Moorin
- School of Public Health, Curtin University, Perth, Australia
| | - G M E E Geeske Peeters
- Department of Geriatric Medicine, Radboud University Medical Centre, Nijmegen, Netherlands
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Huang L, Xia Z, Wade D, Liu J, Zhou G, Yu C, Dawes H, Esser P, Wei S, Song J. Knee osteoarthritis pendulum therapy: In vivo evaluation and a randomised, single-blind feasibility clinical trial. J Orthop Translat 2024; 45:266-276. [PMID: 38617705 PMCID: PMC11015744 DOI: 10.1016/j.jot.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 12/29/2023] [Accepted: 02/26/2024] [Indexed: 04/16/2024] Open
Abstract
Background Exercise is recommended as the first-line management for knee osteoarthritis (KOA); however, it is difficult to determine which specific exercises are more effective. This study aimed to explore the potential mechanism and effectiveness of a leg-swinging exercise practiced in China, called 'KOA pendulum therapy' (KOAPT). Intraarticular hydrostatic and dynamic pressure (IHDP) are suggested to partially explain the signs and symptoms of KOA. As such this paper set out to explore this mechanism in vivo in minipigs and in human volunteers alongside a feasibility clinical trial. The objective of this study is 1) to analyze the effect of KOAPT on local mechanical and circulation environment of the knee in experimental animals and healthy volunteers; and 2) to test if it is feasible to run a large sample, randomized/single blind clinical trial. Methods IHDP of the knee was measured in ten minipigs and ten volunteers (five healthy and five KOA patients). The effect of leg swinging on synovial blood flow and synovial fluid content depletion in minipigs were also measured. Fifty KOA patients were randomly divided into two groups for a feasibility clinical trial. One group performed KOAPT (targeting 1000 swings/leg/day), and the other performed walking exercise (targeting 4000 steps/day) for 12 weeks with 12 weeks of follow-up. Results The results showed dynamic intra-articular pressure changes in the knee joint, increases in local blood flow, and depletion of synovial fluid contents during pendulum leg swinging in minipigs. The intra-articular pressure in healthy human knee joints was -11.32 ± 0.21 (cmH2O), whereas in KOA patients, it was -3.52 ± 0.34 (cmH2O). Measures were completed by 100% of participants in all groups with 95-98% adherence to training in both groups in the feasibility clinical trial. There were significant decreases in the Oxford knee score in both KOAPT and walking groups after intervention (p < 0.01), but no significant differences between the two groups. Conclusion We conclude that KOAPT exhibited potential as an intervention to improve symptoms of KOA possibly through a mechanism of normalising mechanical pressure in the knee; however, optimisation of the method, longer-term intervention and a large sample randomized-single blind clinical trial with a minimal 524 cases are needed to demonstrate whether there is any superior benefit over other exercises. The translational potential of this article The research aimed to investigate the effect of an ancient leg-swinging exercise on knee osteoarthritis. A minipig animal model was used to establish the potential mechanism underlying the exercise of knee osteoarthritis pendulum therapy, followed by a randomised, single-blind feasibility clinical trial in comparison with a commonly-practised walking exercise regimen. Based on the results of the feasibility trial, a large sample clinical trial is proposed for future research, in order to develop an effective exercise therapy for KOA.
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Affiliation(s)
- Lixia Huang
- Tianyuan Translational Medicine R&D Team, Medical School, Jianghan University, Wuhan, Hubei Province, China
| | - Zhidao Xia
- Institute of Life Science, Swansea University Medical School, Singleton Park, Swansea, SA2 8PP, UK
| | - Derick Wade
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford, OX3 0BP, UK
| | - Jicai Liu
- Tianyuan Translational Medicine R&D Team, Medical School, Jianghan University, Wuhan, Hubei Province, China
| | - Guoyong Zhou
- Tianyuan Translational Medicine R&D Team, Medical School, Jianghan University, Wuhan, Hubei Province, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, Hubei Province, China
| | - Helen Dawes
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford, OX3 0BP, UK
- NIHR Exeter BRC, College of Medicine, Department of Public Health & Sports Sciences, Faculty of Health and Life Sciences, University of Exeter, UK
| | - Patrick Esser
- Centre for Movement, Occupation and Rehabilitation Sciences (MOReS), Faculty of Health and Life Sciences, Oxford Brookes University, Gipsy Lane, Headington, Oxford, OX3 0BP, UK
| | - Shijun Wei
- Department of Orthopaedics, General Hospital of Central Theatre Command of PLA, No. 627, Wuluo Road, Wuhan, Hubei Province, China
| | - Jiuhong Song
- Wuhan FL Medical Science & Technology Ltd., Machi Road, Dongxihu District, Wuhan, Hubei Province, China
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Zampieri S, Bersch I, Smeriglio P, Barbieri E, Boncompagni S, Maccarone MC, Carraro U. Program with last minute abstracts of the Padua Days on Muscle and Mobility Medicine, 27 February - 2 March, 2024 (2024Pdm3). Eur J Transl Myol 2024; 34:12346. [PMID: 38305708 PMCID: PMC11017178 DOI: 10.4081/ejtm.2024.12346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 02/01/2024] [Indexed: 02/03/2024] Open
Abstract
During the 2023 Padua Days on Muscle and Mobility Medicine the 2024 meeting was scheduled from 28 February to 2 March 2024 (2024Pdm3). During autumn 2023 the program was expanded with Scientific Sessions which will take place over five days (in 2024 this includes February 29), starting from the afternoon of 27 February 2024 in the Conference Rooms of the Hotel Petrarca, Thermae of Euganean Hills (Padua), Italy. As per consolidated tradition, the second day will take place in Padua, for the occasion in the Sala San Luca of the Monastery of Santa Giustina in Prato della Valle, Padua, Italy. Confirming the attractiveness of the Padua Days on Muscle and Mobility Medicine, over 100 titles were accepted until 15 December 2023 (many more than expected), forcing the organization of parallel sessions on both 1 and 2 March 2024. The five days will include lectures and oral presentations of scientists and clinicians from Argentina, Austria, Belgium, Brazil, Bulgaria, Canada, Denmark, Egypt, France, Germany, Iceland, Ireland, Italy, Romania, Russia, Slovenia, Switzerland, UK and USA. Only Australia, China, India and Japan are missing from this edition. But we are confident that authors from those countries who publish articles in the PAGEpress: European Journal of Translational Myology (EJTM: 2022 ESCI Clarivate's Impact Factor: 2.2; SCOPUS Cite Score: 3.2) will decide to join us in the coming years. Together with the program established by 31 January 2024, the abstracts will circulate during the meeting only in the electronic version of the EJTM Issue 34 (1) 2024. See you soon in person at the Hotel Petrarca in Montegrotto Terme, Padua, for the inauguration scheduled the afternoon of 27 February 2024 or on-line for free via Zoom. Send us your email address if you are not traditional participants listed in Pdm3 and EJTM address books.
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Affiliation(s)
- Sandra Zampieri
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy; Department of Biomedical Sciences, University of Padova, Padua, Italy; Interdepartmental Research Centre of Myology, University of Padova, Padua, Italy; Armando Carraro & Carmela Mioni-Carraro Foundation for Translational Myology, Padua.
| | - Ines Bersch
- Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland; International FES Centre®, Swiss Paraplegic Centre Nottwil, Nottwil.
| | - Piera Smeriglio
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris.
| | - Elena Barbieri
- Department of Biomolecular Sciences, University of Urbino Carlo Bo, Urbino (PU).
| | - Simona Boncompagni
- Center for Advanced Studies and Technology, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy; Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti.
| | | | - Ugo Carraro
- Department of Biomedical Sciences, University of Padova, Padua, Italy; Interdepartmental Research Centre of Myology, University of Padova, Padua, Italy; Armando Carraro & Carmela Mioni-Carraro Foundation for Translational Myology, Padua.
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Chen K, Tao H, Zhu P, Chu M, Li X, Shi Y, Zhang L, Xu Y, Lv S, Huang L, Huang W, Geng D. ADAM8 silencing suppresses the migration and invasion of fibroblast-like synoviocytes via FSCN1/MAPK cascade in osteoarthritis. Arthritis Res Ther 2024; 26:20. [PMID: 38218854 PMCID: PMC10787439 DOI: 10.1186/s13075-023-03238-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 12/13/2023] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVE Osteoarthritis (OA) is a degenerative joint disease that affects elderly populations worldwide, causing pain and disability. Alteration of the fibroblast-like synoviocytes (FLSs) phenotype leads to an imbalance in the synovial inflammatory microenvironment, which accelerates the progression of OA. Despite this knowledge, the specific molecular mechanisms of the synovium that affect OA are still unclear. METHODS Both in vitro and in vivo experiments were undertaken to explore the role of ADAM8 playing in the synovial inflammatory of OA. A small interfering RNA (siRNA) was targeting ADAM8 to intervene. High-throughput sequencing was also used. RESULTS Our sequencing analysis revealed significant upregulation of the MAPK signaling cascade and ADAM8 gene expression in IL-1β-induced FLSs. The in vitro results demonstrated that ADAM8 blockade inhibited the invasion and migration of IL-1β-induced FLSs, while also suppressing the expression of related matrix metallomatrix proteinases (MMPs). Furthermore, our study revealed that inhibiting ADAM8 weakened the inflammatory protein secretion and MAPK signaling networks in FLSs. Mechanically, it revealed that inhibiting ADAM8 had a significant effect on the expression of migration-related signaling proteins, specifically FSCN1. When siADAM8 was combined with BDP-13176, a FSCN1 inhibitor, the migration and invasion of FLSs was further inhibited. These results suggest that FSCN1 is a crucial downstream factor of ADAM8 in regulating the biological phenotypes of FLSs. The in vivo experiments demonstrated that ADAM8 inhibition effectively reduced synoviocytes inflammation and alleviated the progression of OA in rats. CONCLUSIONS ADAM8 could be a promising therapeutic target for treating OA by targeting synovial inflammation.
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Affiliation(s)
- Kai Chen
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China
- Department of Orthopedics, Hai'an People's Hospital, Zhongba Road 17, Hai'an, Jiangsu, China
| | - Huaqiang Tao
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China
| | - Pengfei Zhu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China
| | - Miao Chu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China
- Department of Orthopedics, Yixing Peoples's Hospital, Xincheng Road 1588, Yixing, Jiangsu, China
| | - Xueyan Li
- Anesthesiology department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, Guangjj Road 242, Suzhou, Jiangsu, China
| | - Yi Shi
- Anesthesiology department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, Guangjj Road 242, Suzhou, Jiangsu, China
| | - Liyuan Zhang
- Anesthesiology department, Suzhou Municipal Hospital (North District), Nanjing Medical University Affiliated Suzhou Hospital, Guangjj Road 242, Suzhou, Jiangsu, China
| | - Yaozeng Xu
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China
| | - Shujun Lv
- Department of Orthopedics, Hai'an People's Hospital, Zhongba Road 17, Hai'an, Jiangsu, China.
| | - Lixin Huang
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China.
| | - Wei Huang
- Department of Orthopedics, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Lujiang Road 17, Hefei, An'hui, China.
| | - Dechun Geng
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Shizi Street 188, Suzhou, Jiangsu, China.
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Wang T, Wang J, Chen Y, Ruan Y, Dai S. Efficacy of aquatic exercise in chronic musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2023; 18:942. [PMID: 38066577 PMCID: PMC10704680 DOI: 10.1186/s13018-023-04417-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Aquatic exercise (AE) is becoming ever more popular as a physical therapy, while it is unclear what precise improvements it will produce and how effective it will be in comparison with other non-surgical therapies. The study aimed to assess whether AE positively impacts chronic musculoskeletal disorder patients in terms of pain, physical function, and quality of life. METHODS PRISMA guidelines were followed, and our study protocol was published online at PROSPERO under registration number CRD42023417411. We searched PubMed, Embase, Web of Science, and Cochrane library databases for English-language articles published before April 11, 2023, including studies from all relevant randomized controlled trials (RCTs). After screening, we ultimately included 32 RCTs with a total of 2,200 participants. We also performed subgroup analyses for all included studies. This meta-analysis calculated standardized mean difference (SMD) with 95% confidence interval (CI), and the variance was estimated using a random-effects model. The quality of the included studies was assessed by using the Cochrane collaborative "risk of bias" assessment tool (version 2.0). Thus ensuring that the literature included is of high quality. RESULTS This meta-analysis included 32 trials with 2,200 participants; these patients were all between the ages of 38-80. The study showed that compared to the no exercise (NE) group, patients in the AE group experienced a remarkable reduction in pain (SMD: -0.64, P < 0.001), a significant increase in physical function (SMD: 0.62, P < 0.001), and a statistically significant improvement in quality of life (SMD: -0.64, P < 0.001). When compared to land-based exercise (LE), AE significantly relieves patients' pain (SMD: -0.35, P = 0.03). CONCLUSIONS This is the first systematic review and meta-analysis to study whether AE could improve chronic musculoskeletal disorders. The evidence suggests that AE benefits pain, physical function, and quality of life in adults with chronic musculoskeletal conditions compared to NE. Furthermore, when compared to LE, AE continues to provide a better improvement in patient pain. More long-term clinical trials are needed to confirm AE's positive effects and improvement mechanisms and the more existential advantages compared to LE.
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Affiliation(s)
- Tianyue Wang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Jiamin Wang
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yuheng Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yanmin Ruan
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Senjie Dai
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
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Irnich D, Bäumler P. [Concept for integrative pain treatment of osteoarthritis of the knee based on the evidence for conservative and complementary therapies]. Schmerz 2023; 37:413-425. [PMID: 37505229 DOI: 10.1007/s00482-023-00739-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/09/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Osteoarthritis of the knee (gonarthritis) represents a medical challenge. RESEARCH QUESTION What is the evidence with respect to approaches of complementary medicine and their integration into multimodal pain management concepts? MATERIAL AND METHODS Qualitative nonsystematic literature search on the epidemiology and pathophysiology as well as informative clinical trials, meta-analyses and clinical guidelines about conservative treatment including complementary therapy for gonarthritis. RESULTS Osteoarthritis of the knee is a frequent condition with biopsychosocial risks factors for chronification. The German S2k clinical guideline (k = consensus-based, not based on scientific systematic literature searches) published by the Association of the Scientific Medical Societies in Germany (AWMF) in 2017 has not yet been updated. The current guidelines of the American College of Rheumatology (ACR) date from 2020. Both guidelines recommend exercise therapy, weight reduction, short-term analgesics, topical therapy, intra-articular corticoid injections and acupuncture with variable strengths. Furthermore, transcutaneous electrical nerve stimulation (TENS), laser and other electrophysical therapies, shock waves, traction treatment, ergotherapy, comfrey poultices and mudpacks can also be used. Current research supports the benefits of tai chi/qigong and medicinal leaches. CONCLUSION Complementary treatment approaches, such as acupuncture, tai chi/qigong, topical naturopathic self-treatment and leeches (with limitations) can, in addition to behavioral changes, exercise therapy and short-term pharmacological treatment, be important evidence-based components of integrative pain management concepts, e.g. in terms of an interdisciplinary multimodal pain treatment (IMPT). Besides pain reduction and functional improvement they promote the internal control conviction through the possibility of self-treatment and self-exercise.
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Affiliation(s)
- Dominik Irnich
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland.
| | - Petra Bäumler
- Interdisziplinäre Schmerzambulanz, Klinik für Anaesthesiologie, Klinikum der Ludwig-Maximilians-Universität München, LMU München, Campus Innenstadt, Pettenkoferstr. 8a, 80336, München, Deutschland
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Rizvi MR, Sharma A, Hasan S, Ahmad F, Asad MR, Iqbal A, Alghadir AH. Exploring the impact of integrated polyvagal exercises and knee reinforcement in females with grade II knee osteoarthritis: a randomized controlled trial. Sci Rep 2023; 13:18964. [PMID: 37923783 PMCID: PMC10624888 DOI: 10.1038/s41598-023-45908-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/25/2023] [Indexed: 11/06/2023] Open
Abstract
This study aimed to compare the effects of knee strengthening exercises to those of polyvagal theory-based exercises combined with knee strengthening exercises on selected outcomes in women with grade II knee osteoarthritis (OA). A randomized controlled trial was conducted, in which 60 female participants diagnosed with grade II knee OA, with a mean age of 57.27 ± 7.81 years and knee pain rated between 4 and 7 on the visual analog scale (VAS), were assigned to either the knee strengthening exercise group (Group 1, n = 30) or the polyvagal theory-based exercise plus knee strengthening exercise group (Group 2, n = 30). Pre- and posttreatment assessment of outcome variables, including WOMAC scores (joint pain, joint stiffness, functional limitations, and the overall index), WHOQOL scores (overall quality of life, general health, physical, psychological, social, and environmental domains), and heart rate variability (HRV, time and frequency domains), were analyzed. Group 2 demonstrated significantly greater reductions in joint pain, stiffness, and functional limitations than Group 1 after the intervention. Group 2 presented with significantly improved WOMAC scores, indicating better overall outcomes. Group 2 showed significant improvements in the psychological and social domains regarding quality of life. There were no significant differences in the physical domain or the environmental domain. Group 2 showed a significant increase in high-frequency power (HF) and a significant decrease in the LF/HF ratio, suggesting improved autonomic regulation. A combination of polyvagal exercise and knee strengthening training resulted in superior outcomes compared to knee strengthening exercises alone in women with grade II knee OA. These findings support the potential effectiveness of incorporating polyvagal exercises as an adjunctive intervention for osteoarthritis management.
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Affiliation(s)
- Moattar Raza Rizvi
- Department of Physiotherapy, School of Allied Health Science, Manav Rachna International Institute of Research and Studies, Faridabad, 121004, India
| | - Ankita Sharma
- Department of Physiotherapy, School of Allied Health Science, Manav Rachna International Institute of Research and Studies, Faridabad, 121004, India
| | - Shahnaz Hasan
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia
| | - Fuzail Ahmad
- Respiratory Care Department, College of Applied Sciences, Almaarefa University, Ad Diriyah, 13713, Saudi Arabia
| | - Mohammad Rehan Asad
- Department of Basic Sciences, College of Medicine, Majmaah University, Al-Majmaah, 15341, Saudi Arabia
| | - Amir Iqbal
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia.
| | - Ahmad H Alghadir
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia
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Li D, Cheng Y, Yuan P, Wu Z, Liu J, Kan J, Zhang K, Wang Z, Zhang H, Zhang G, Xue T, Jia J, Zhai S, Guan Z. Efficacy and safety of flurbiprofen cataplasms versus loxoprofen sodium cataplasms in knee osteoarthritis: a randomized controlled trial. Chin Med J (Engl) 2023; 136:2187-2194. [PMID: 37545031 PMCID: PMC10508367 DOI: 10.1097/cm9.0000000000002797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Clinical trial evidence is limited to identify better topical non-steroidal anti-inflammatory drugs (NSAIDs) for treating knee osteoarthritis (OA). We aimed to compare the clinical efficacy and safety of flurbiprofen cataplasms (FPC) with loxoprofen sodium cataplasms (LSC) in treating patients with knee OA. METHODS This is an open-label, non-inferiority randomized controlled trial conducted at Peking University Shougang Hospital. Overall, 250 patients with knee OA admitted from October 2021 to April 2022 were randomly assigned to FPC and LSC treatment groups in a 1:1 ratio. Both medications were administered to patients for 28 days. The primary outcome was the change of pain measured by visual analog scale (VAS) score from baseline to day 28 (range, 0-10 points; higher score indicates worse pain; non-inferiority margin: 1 point; superiority margin: 0 point). There were four secondary outcomes, including the extent of pain relief, the change trends of VAS scores, joint function scores measured by the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and adverse events. RESULTS Among 250 randomized patients (One patient without complete baseline record in the flurbiprofen cataplasms was excluded; age, 62.8 ± 10.5 years; 61.4% [153/249] women), 234 (93.6%) finally completed the trial. In the intention-to-treat analysis, the decline of the VAS score for the 24-h most intense pain in the FPC group was non-inferior, and also superior to that in the LSC group (differences and 95% confidence interval, 0.414 (0.147-0.681); P <0.001 for non-inferiority; P = 0.001 for superiority). Similar results were observed of the VAS scores for the current pain and pain during exercise. WOMAC scores were also lower in the FPC group at week 4 (12.50 [8.00-22.50] vs . 16.00 [11.00-27.00], P = 0.010), mainly driven by the dimension of daily activity difficulty. In addition, the FPC group experienced a significantly lower incidence of adverse events (5.6% [7/124] vs . 33.6% [42/125], P <0.001), including irritation, rash and pain of the skin, and sticky hair uncovering pain. CONCLUSIONS This study suggested that FPC is superior to LSC for treating patients with knee OA in pain relief, joint function improvement, and safety profile.
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Affiliation(s)
- Dong Li
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Yinchu Cheng
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
| | - Ping Yuan
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Ziyang Wu
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
| | - Jiabang Liu
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Jinfu Kan
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Kun Zhang
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Zhanguo Wang
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Hui Zhang
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Guangwu Zhang
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Tao Xue
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Junxiu Jia
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
| | - Suodi Zhai
- Department of Pharmacy, Peking University Third Hospital, Beijing 100191, China
| | - Zhenpeng Guan
- Department of Orthopedic, Peking University Shougang Hospital, Beijing 100144, China
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10
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Sun JN, Shan YZ, Wu LX, Li N, Xu FH, Kong XR, Zhang B. Preoperative high-intensity strength training combined with balance training can improve early outcomes after total knee arthroplasty. J Orthop Surg Res 2023; 18:692. [PMID: 37715204 PMCID: PMC10504716 DOI: 10.1186/s13018-023-04197-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 09/13/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND To investigate the effect of preoperative high-intensity strength training combined with balance training on the knee function of end-stage knee osteoarthritis (KOA) patients after total knee arthroplasty (TKA). METHODS A prospective study was conducted on end-stage KOA patients awaiting TKA. The patients were divided into an experimental group and a control group according to whether they received a preoperative training intervention. The differences in knee flexor-extensor strength, knee range of motion (ROM), timed up and go (TUG) test result, stair ascend/descend test result, Knee Society score (KSS) and Berg balance scale (BBS) score were assessed in both groups at baseline (T1), before operation (T2), 3 months after operation (T3), and 1 year after operation (T4). RESULTS After high-intensity strength training and balance training, the knee flexor-extensor strength, TUG test result, stair ascend/descend test result, and KSS were all significantly improved at T2 in the experimental group over the control group. At T3, the knee ROM, knee flexor-extensor strength, TUG test result, BBS score, and KSS clinical and functional scores were all significantly superior in the experimental group. The experimental group enjoyed a superiority in KSS clinical and functional scores until T4. Group × time and between-group interactions were found in all assessment indicators in both groups (p < 0.01). CONCLUSION Preoperative high-intensity strength training combined with balance training can enhance the knee flexor-extensor strength and balance of patients with end-stage KOA in the short term and help improve early outcomes after KOA. Trial registration ChiCTR2000032857, 2020-05-13.
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Affiliation(s)
- Jian-Ning Sun
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Yu-Zhou Shan
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Li-Xia Wu
- Research Center, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Li
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Fei-Hu Xu
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Xiang-Ru Kong
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China
| | - Bei Zhang
- Department of Orthopedics, Nanjing Drum Tower Hospital Group Suqian Hospital, Suqian, China.
- Department of Orthopedics, Suqian hospital affiliated to Xuzhou Medical University, Suqian, China.
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11
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Wang J, Chen Z, Chen X, Yang Y, Gan W, Wang F. Impact of Bad Ragaz ring in hot spring water on knee osteoarthritis: A prospective observational study. Medicine (Baltimore) 2023; 102:e34457. [PMID: 37565912 PMCID: PMC10419570 DOI: 10.1097/md.0000000000034457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/03/2023] [Indexed: 08/12/2023] Open
Abstract
To evaluate the impact of the Bad Ragaz ring method (BRRM) in hot spring water for knee osteoarthritis (KOA), this prospective study enrolled KOA patients treated at the hospital between March 2020 and December 2020. The primary outcome was the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index score. A total of 60 patients were included, with 30 participants in the BRRM group and 30 patients in the non-BRRM group, respectively. The mean age was 56.4 ± 10.2 years (13 females), and the duration of disease was 5.0 ± 2.2 years in the BRRM group. The mean age was 56.0 ± 11.3 years (14 females), and the disease duration was 4.7 ± 2.1 years in the non-BRRM group. There were no differences between the 2 groups in the pain, stiffness, and function scores of the WOMAC (all P > .05) before treatment. The pre post difference in total WOMAC scores (56.57 ± 12.45 vs 36.81 ± 13.51, Cohen d = 1.52, P < .01) between the 2 groups was statistically significant. Compared with the non-BRRM group, the BRRM group showed lower scores for pain (6.5 ± 1.5 vs 8.1 ± 2.9, Cohen d = -0.69, P = .01), stiffness (2.7 ± 1.0 vs 5.0 ± 1.2, Cohen d = -1.93, P < .01), and function (14.8 ± 6.6 vs 26.7 ± 7.5, Cohen d = -1.68, P < .01) after treatment. In conclusion, the BRRM might improve the pain and function of patients with KOA.
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Affiliation(s)
- Jianqiang Wang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Zeng Chen
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Xiaoqing Chen
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Yang Yang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Wei Gan
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Fachao Wang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
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12
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Ferreira RM, Martins PN, Pimenta N, Gonçalves RS. Physical Therapists' Choices, Views and Agreements Regarding Non-Pharmacological and Non-Surgical Interventions for Knee Osteoarthritis Patients: A Mixed-Methods Study. Mediterr J Rheumatol 2023; 34:188-219. [PMID: 37654628 PMCID: PMC10466349 DOI: 10.31138/mjr.34.2.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Revised: 09/08/2022] [Accepted: 09/21/2022] [Indexed: 09/01/2023] Open
Abstract
Objective/Aims The aims of this study are to collect the most common non-pharmacological and non-surgical interventions used by the Portuguese physical therapists in their knee osteoarthritis patients, and to deeper understand the factors associated to their intervention choices. Methods This study incorporated a mixed-methods design. For the quantitative data it was choose an e-survey (with 25 close-end questions, plus general information of the study and a clinical vignette), retrieving sociodemographic and self-reported practice on knee osteoarthritis information. It was analysed response frequencies and associations between variables with logistic regression analyses. For the qualitative data, it was chosen to perform semi-structured interviews in purposefully selected physical therapists to include different sociodemographic factors and survey responses regarding the physical therapists' interventions chosen. After the interviews, the audios were collected, anonymised, transcribed verbatim, and the texts explored by the thematic approach. Results From the 277 PTs that shown interest in participating in the study, 120 fully completed the questionnaire and, from those, 10 participated in the interviews. The most chosen interventions included Resistance Exercise, Manual Therapy, Nutrition/Weight Loss, Self-care/Education, Stretching and Aquatic Exercise. Furthermore, it seems that PTs' individual characteristics (age, experience, and clinical reasoning), patient's characteristics (clinical findings and preferences), and work-related factors (facility type, work environment and available resources) are the main actors responsible for an intervention chosen. Conclusions In the Portuguese PTs context the most important interventions are Exercise, Manual Therapy, Nutrition/Weight Loss, and Self-care/Education; these interventions chosen may be influenced by PT, patient and work-related factors.
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Affiliation(s)
- Ricardo M. Ferreira
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, N2i, Maia, Portugal
- Physical Therapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, São Martinho do Bispo, Coimbra, Portugal
| | - Pedro N Martins
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, N2i, Maia, Portugal
- Physical Exercise and Sports Department, Polytechnic Institute of Bragança, Bragança, Portugal
| | - Nuno Pimenta
- Physical Exercise and Sports Department, Polytechnic Institute of Maia, N2i, Maia, Portugal
| | - Rui S. Gonçalves
- Physical Therapy Department, Coimbra Health School, Polytechnic Institute of Coimbra, São Martinho do Bispo, Coimbra, Portugal
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13
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Young JJ, Pedersen JR, Bricca A. Exercise Therapy for Knee and Hip Osteoarthritis: Is There An Ideal Prescription? CURRENT TREATMENT OPTIONS IN RHEUMATOLOGY 2023; 9:1-17. [PMID: 37362069 PMCID: PMC10199279 DOI: 10.1007/s40674-023-00205-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 06/28/2023]
Abstract
Purpose of review Exercise therapy is the first line treatment for patients with knee and hip osteoarthritis (OA) but is consistently underutilized. In this review, we aim to provide health care professionals with an overview of the latest evidence in the areas of exercise therapy for OA, which can serve as a guide for incorporating the ideal exercise therapy prescription in the overall management plan for their patients with OA. Recent findings Evidence continues to be produced supporting the use of exercise therapy for all patients with knee or hip OA. Ample evidence exists suggesting exercise therapy is a safe form of treatment, for both joint structures and the patient overall. Several systematic reviews show that exercise therapy is likely to improve patient outcomes, regardless of disease severity or comorbidities. However, no single type of exercise therapy is superior to others. Summary Health care practitioners and patients should be encouraged to incorporate exercise therapy into treatment plans and can be assured of the safety profile and likelihood of improvement in important patient outcomes. Since no single exercise therapy program shows vastly superior benefit, patient preference and contextual factors should be central to the shared decision-making process when selecting and individualising appropriate exercise therapy prescriptions.
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Affiliation(s)
- James J. Young
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Julie Rønne Pedersen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Alessio Bricca
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Ringsted, Denmark
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14
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Maccarone MC, Magro G, Albertin C, Barbetta G, Barone S, Castaldelli C, Manica P, Marcoli S, Mediati M, Minuto D, Poli P, Sigurtà C, Raffaetà G, Masiero S. Short-time effects of spa rehabilitation on pain, mood and quality of life among patients with degenerative or post-surgery musculoskeletal disorders. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:29-36. [PMID: 36207541 PMCID: PMC9546417 DOI: 10.1007/s00484-022-02381-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.
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Affiliation(s)
| | - Giacomo Magro
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy
| | | | | | | | | | | | | | | | | | | | | | - Gloria Raffaetà
- Second Orthopaedic and Traumatologic Clinic of Pisa, University of Pisa, Pisa, Italy
| | - Stefano Masiero
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy
- Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua, Italy
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15
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Bąkowski P, Kaszyński J, Baka C, Kaczmarek T, Ciemniewska-Gorzela K, Bąkowska-Żywicka K, Piontek T. Patients with stage II of the knee osteoarthritis most likely benefit from the intra-articular injections of autologous adipose tissue-from 2 years of follow-up studies. Arch Orthop Trauma Surg 2023; 143:55-62. [PMID: 34117558 PMCID: PMC9886583 DOI: 10.1007/s00402-021-03979-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 05/26/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a common, chronic, progressive and degenerative disease which affects patients' quality of life and may cause disability and social isolation. OA is a huge economic burden for the patient and a large strain for the whole healthcare system. Articular cartilage has a small potential to repair, with progressively more clinicians emphasizing cellular therapy. Subcutaneous fat tissue in human body is a large reservoir of mesenchymal stem cells (MSCs) and is been harvested in minimally invasive, simple procedure. The purpose of this study was to define a specific group of patients with knee osteoarthritis, who are the most likely to benefit from the treatment with intra-articular injection of an autologous adipose tissue (AAT). METHODS From 2016 to 2018, 59 symptomatic bilateral and unilateral knee OA patients were treated with a single intra-articular (IA) injection of an autologous adipose tissue (AAT). Before the treatment and at the follow-up, the participant was asked to fulfill the Knee Injury and Osteoarthritis Outcome Score (KOOS), the International Knee Documentation Committee 2000 (IKDC 2000), The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Health Questionnaire EQ-5D-5L and to quantify the pain in the affected joint with a Numeric Rating Scale (NRS). Moreover, the patients were asked to: (i) assess their satisfaction with the effects of the conducted treatment: from 0 (unsatisfied) to 10 (very satisfied), (ii) describe the rehabilitation, if it was performed (supervised or individual and duration in weeks) and (iii) indicate any additional treatment applied, like IA injections of hyaluronic acid (HA) or platelet-rich plasma (PRP), knee arthroscopy, partial or total knee arthroplasty (TKA) at the follow-up. RESULTS The mean age of 37 participants (16 males and 21 females) included into statistical analysis was 57.78 ± 7.39 years, the mean BMI was 31.30 ± 7.51. The questionnaires were fulfilled after the average follow-up time of 27 ± 6.5 months. A significant difference (p < 0.05) compared with the baseline, was observed in pain [NRS], WOMAC, KOOS index, pain, symptoms, ADL, Sport and Rec, QoL, EQ-5D-5L index. The satisfaction in the whole group was 6.16 ± 3.07. There was no significant difference between satisfied and unsatisfied patients in BMI and pain [NRS] at the baseline. 6 out of 7 patients with stage IV in K-L were unsatisfied with the effects of the treatment with AAT. DISCUSSION The main conclusion of this study is that the patients with stage II of the knee OA with normal BMI are were most likely to benefit from IA injection of AAT, in contrast to the patients with stage IV, who will not beware not satisfied with the effectiveness of this kind of treatment. There were no adverse events reported at the donor site as well as in the treated knee joints.
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Affiliation(s)
- Paweł Bąkowski
- Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland
| | - Jakub Kaszyński
- Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland
| | - Cezary Baka
- Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland
| | - Tomasz Kaczmarek
- Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland
| | | | | | - Tomasz Piontek
- Department of Orthopedic Surgery, Rehasport Clinic, Poznan, Poland
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences Poznan, Poznan, Poland
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Silisteanu AE, Antonescu OR, Racheriu M. The role of the therapeutic physical exercise and the complex recovery treatment for the patients with chronic degenerative diseases during the COVID-19 pandemic. BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract: Background: Osteoarthritis is one of the most common causes of pain and musculoskeletal disability and mainly affects the middle-aged and the elderly. The condition is chronic and disabling, it diminishes the patients' quality of life. Purpose. The study had the purpose of pointing out a possible connection between physical ac-tivity and the reduction of pain accompanied by the increased functional capacity in patients with chronic degenerative diseases during the COVID-19 pandemic. Material and method: The study was conducted on an outpatient basis for a period of 6 months on a number of 40 patients diagnosed with osteoarthritis. The evaluation of the pa-tients was made at the beginning of the treatment and at its end (after 4 weeks), as well as at the control after 12 weeks. Results: The study included a number of 40 patients over 45 years old, divided into 2 study groups: in group L1-knee osteoarthritis and in group L2 -hip osteoarthritis. The therapeutic physical exercise reduced pain and stiff-ness, and it also improved the functional capacity. Conclusions: Therapeutic physical exercise has an important role in the reduction of pain and disability, as well as in the increase in the quality of life, if it is done properly.
Keywords: osteoarthritis, therapeutic physical exercise, pain, pandemic COVID-19
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Affiliation(s)
- Andrei Emanuel Silisteanu
- Healthcare Management, Lucian Blaga University of Sibiu, Faculty of Medicine /FPACS-Cluj Napoca, Romania
| | | | - Mihaela Racheriu
- Lucian Blaga University of Sibiu, Faculty of Medicine,Sibiu, Romania
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17
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Gislason MK, Einarsson IT, Ingvason SS, Saavedra JM, Waller B. Measurements on the external load acting on aquatic resistance fins during flexion/extension movements using a robotic joint. Front Physiol 2022; 13:1046502. [DOI: 10.3389/fphys.2022.1046502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022] Open
Abstract
Aquatic resistance training has been proven to be beneficial to many people, in particular those struggling with degenerative joint diseases or recovering from other musculoskeletal issues as the reaction forces acting on the joints become lower, but without compromising the cardiovascular and neuromuscular benefit of the movement. Little has been written on the load produced by or measurements of the devices used in aquatic resistance training. Therefore, uncertainties exist regarding details of how much load can be applied onto the foot when performing the movements and how to quantify progression. In this study, an instrumented robotic arm was designed, built, and used to measure the load acting on the three different types of fins during a simulated flexion/extension movement of a knee. The angular velocities of the knee ranged from 25°/s to 150°/s, which represent the physiological range of in vivo movements. The results demonstrated that the load followed a second-order polynomial with the angular velocities. The load is therefore a function of the angular velocity, the surface area of the fins, and the location of the fins away from the joint center rotation. We modeled the progression of speeds at maximal voluntary movements based on previous studies. The maximum loads measured between 11 kg and 13 kg in extension and 6 kg and 9 kg in flexion at 150°/s rotational velocity.
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Rai AK, Mohanty SS, Rathod TN, Kamble P, Keny SA, Kothari RA. Outcome of Joint Aspiration in Acute Knee Haemarthrosis in a Haemophilic Joint: A Prospective Randomised Controlled Trial in 120 Patients in a Tertiary Haemophilia Care Centre. Indian J Orthop 2022; 56:2060-2065. [PMID: 36507206 PMCID: PMC9705623 DOI: 10.1007/s43465-022-00745-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/02/2022] [Indexed: 02/04/2023]
Abstract
Background Bleeding into the joints cause major morbidity in haemophilia patients. The clinical hallmark of haemophilia is haemarthrosis especially in knee, ankle and elbow joint. Current literature suggests that aspiration of an acute haemarthrosis in haemophilia may lead to further bleeding and prevent tamponade effect. But the rehabilitation gets delayed, leading to joint stiffness and the function gets deteriorated. This study was done to evaluate the efficacy of joint aspiration in the management of acute knee haemarthrosis, with regard to pain relief and functional outcome. Materials and Methods This is a prospective, randomised controlled trial in a tertiary care haemophilia treatment centre comprising 120 haemophilic patients with unilateral acute knee haemarthrosis. Factor level was checked and appropriate factor replacement [40%] was done. The patients were randomly allocated in two groups: Group A and Group B, each consisting of 60 patients. All patients received ice application, limb immobilisation, analgesics, physiotherapy and compression bandage as the routine primary management. In addition, study Group A also received therapeutic aspiration of the knee joint at initial presentation, after the first factor infusion. All patients were clinically evaluated for pain in terms of Visual Analogue Scale (VAS score) and function in terms of Haemophilic Joint Health Score [HJHS], before and at 4 h, 48 h and 7 days after initial factor administration. Results All patients showed therapeutic improvement in terms of a declining trend in VAS and HJHS scores. Pain relief (VAS Score) in Group A, was found to be significantly better compared to Group B at the end of 4 h [4.80 ± 0.49 vs 6.54 ± 1.05; p < 0.001], 48 h [2.48 ± 0.50 vs 3.30 ± 0.46; p < 0.001] and 7 days [1.16 ± 0.37 vs 1.70 ± 0.46; p < 0.001]. Functional improvement (HJHS Score) in Group A, was found to be significantly better compared to Group B as well at the end of 4 h [11.24 ± 0.77 vs 14.52 ± 0.61; p < 0.001], 48 h [7.24 ± 0.65 vs 11.28 ± 0.64; p < 0.001] and 7 days [2.36 ± 0.48 vs 5.52 ± 0.67; p < 0.001]. Conclusion Our study recommends the use of joint aspiration as a therapeutic tool in the holistic management of acute knee haemarthrosis in addition to usual treatment of ice application, immobilization and oral tranexamic acid. Early factor replacement along with therapeutic joint aspiration is a key for better pain relief and a better functional outcome.
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Affiliation(s)
- Abhishek Kumar Rai
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | | | | | - Prashant Kamble
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Swapnil Anil Keny
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - Ronak Ashok Kothari
- Department of Orthopaedics, Seth GS Medical College and KEM Hospital, Mumbai, India
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19
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Cordani C, Lazzarini SG, Del Furia MJ, Kiekens C, Arienti C, Negrini S. Arthralgia: a map of Cochrane evidence relevant to rehabilitation for people with post COVID-19 condition. Eur J Phys Rehabil Med 2022; 58:870-874. [PMID: 36472559 PMCID: PMC10153548 DOI: 10.23736/s1973-9087.22.07803-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Rehabilitation focuses on impairments, activity limitations and participation restrictions being informed by the underlying health condition. In the current absence of direct "evidence on" rehabilitation interventions for people with post COVID-19 condition (PCC), we can search and synthesize the indirect "evidence relevant to" coming from interventions effective on the symptoms of PCC in other health conditions. The World Health Organization (WHO) required this information to inform expert teams and provide specific recommendations in its Guidelines. With this overview of reviews with mapping we aimed to synthesize the Cochrane evidence relevant to rehabilitation for arthralgia due to PCC in a map. EVIDENCE ACQUISITION We searched the last five years' Cochrane Systematic Review (CSRs) using the terms "arthralgia," "joint pain," and "rehabilitation" and their synonyms in the Cochrane Library. We extracted and summarized all the available evidence using a map. We grouped the included CSRs for health conditions and interventions, indicating the effect and the quality of evidence. EVIDENCE SYNTHESIS We found 200 CSRs published between 2016 and 2021, and included 11 in this overview. They provided data from 7 health conditions, with osteoarthritis (5 studies) being the most studied. Effective rehabilitation interventions included exercise training, transcranial magnetic stimulation, different types of electrical stimulation and Tai chi. The overall quality of evidence was mainly low to very low, and moderate in a few cases. CONCLUSIONS These results provided the requested information to the WHO and served as the basis for one recommendation on treatments for arthralgia due to PCC in the current Guidelines for clinical practice. These results should be interpreted as a first step of indirect evidence able to generate helpful hypotheses for future research.
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Affiliation(s)
- Claudio Cordani
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University "La Statale", Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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20
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Ebert JR, Fearon AM, Smith PN, Janes GC. Recommendations in the rehabilitation of patients undergoing hip abductor tendon repair: a systematic literature search and evidence based rehabilitation protocol. Arch Orthop Trauma Surg 2022; 142:3165-3182. [PMID: 33983527 DOI: 10.1007/s00402-021-03952-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/04/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Advanced hip imaging and surgical findings have demonstrated that a common cause of greater trochanteric pain syndrome (GTPS) is hip abductor tendon (HAT) tears. Traditionally, these patients have been managed non-operatively, often with temporary pain relief. More recently, there has been an increase in published work presenting the results of surgical intervention. A variety of open and endoscopic transtendinous, transosseous and/or bone anchored suture surgical techniques have been reported, with and without the use of tendon augmentation for repair reinforcement. While patient outcomes have demonstrated improvements in pain, symptoms and function, post-operative rehabilitation guidelines are often vague and underreported, providing no guidance to therapists. MATERIALS AND METHODS A systematic search of the literature was initially undertaken to identify published clinical studies on patients undergoing HAT repair, over a 3-year period up until May 2020. Following the application of strict inclusion and exclusion criteria, studies were identified and the detail relevant to rehabilitation was synthesized and presented. Published detail was combined with the authors clinical experience, with a detailed overview of rehabilitation proposed for this patient cohort. RESULTS A total of 17 studies were included, reporting varied detail on components of rehabilitation including post-operative weight bearing (WB) restrictions, the initiation of passive/active hip range of motion (ROM) and resistance exercises. A detailed rehabilitation guide is proposed. CONCLUSION In combining the current published literature on rehabilitation after HAT repair and our own clinical experience in the surgical management and post-operative rehabilitation of these patients, we present an evidence-based, structured rehabilitation protocol to better assist surgeons and therapists in treating these patients. This rehabilitation protocol has been implemented for several years through our institutions with encouraging published clinical outcomes.
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Affiliation(s)
- Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia. .,HFRC, 117 Stirling Highway, Nedlands, WA, 6009, Australia.
| | - Angela M Fearon
- ACT, UCRISE, Faculty of Health, University of Canberra, Woden, 2617, Australia
| | - Paul N Smith
- ACT, Trauma & Orthopaedic Research Unit Canberra Hospital, Woden, 2617, Australia
| | - Gregory C Janes
- Perth Orthopaedic and Sports Medicine Centre, 31 Outram Street, West Perth, WA, 6005, Australia
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21
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How Physical Activity Affects Knee Cartilage and a Standard Intervention Procedure for an Exercise Program: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10101821. [PMID: 36292268 PMCID: PMC9602429 DOI: 10.3390/healthcare10101821] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/14/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: Cartilage degeneration with the natural aging process and the role of physical activity on cartilage wellness is still not clear. The objective of the present review was to understand how different physical activity interventions affect the cartilage and to propose a Standard Operating Procedure for an exercise program to maintain knee joint health; (2) Methods: Articles were collected on three different electronic databases and screened against the eligibility criteria. Results were collected in tables and the main outcomes were discussed narratively; (3) Results: A total of 24 studies have been included after the screening process and aerobic, strength, flexibility, postural balance, and mobility interventions were detected. Different protocols and types of interventions were adopted by the authors; (4) Conclusions: Physical activity interventions have mainly positive outcomes on cartilage structure, but the protocols adopted are different and various. A Standard Operating Procedure has been proposed for a physical intervention focalized on cartilage wellness that could be adopted as an intervention in the clinical setting. Furthermore, the creation of a standardized protocol wants to help scientific research to move in the same direction.
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22
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Cui J, Shibata Y, Itaka K, Zhou J, Zhang J. Unbiased comparison and modularization identify time-related transcriptomic reprogramming in exercised rat cartilage: Integrated data mining and experimental validation. Front Physiol 2022; 13:974266. [PMID: 36187764 PMCID: PMC9520919 DOI: 10.3389/fphys.2022.974266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Exercise is indispensable for maintaining cartilage integrity in healthy joints and remains a recommendation for knee osteoarthritis. Although the effects of exercise on cartilage have been implied, the detailed mechanisms, such as the effect of exercise time which is important for exercise prescription, remain elusive. In this study, bioinformatic analyses, including unbiased comparisons and modularization, were performed on the transcriptomic data of rat cartilage to identify the time-related genes and signaling pathways. We found that exercise had a notable effect on cartilage transcriptome. Exercise prominently suppressed the genes related to cell division, hypertrophy, catabolism, inflammation, and immune response. The downregulated genes were more prominent and stable over time than the upregulated genes. Although exercise time did not prominently contribute to the effects of exercise, it was a factor related to a batch of cellular functions and signaling pathways, such as extracellular matrix (ECM) homeostasis and cellular response to growth factors and stress. Two clusters of genes, including early and late response genes, were identified according to the expression pattern over time. ECM organization, BMP signaling, and PI3K-Akt signaling were early responsive in the exercise duration. Moreover, time-related signaling pathways, such as inositol phosphate metabolism, nicotinate/nicotinamide metabolism, cell cycle, and Fc epsilon RI signaling pathway, were identified by unbiased mapping and polarization of the highly time-correlated genes. Immunohistochemistry staining showed that Egfr was a late response gene that increased on day 15 of exercise. This study elucidated time-related transcriptomic reprogramming induced by exercise in cartilage, advancing the understanding of cartilage homeostasis.
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Affiliation(s)
- Jiarui Cui
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yo Shibata
- Department of Conservative Dentistry, Division of Biomaterials and Engineering, Showa University School of Dentistry, Tokyo, Japan
| | - Keiji Itaka
- Department of Biofunction Research, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Jun Zhou
- Department of Biofunction Research, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- *Correspondence: Jun Zhou, ; Jiaming Zhang,
| | - Jiaming Zhang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Jun Zhou, ; Jiaming Zhang,
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23
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Güneri FD, Karaarslan F, Forestıer FBE, Forestıer RJ, Odabaşı E. Publication activity in water treatments: Web of Science-based bibliometric analysis of the last two decades. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2022; 66:1829-1839. [PMID: 35779167 DOI: 10.1007/s00484-022-02323-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/20/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
We evaluated the quantity and quality of scientific publications linked with water treatments using the Web of Science (WoS) database. The WoS was searching by using the following terms "hydrotherapy," "balneotherapy," "spa therapy," "spa treatment," "creno-balneotherapy," "water treatments," and "aqua therapy," on February 10th, 2022. The recorded data were the total number of articles, year of articles, country of articles, journal, document type, index data, and citation data. Also, the studies performed with natural source mineral water were marked to make a further subgroup analysis through quality and quantity. We obtained 816 articles; 667 (81.74%) were original research articles, and 149 (18.26%) were review articles. A statistically significant and increasing trend was shown in the publication about water treatments (p < 0.01). About three-quarters of the trials were sourced from high-income countries. Italy (n = 98; 12.01%); Turkey (n = 75; 9.19%); Australia (n = 65; 7.97%); Brazil (n = 46; 5.64%); and France (n = 38; 4.66%) were the most productive countries. Calculating the number of articles per million population, Hungary (3.38), Australia (2.53), and Italy (1.64) ranked in the top three. According to 100 billion dollars GDP, the top three countries were Brazil (24.41), Hungary (21.15), and Turkey (10.41). In the average citation calculation, the Netherlands (60.84), Israel (29.86), and Australia (29.06) were in the top three. The International Journal of Biometeorology was the leading journal for publication trials about water treatments. In the subgroup analysis, we found the total number of studies performed with natural source mineral water and non-specified source water trials as 430 and 386, respectively. We also presented that the natural source and non-specified water trials had a statistically significant and increasing trend between 2000 and 2021 (p < 0.01 and p < 0.01, respectively). The trials performed with natural source water mainly were sourced from Italy (n = 79; 18.37%), Turkey (n = 61; 14.19%), France (n = 38; 8.84%), Poland (n = 30; 6.98%), and Hungary (n = 29; 6.74%), the trials performed with non-specified water were sourced from Australia (n = 61; 15.80%), Brazil (n = 46; 11.92%), USA (n = 27; 6.99%), Italy (n = 19; 4.92%), and England (n = 18; 4.66%). The top journal of the natural source water trials was the International Journal of Biometeorology (n = 65; 15.12%), and for the non-specified water trials, it was the International Journal of Sports Physiology (n = 12; 3.11%).Our study presented an increasing trend in trial publications regarding water treatments between 2000 and 2021. Most of the trials were from high and upper-middle-income countries. We suggest that by demonstrating global productivity worldwide, our results can create more scientific attention on this topic and may promote the quantity and quality of the trials.
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Affiliation(s)
- Fulya Demircioğlu Güneri
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
| | - Fatih Karaarslan
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
| | | | | | - Ersin Odabaşı
- Department of Medical Ecology and Hydroclimatology, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
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24
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Augmented Rehabilitation Program for Patients 60 Years and Younger Following Total Hip Arthroplasty-Feasibility Study. Healthcare (Basel) 2022; 10:healthcare10071274. [PMID: 35885801 PMCID: PMC9324868 DOI: 10.3390/healthcare10071274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/29/2022] [Accepted: 07/06/2022] [Indexed: 11/21/2022] Open
Abstract
The purpose of this study is to examine the feasibility, safety and outcomes of a study comparing a 6-week post-operative rehabilitation program to usual care in patients ≤60 years undergoing elective unilateral total hip arthroplasty (THA). Methods: A cohort of 24 THA patients were recruited during their 6-week postoperative visit to their surgeons. The community-based rehabilitation program, which was designed to improve function and increase activity, consisted of 12 structured exercise classes on land and water over 6 weeks. Physical activity was assessed using a Sense Wear Pro Armband (SWA). Participants completed the Hip Osteoarthritis Outcome Score (HOOS) and THA satisfaction questionnaire before and immediately after the intervention. Results: 14 participants received the augmented rehabilitation, and 10 participants were in the control group. All except one in the intervention group completed at least 80% of the sessions. The intervention group took significantly more steps/day (mean difference = 2440 steps/day, 95% CI = 1678, 4712) (p < 0.05), at the follow-up compared to baseline. The intervention group had a higher mean change of number of weekly PA bouts than the control group. Within the intervention group, all HOOS subscales were significantly higher at the follow-up compared to baseline. Conclusion: Findings provided pragmatic insight regarding the intervention and assessments of implementing an augmented rehabilitation program for elective THA.
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25
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Chronic Pain in Musculoskeletal Diseases: Do You Know Your Enemy? J Clin Med 2022; 11:jcm11092609. [PMID: 35566735 PMCID: PMC9101840 DOI: 10.3390/jcm11092609] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/02/2022] [Accepted: 05/03/2022] [Indexed: 02/06/2023] Open
Abstract
Musculoskeletal pain is a condition that characterises several diseases and represents a constantly growing issue with enormous socio-economic burdens, highlighting the importance of developing treatment algorithms appropriate to the patient’s needs and effective management strategies. Indeed, the algic condition must be assessed and treated independently of the underlying pathological process since it has an extremely negative impact on the emotional and psychic aspects of the individual, leading to isolation and depression. A full understanding of the pathophysiological mechanisms involved in nociceptive stimulation and central sensitization is an important step in improving approaches to musculoskeletal pain. In this context, the bidirectional relationship between immune cells and neurons involved in nociception could represent a key point in the understanding of these mechanisms. Therefore, we provide an updated overview of the magnitude of the musculoskeletal pain problem, in terms of prevalence and costs, and summarise the role of the most important molecular players involved in the development and maintenance of pain. Finally, based on the pathophysiological mechanisms, we propose a model, called the “musculoskeletal pain cycle”, which could be a useful tool to counteract resignation to the algic condition and provide a starting point for developing a treatment algorithm for the patient with musculoskeletal pain.
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26
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Kuptniratsaikul V, Chaiworapuek W, Kovintaset K, Meesawang M, Chinsawangwatanakul P, Danoi A. Pain management and strength gains compared between pneumatic partial weight support treadmill and underwater treadmill in overweight patients with knee osteoarthritis: A randomized controlled trial. Clin Rehabil 2022; 36:1214-1228. [PMID: 35506932 DOI: 10.1177/02692155221097032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate the efficacy of the pneumatic partial weight support treadmill compared to the underwater treadmill (UTM) for reducing pain and increasing quadriceps strength in overweight patients with knee osteoarthritis. DESIGN Non-inferiority trial with a pre-specified 1-point range. METHODS Participants (N = 109) were randomly assigned to the study (pneumatic partial weight support treadmill) (n = 55) or control (UTM) (n = 54) groups. Patients in both groups started with 50% weight support during the first week, 40% during the second week, and 30% during the third week and until the end of the study. Both groups received exercise for 30 min, 3 times per week for 8 weeks (24 sessions). Outcome measurements, including numerical pain rating scale, Western Ontario and McMaster Universities Osteoarthritis Index pain subscale, quadriceps strength, body weight, 6-min walking test, and quality of life, were evaluated at baseline, 8 weeks, and 12 weeks. RESULTS Only 74 participants completed the study. Numerical pain rating scale and the Western Ontario and McMaster Universities Osteoarthritis Index showed non-inferiority of the study to control group. Improvement in quadriceps strength was significantly greater in the study than in control group. Adverse events were not significantly different between groups. Most subjects were satisfied and rated themselves as improved or much improved. Approximately three-quarters of participants attended more than 20 sessions, and there was no significant difference in outcomes between good and poor compliance. CONCLUSION Pneumatic partial weight support treadmill can significantly decrease pain non-inferior to UTM, and can significantly increase quadriceps strength compared to UTM.
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Affiliation(s)
- V Kuptniratsaikul
- Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - W Chaiworapuek
- Department of Mechanical Engineering, Faculty of Engineering, 122106Kasetsart University, Bangkok, Thailand
| | - K Kovintaset
- Division of Physical Therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - M Meesawang
- Division of Physical Therapy, Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - P Chinsawangwatanakul
- Research Group and Research Network Division, Research Department, Faculty of Medicine Siriraj Hospital, 65106Mahidol University, Bangkok, Thailand
| | - A Danoi
- Division of Surgical Nursing, Department of Nursing, Siriraj Hospital, Bangkok, Thailand
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27
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Restuccia R, Ruggieri D, Magaudda L, Talotta R. The preventive and therapeutic role of physical activity in knee osteoarthritis. Reumatismo 2022; 74. [PMID: 35506320 DOI: 10.4081/reumatismo.2022.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/18/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this narrative review is to discuss the results of studies investigating the role of physical activity in knee osteoarthritis (OA). We also formulated two evidence-based exercise programs that could be prescribed to patients with symptomatic knee OA or after joint replacement. The PubMed and Google Scholar databases were searched for articles related to knee OA and physical activity. A total of 86 papers written in English and published from 1957 to 2021 were selected. Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb muscle weakness, both of which are considered predisposing factors for the disease. In patients already diagnosed with knee OA, scientific evidence suggests that both land-based and aquatic activities combining aerobics, strength, and endurance programs are safe and effective. Physical interventions tailored to the patient may also accelerate recovery time after knee arthroplasty. Knee OA is a painful and disabling rheumatic disease that is very common in the elderly population. Pharmacotherapy has a modest effect in controlling disease progression, possibly due to the still limited understanding of OA pathogenesis. Non-pharmacologic interventions, including dietary and lifestyle changes and physical activity, may be more effective and safer than drugs in preventing or treating knee OA.
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Affiliation(s)
- R Restuccia
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina.
| | - D Ruggieri
- Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - L Magaudda
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina, Italy; Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - R Talotta
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina.
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28
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Gwinnutt JM, Wieczorek M, Cavalli G, Balanescu A, Bischoff-Ferrari HA, Boonen A, de Souza S, de Thurah A, Dorner TE, Moe RH, Putrik P, Rodríguez-Carrio J, Silva-Fernández L, Stamm T, Walker-Bone K, Welling J, Zlatković-Švenda MI, Guillemin F, Verstappen SMM. Effects of physical exercise and body weight on disease-specific outcomes of people with rheumatic and musculoskeletal diseases (RMDs): systematic reviews and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open 2022; 8:rmdopen-2021-002168. [PMID: 35361692 PMCID: PMC8971792 DOI: 10.1136/rmdopen-2021-002168] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/23/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A European League Against Rheumatism (EULAR) taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). This paper reviews the literature on the effects of physical exercise and body weight on disease-specific outcomes of people with RMDs. METHODS Three systematic reviews were conducted to summarise evidence related to exercise and weight in seven RMDs: osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis (axSpA), psoriatic arthritis, systemic sclerosis and gout. Systematic reviews and original studies were included if they assessed exercise or weight in one of the above RMDs, and reported results regarding disease-specific outcomes (eg, pain, function, joint damage). Systematic reviews were only included if published between 2013-2018. Search strategies were implemented in the Medline, Embase, Cochrane Library of systematic reviews and CENTRAL databases. RESULTS 236 articles on exercise and 181 articles on weight were included. Exercise interventions resulted in improvements in outcomes such as pain and function across all the RMDs, although the size of the effect varied by RMD and intervention. Disease activity was not influenced by exercise, other than in axSpA. Increased body weight was associated with worse outcomes for the majority of RMDs and outcomes assessed. In general, study quality was moderate for the literature on exercise and body weight in RMDs, although there was large heterogeneity between studies. CONCLUSION The current literature supports recommending exercise and the maintenance of a healthy body weight for people with RMDs.
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Affiliation(s)
- James M Gwinnutt
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Maud Wieczorek
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Center on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Andra Balanescu
- Department of Internal Medicine and Rheumatology, “Sf. Maria” Hospital, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Heike A Bischoff-Ferrari
- Center on Aging and Mobility, University of Zurich, Zurich, Switzerland,Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland,University Clinic for Aging Medicine, City Hospital Zurich - Waid, Zurich, Switzerland
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Savia de Souza
- Centre for Rheumatic Diseases, King's College London, London, UK
| | - Annette de Thurah
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Rheumatology, Aarhus University Hospital, Aarhus, Denmark
| | - Thomas E Dorner
- Centre for Public Health, Department of Social and Preventive Medicine, Medical University of Vienna, Vienna, Austria,Social Insurance Fund for Public Service, Railway and Mining Industries, Sitzenberg-Reidling, Austria,Karl-Landsteiner Institute for Health Promotion Research, Sitzenberg-Reidling, Austria
| | - Rikke Helene Moe
- National Advisory Unit for Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Polina Putrik
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Javier Rodríguez-Carrio
- Area of Immunology, Department of Functional Biology, Universidad de Oviedo, Oviedo, Spain,Department of Metabolism, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Lucía Silva-Fernández
- Rheumatology Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria,Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Joep Welling
- NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands
| | - Mirjana I Zlatković-Švenda
- Institute of Rheumatology, University of Belgrade School of Medicine, Belgrade, Serbia,Department of Internal Medicine, University of East Sarajevo Faculty of Medicine Foča, Republika Srpska, Bosnia and Herzegovina
| | - Francis Guillemin
- EA 4360 Apemac, Université de Lorraine, Nancy, France,Inserm, CHRU Nancy, CIC-1433 Epidémiologie Clinique, Université de Lorraine, Nancy, France
| | - Suzanne M M Verstappen
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK .,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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29
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Ma J, Chen X, Xin J, Niu X, Liu Z, Zhao Q. Overall treatment effects of aquatic physical therapy in knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res 2022; 17:190. [PMID: 35346294 PMCID: PMC8961922 DOI: 10.1186/s13018-022-03069-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the benefits of aquatic physical therapy as a rehabilitation strategy for knee osteoarthritis patients. Methods Electronic databases systematically searched up to July 2021. Results 580 RCTs were selected. A total of thirteen studies comprising 883 participants were included in the study. For pain, meta-analyses showed that aquatic physical therapy is associated with a significant change in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain (SMD = − 1.09, 95%CI − 1.97, − 0.21, p = 0.02) and visual analog scale (VAS) (SMD = − 0.55, 95%CI − 0.98, − 0.12, p = 0.01). In addition, for physical function, meta-analyses showed that aquatic physical therapy effectively improved WOMAC physical function (SMD = − 0.57, 95%CI − 1.14, − 0.01, p = 0.05). However, our findings showed no significant improvements in symptoms of joints, quality of life (QOL), flexibility, and body composition with knee osteoarthritis. For muscle strength, we found that aquatic physical therapy can only improve knee extension muscle strength (MD = 2.11, 95%CI 0.02, 4.20, p = 0.05). Additionally, for walking ability, we observed that aquatic physical therapy effectively reduced Timed-Up-and-Go Test (TUGT) in a large degree (MD = − 0.89, 95%CI − 1.25, − 0.53, p < 0.05). Conclusions According to the findings reported in the studies analyzed in the review, aquatic physical therapy had a positive effect on the pain, physical function, knee extension muscle strength, and walking ability among people with knee osteoarthritis.
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Kaszyński J, Bąkowski P, Kiedrowski B, Stołowski Ł, Wasilewska-Burczyk A, Grzywacz K, Piontek T. Intra-Articular Injections of Autologous Adipose Tissue or Platelet-Rich Plasma Comparably Improve Clinical and Functional Outcomes in Patients with Knee Osteoarthritis. Biomedicines 2022; 10:biomedicines10030684. [PMID: 35327486 PMCID: PMC8945733 DOI: 10.3390/biomedicines10030684] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 12/13/2022] Open
Abstract
The use of biologic therapies for the management of knee osteoarthritis (OA) has largely increased in recent years. The purpose of this study was to evaluate the efficiency and the therapeutic potential of platelet-rich plasma (PRP) and autologous adipose tissue (AAT) injections as a treatment for knee OA. Sixty participants were enrolled in the study: 20 healthy ones and 40 with minimal to moderate knee OA (KL I-III). The OA patients were randomly assigned either to the PRP or to the AAT group. The PRP samples showed a low expression level of NF-κB-responsive gene CCL5 and high expression levels of classic inflammatory and TNF-l INF responses. The AAT injection product was prepared using a Lipogems device, and its regenerative potential as well as the ability for expansion of mesenchymal stem cells were tested in the cell culture conditions. The patient assessments were carried out five times. Significant improvement was observed regardless of the treatment method in the VAS, KOOS, WOMAC and IKDC 2000 subjective evaluations as well as in the functional parameters. Intra-articular injections of AAT or PRP improved pain, symptoms, quality of life and functional capacity with a comparable effectiveness in the patients with mild to moderate knee osteoarthritis.
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Affiliation(s)
- Jakub Kaszyński
- Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland; (J.K.); (B.K.); (Ł.S.); (T.P.)
| | - Paweł Bąkowski
- Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland; (J.K.); (B.K.); (Ł.S.); (T.P.)
- Correspondence:
| | - Bartosz Kiedrowski
- Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland; (J.K.); (B.K.); (Ł.S.); (T.P.)
| | - Łukasz Stołowski
- Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland; (J.K.); (B.K.); (Ł.S.); (T.P.)
| | - Anna Wasilewska-Burczyk
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznań, Poland; (A.W.-B.); (K.G.)
| | - Kamilla Grzywacz
- Institute of Bioorganic Chemistry Polish Academy of Sciences, 61-704 Poznań, Poland; (A.W.-B.); (K.G.)
| | - Tomasz Piontek
- Department of Orthopedic Surgery, Rehasport Clinic, 60-201 Poznań, Poland; (J.K.); (B.K.); (Ł.S.); (T.P.)
- Department of Spine Disorders and Pediatric Orthopedics, University of Medical Sciences Poznań, 61-701 Poznań, Poland
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Lavin KM, Coen PM, Baptista LC, Bell MB, Drummer D, Harper SA, Lixandrão ME, McAdam JS, O’Bryan SM, Ramos S, Roberts LM, Vega RB, Goodpaster BH, Bamman MM, Buford TW. State of Knowledge on Molecular Adaptations to Exercise in Humans: Historical Perspectives and Future Directions. Compr Physiol 2022; 12:3193-3279. [PMID: 35578962 PMCID: PMC9186317 DOI: 10.1002/cphy.c200033] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.
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Affiliation(s)
- Kaleen M. Lavin
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Paul M. Coen
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Liliana C. Baptista
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Margaret B. Bell
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Devin Drummer
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sara A. Harper
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manoel E. Lixandrão
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jeremy S. McAdam
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Samia M. O’Bryan
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sofhia Ramos
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Lisa M. Roberts
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Rick B. Vega
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Bret H. Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Advent Health, Orlando, Florida, USA
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, Florida, USA
| | - Marcas M. Bamman
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Cell, Developmental, and Integrative Biology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Center for Human Health, Resilience, and Performance, Institute for Human and Machine Cognition, Pensacola, Florida, USA
| | - Thomas W. Buford
- Center for Exercise Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
- Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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O'Connor D, Johnston RV, Brignardello-Petersen R, Poolman RW, Cyril S, Vandvik PO, Buchbinder R. Arthroscopic surgery for degenerative knee disease (osteoarthritis including degenerative meniscal tears). Cochrane Database Syst Rev 2022; 3:CD014328. [PMID: 35238404 PMCID: PMC8892839 DOI: 10.1002/14651858.cd014328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Arthroscopic knee surgery remains a common treatment for symptomatic knee osteoarthritis, including for degenerative meniscal tears, despite guidelines strongly recommending against its use. This Cochrane Review is an update of a non-Cochrane systematic review published in 2017. OBJECTIVES To assess the benefits and harms of arthroscopic surgery, including debridement, partial menisectomy or both, compared with placebo surgery or non-surgical treatment in people with degenerative knee disease (osteoarthritis, degenerative meniscal tears, or both). SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trials registers up to 16 April 2021, unrestricted by language. SELECTION CRITERIA We included randomised controlled trials (RCTs), or trials using quasi-randomised methods of participant allocation, comparing arthroscopic surgery with placebo surgery or non-surgical interventions (e.g. exercise, injections, non-arthroscopic lavage/irrigation, drug therapy, and supplements and complementary therapies) in people with symptomatic degenerative knee disease (osteoarthritis or degenerative meniscal tears or both). Major outcomes were pain, function, participant-reported treatment success, knee-specific quality of life, serious adverse events, total adverse events and knee surgery (replacement or osteotomy). DATA COLLECTION AND ANALYSIS Two review authors independently selected studies for inclusion, extracted data, and assessed risk of bias and the certainty of evidence using GRADE. The primary comparison was arthroscopic surgery compared to placebo surgery for outcomes that measured benefits of surgery, but we combined data from all control groups to assess harms and knee surgery (replacement or osteotomy). MAIN RESULTS Sixteen trials (2105 participants) met our inclusion criteria. The average age of participants ranged from 46 to 65 years, and 56% of participants were women. Four trials (380 participants) compared arthroscopic surgery to placebo surgery. For the remaining trials, arthroscopic surgery was compared to exercise (eight trials, 1371 participants), a single intra-articular glucocorticoid injection (one trial, 120 participants), non-arthroscopic lavage (one trial, 34 participants), non-steroidal anti-inflammatory drugs (one trial, 80 participants) and weekly hyaluronic acid injections for five weeks (one trial, 120 participants). The majority of trials without a placebo control were susceptible to bias: in particular, selection (56%), performance (75%), detection (75%), attrition (44%) and selective reporting (75%) biases. The placebo-controlled trials were less susceptible to bias and none were at risk of performance or detection bias. Here we limit reporting to the main comparison, arthroscopic surgery versus placebo surgery. High-certainty evidence indicates arthroscopic surgery leads to little or no difference in pain or function at three months after surgery, moderate-certainty evidence indicates there is probably little or no improvement in knee-specific quality of life three months after surgery, and low-certainty evidence indicates arthroscopic surgery may lead to little or no difference in participant-reported success at up to five years, compared with placebo surgery. Mean post-operative pain in the placebo group was 40.1 points on a 0 to 100 scale (where lower score indicates less pain) compared to 35.5 points in the arthroscopic surgery group, a difference of 4.6 points better (95% confidence interval (CI) 0.02 better to 9 better; I2 = 0%; 4 trials, 309 participants). Mean post-operative function in the placebo group was 75.9 points on a 0 to 100 rating scale (where higher score indicates better function) compared to 76 points in the arthroscopic surgery group, a difference of 0.1 points better (95% CI 3.2 worse to 3.4 better; I2 = 0%; 3 trials, 302 participants). Mean post-operative knee-specific health-related quality of life in the placebo group was 69.7 points on a 0 to 100 rating scale (where higher score indicates better quality of life) compared with 75.3 points in the arthroscopic surgery group, a difference of 5.6 points better (95% CI 0.36 better to 10.68 better; I2 = 0%; 2 trials, 188 participants). We downgraded this evidence to moderate certainty as the 95% confidence interval does not rule in or rule out a clinically important change. After surgery, 74 out of 100 people reported treatment success with placebo and 82 out of 100 people reported treatment success with arthroscopic surgery at up to five years (risk ratio (RR) 1.11, 95% CI 0.66 to 1.86; I2 = 53%; 3 trials, 189 participants). We downgraded this evidence to low certainty due to serious indirectness (diversity in definition and timing of outcome measurement) and serious imprecision (small number of events). We are less certain if the risk of serious or total adverse events increased with arthroscopic surgery compared to placebo or non-surgical interventions. Serious adverse events were reported in 6 out of 100 people in the control groups and 8 out of 100 people in the arthroscopy groups from eight trials (RR 1.35, 95% CI 0.64 to 2.83; I2 = 47%; 8 trials, 1206 participants). Fifteen out of 100 people reported adverse events with control interventions, and 17 out of 100 people with surgery at up to five years (RR 1.15, 95% CI 0.78 to 1.70; I2 = 48%; 9 trials, 1326 participants). The certainty of the evidence was low, downgraded twice due to serious imprecision (small number of events) and possible reporting bias (incomplete reporting of outcome across studies). Serious adverse events included death, pulmonary embolism, acute myocardial infarction, deep vein thrombosis and deep infection. Subsequent knee surgery (replacement or high tibial osteotomy) was reported in 2 out of 100 people in the control groups and 4 out of 100 people in the arthroscopy surgery groups at up to five years in four trials (RR 2.63, 95% CI 0.94 to 7.34; I2 = 11%; 4 trials, 864 participants). The certainty of the evidence was low, downgraded twice due to the small number of events. AUTHORS' CONCLUSIONS Arthroscopic surgery provides little or no clinically important benefit in pain or function, probably does not provide clinically important benefits in knee-specific quality of life, and may not improve treatment success compared with a placebo procedure. It may lead to little or no difference, or a slight increase, in serious and total adverse events compared to control, but the evidence is of low certainty. Whether or not arthroscopic surgery results in slightly more subsequent knee surgery (replacement or osteotomy) compared to control remains unresolved.
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Affiliation(s)
- Denise O'Connor
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
| | - Renea V Johnston
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
| | | | - Rudolf W Poolman
- Department of Orthopaedic Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, Netherlands
| | - Sheila Cyril
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
| | - Per O Vandvik
- Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Rachelle Buchbinder
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University; Monash-Cabrini Department of Musculoskeletal Health and Clinical Epidemiology, Cabrini Health, Melbourne, Australia
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Abstract
PURPOSE OF REVIEW To present a synthesis of recent literature regarding the treatment of patellofemoral arthritis RECENT FINDINGS: Risk factors of PFJ OA include patella malalignment or maltracking, injury to supportive structures including the MPFL, dysfunction of hamstring and quadriceps coordination, lower limb alignment, trochlear dysplasia, patellar trauma, or ACL surgery. Special physical exam maneuvers include patellar grind test, apprehension test, and lateral patellar tilt angle. Radiographs that should be obtained first-line include weight bearing bilateral AP, lateral, and Merchant views. CT and MRI are used to assess trochlear dysplasia, excessive patellar height, and TT-TG distance. Non-operative management options discussed include non-pharmacologic treatment (patient education, self-management, physical therapy, weight loss), ESWT, cold therapy, taping, bracing, and orthotics. Pharmacologic management options discussed include NSAIDs, acetaminophen, oral narcotics, and duloxetine. Injection therapies include glucocorticoids, hyaluronic acid, PRP, and other regenerative therapies (BMAC, adipose, or mesenchymal stem cells). Other treatment options include radiofrequency ablation and botulinum toxin. The algorithm for the surgical treatment of PFJ OA can begin with arthroscopic assessment of the PF articular cartilage to address mechanical symptoms and to evaluate/treat lateral soft tissue with or without overhanging lateral osteophytes. If patients fail to have symptomatic improvement, a TTO can be considered in those patients less than 50 years of age or active patients >50 years old. In patients with severe PFJ OA, refractory to the above treatments, PFA should be considered. While early PFA design and technique were less than encouraging, more recent implant design and surgical technique have demonstrated robust results in the literature. Patellofemoral osteoarthritis is a challenging orthopedic problem to treat, in that it can often affect younger patients, with otherwise well-functioning knees. It is a unique entity compared to TF OA with distinct epidemiology, biomechanics and risk factors and treatment options.
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Jardim RAC, de Sousa TS, Dos Santos WNN, Matos AP, Iosimuta NCR. Blood flow restriction with different load levels in patients with knee osteoarthritis: protocol of a randomized controlled trial. Trials 2022; 23:41. [PMID: 35033169 PMCID: PMC8761307 DOI: 10.1186/s13063-022-05998-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 01/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background The effectiveness of blood flow restriction training (BFR) in elderly with knee osteoarthritis (OA) is comparable to performing high-intensity protocols (70 to 80% of 1 RM [repetition maximum]) that are known to be effective for improving the muscle strength of knee extensors, with the advantage of generating less particular rating of perceived exertion and pain immediately after training. However, despite being a promising alternative, little is known about the best way to apply the BFR, such as level of pressure and combination or not with other therapeutic modalities. The purpose of this study is to evaluate whether different levels of blood flow restriction with low load (BFR + LL) and no load (BFR + rest) are non-inferior to high-intensity resistance exercise (HIRE+BFRplacebo) for pain reduction in patients with knee OA. Methods/design This clinical trial is a non-inferiority, five-arm, randomized, active-controlled, single trial which will be carried out in 165 patients of both sexes with knee OA, aged 50 years and older. Participants will be randomly allocated into 5 exercise groups (40% of BFR + LL; 80% of BFR + LL; 40% of BFR + rest; 80% BFR + rest, and HIRE+BFR placebo). A mixed linear model will be used to examine the effect of group-by-time interaction on pain intensity on the WOMAC subscale (primary outcome) and on disease severity, physical functional data, balance data, quality of life, global perceived effect scale, and muscle strength (secondary outcomes). Participants will be analyzed for intention-to-treat, and the statistical assessor blinded to the groups. The collection of outcomes 72 h after completion of the 16 weeks of interventions will be the primary measurement point. Follow-up secondary timepoints will be collected at 20, 28, 40, 52, and 64 weeks after the end of interventions, except for pain during the training, which will be measured immediately at the end of each session. Only the comparison of the primary outcome between the HIRE group with each BFR group will be analyzed in the non-inferiority framework, the other comparisons between the BFR groups for the primary outcome, and all secondary outcomes will be interpreted in the superiority framework. Discussion The results of this clinical trial can point out more clearly to ways to optimize the BFR training with the minimum of pain immediately after training, which will allow the offer of an effective and more adherent strengthening training to patients with knee OA. Trial registration Registro Brasileiro de Ensaios Clínicos, RBR-93rx9q. Registered on 23 July 2020. Version 1.0. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-05998-3.
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Affiliation(s)
- Roger Andrey Carvalho Jardim
- Postgraduate Program of Health Sciences, Department of Biological Sciences and Health, Federal University of Amapá - UNIFAP, Macapá, AP, Brazil.
| | - Tamara Silva de Sousa
- Postgraduate Program of Health Sciences, Department of Biological Sciences and Health, Federal University of Amapá - UNIFAP, Macapá, AP, Brazil
| | | | - Areolino Pena Matos
- Postgraduate Program of Health Sciences, Department of Biological Sciences and Health, Federal University of Amapá - UNIFAP, Macapá, AP, Brazil
| | - Natália Camargo Rodrigues Iosimuta
- Postgraduate Program of Health Sciences, Department of Biological Sciences and Health, Federal University of Amapá - UNIFAP, Macapá, AP, Brazil
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Zeng CY, Zhang ZR, Tang ZM, Hua FZ. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol 2022; 12:794062. [PMID: 34975542 PMCID: PMC8716769 DOI: 10.3389/fphys.2021.794062] [Citation(s) in RCA: 43] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
Knee osteoarthritis is a chronic degenerative disease. Cartilage and subchondral bone degeneration, as well as synovitis, are the main pathological changes associated with knee osteoarthritis. Mechanical overload, inflammation, metabolic factors, hormonal changes, and aging play a vital role in aggravating the progression of knee osteoarthritis. The main treatments for knee osteoarthritis include pharmacotherapy, physiotherapy, and surgery. However, pharmacotherapy has many side effects, and surgery is only suitable for patients with end-stage knee osteoarthritis. Exercise training, as a complementary and adjunctive physiotherapy, can prevent cartilage degeneration, inhibit inflammation, and prevent loss of the subchondral bone and metaphyseal bone trabeculae. Increasing evidence indicates that exercise training can improve pain, stiffness, joint dysfunction, and muscle weakness in patients with knee osteoarthritis. There are several exercise trainings options for the treatment of knee osteoarthritis, including aerobic exercise, strength training, neuromuscular exercise, balance training, proprioception training, aquatic exercise, and traditional exercise. For Knee osteoarthritis (KOA) experimental animals, those exercise trainings can reduce inflammation, delay cartilage and bone degeneration, change tendon, and muscle structure. In this review, we summarize the main symptoms of knee osteoarthritis, the mechanisms of exercise training, and the therapeutic effects of different exercise training methods on patients with knee osteoarthritis. We hope this review will allow patients in different situations to receive appropriate exercise therapy for knee osteoarthritis, and provide a reference for further research and clinical application of exercise training for knee osteoarthritis.
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Affiliation(s)
- Chu-Yang Zeng
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhen-Rong Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
| | - Zhi-Ming Tang
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Fu-Zhou Hua
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Marinho-Buzelli AR, Gauthier C, Chan K, Bonnyman AM, Mansfield A, Musselman KE. The state of aquatic therapy use for clients with spinal cord injury or disorder: Knowledge and current practice. J Spinal Cord Med 2022; 45:82-90. [PMID: 33830895 PMCID: PMC8890513 DOI: 10.1080/10790268.2021.1896274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
CONTEXT/OBJECTIVES Aquatic therapy (AT) has been reported to be beneficial for individuals with spinal cord injury or disorder (SCI/D); however, AT has also been reported to be underutilized in SCI/D rehabilitation. We aimed to understand the knowledge and current practice of AT for clients with SCI/D by physiotherapists, physiotherapy assistants and kinesiologists across Canada. DESIGN/METHOD A survey with closed- and open-ended questions was distributed (July-October 2019) to professionals through letters sent by professional associations. Non-parametric analyses were used to compare AT knowledge and practice between AT and non-AT users; content analysis was used to identify the themes from open-ended questions. RESULTS Seventy-eight respondents from 10 provinces were included in the analysis: 33 physiotherapists, 5 physiotherapy assistants and 40 kinesiologists. Respondents using AT (73%) reported greater knowledge of AT benefits and confidence to apply AT than respondents not using AT (p<0.01). Four themes were identified: 1-Variety of physical and psychosocial benefits of AT for people with SCI/D; 2-Attainment of movement and independence not possible on land; 3-Issues around pool accessibility; and 4-Constraints on AT implementation. CONCLUSIONS Respondents implemented AT to improve health outcomes for patients with SCI/D, despite facing challenges with pool accessibility and numerous constraints. Respondents who provided AT reported having better knowledge of AT and a supported AT practice in the work environment than respondents not providing AT. This study will inform AT stakeholders and institutions when considering strategies to increase the access to AT after SCI/D.
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Affiliation(s)
| | - Cindy Gauthier
- KITE-Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | - Katherine Chan
- KITE-Toronto Rehabilitation Institute-University Health Network, Toronto, Canada
| | | | - Avril Mansfield
- KITE-Toronto Rehabilitation Institute-University Health Network, Toronto, Canada,Department of Physical Therapy, University of Toronto, Toronto, Canada,Evaluative Clinical Sciences, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Kristin E. Musselman
- KITE-Toronto Rehabilitation Institute-University Health Network, Toronto, Canada,Department of Physical Therapy, University of Toronto, Toronto, Canada,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, Canada,Correspondence to: Kristin E. Musselman, Lyndhurst Center, KITE-Toronto Rehabilitation Institute-UHN, 520 Sutherland Dr, Toronto, CanadaM4G 3V9.
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wei W, He S, Wang Z, Dong J, Xiang D, Li Y, Ren L, Kou N, Lv J. LINC01534 Promotes the Aberrant Metabolic Dysfunction and Inflammation in IL-1β-Simulated Osteoarthritic Chondrocytes by Targeting miR-140-5p. Cartilage 2021; 13:898S-907S. [PMID: 31735077 PMCID: PMC8804787 DOI: 10.1177/1947603519888787] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Long non-coding RNA 01534 (LINC01534) is highly expressed in the tissues of patients with osteoarthritis (OA). This study investigated the mechanism of LINC01534 on abnormal metabolic dysfunction in OA chondrocytes induced by interleukin-1β (IL-1β). METHODS The quantitative real-time polymerase chain reaction (qRT-PCR) was used to determine the expressions of LINC01534, aggrecan, collagen II, and matrix metalloproteinase (MMPs) in OA cartilage tissue or OA chondrocyte model induced by IL-1β. The expressions of aggrecan and collagen II in the chondrocyte were detected by Western blot. The levels of tumor necrosis factor-α (TNF-α), IL-8, IL-6, MMP-13, MMP-9, MMP-3, and prostaglandin E2 (PGE2) in chondrocyte were determined by enzyme-linked immunosorbernt assay. Bioinformatics, dual luciferin gene reporting, RNA pulldown, and Northern blot were used to determine the interaction between LINC01534 and miR-140-5p. RESULTS The results showed that LINC01534 was upregulated in both OA cartilage tissue and OA chondrocyte model. In addition, silencing LINC01534 significantly alleviated the inhibitory effect of IL-1β on expressions of aggrecan and collagen II in chondrocytes, and significantly downregulated the expression of matrix metalloproteinases in IL-1β-induced chondrocytes. Meanwhile, silencing LINC01534 also significantly inhibited the productions of proinflammatory factors NO, PGE2, TNF-α, IL-6, and IL-8 in the IL-1β-induced chondrocytes. Furthermore, miR-140-5p was confirmed to be a direct target of LINC01534. More importantly, inhibition of miR-140-5p significantly reversed the inhibitory effect of silencing LINC01534 on abnormal matrix degradation in the IL-1β-induced chondrocyte model of OA. CONCLUSION Therefore, LINC01534 could promote the abnormal matrix degradation and inflammatory response of OA chondrocytes through the targeted binding of miR-140-5p.
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Affiliation(s)
- Wei wei
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Shaoxuan He
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Zhihua Wang
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Junjie Dong
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Dong Xiang
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Yunxuan Li
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Lirong Ren
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Nannan Kou
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
| | - Jia Lv
- Department of Traumatology, The Second
Affiliated Hospital of Kunming Medical University, Kunming City, Yunnan Province,
People’s Republic of China
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Kela I, Kakarala CL, Hassan M, Belavadi R, Gudigopuram SVR, Raguthu CC, Gajjela H, Sange I. Chronic Pain: A Complex Condition With a Multi-Tangential Approach. Cureus 2021; 13:e19850. [PMID: 34963858 PMCID: PMC8703086 DOI: 10.7759/cureus.19850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2021] [Indexed: 11/05/2022] Open
Abstract
Chronic pain is known as ongoing pain that lasts longer than three months with increasing healing time. It is approximated that 20% of adults of different sexes, races, and socioeconomic backgrounds fall victim to chronic pain. It is a result of several factors and can have lifelong effects. Pain is a complex matter to measure; therefore, the physician needs to understand the patient's health state to create a management plan tending to each issue adequately. There are many complications of such pain, and it can interfere terribly with an individual's quality of life. This article has reviewed the complex pathogenesis of chronic pain and the spectrum of non-pharmacologic modalities and pharmacological treatment options. It has also explored the efficacy of certain drugs and underlined the importance of nonpharmacological options such as physical exercise, cognitive therapy, and physical modalities to treat chronic pain and all the conditions that accompany this disorder.
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Affiliation(s)
- Iljena Kela
- Family Medicine, Jagiellonian University Medical College, Krakow, POL
| | - Chandra L Kakarala
- Internal Medicine, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, IND
| | - Mohammad Hassan
- Internal Medicine, Mohiuddin Islamic Medical College, Mirpur, PAK
| | - Rishab Belavadi
- Surgery, Jawaharlal Institute of Post-Graduate Medical Education and Research (JIPMER), Puducherry, IND
| | | | | | - Harini Gajjela
- Research, Our Lady of Fatima University College of Medicine Valenzuela, Metro Manila, PHL
| | - Ibrahim Sange
- Research, K. J. Somaiya Medical College, Mumbai, IND
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Reid H, Ridout AJ, Tomaz SA, Kelly P, Jones N. Benefits outweigh the risks: a consensus statement on the risks of physical activity for people living with long-term conditions. Br J Sports Med 2021; 56:427-438. [PMID: 34649919 PMCID: PMC8995821 DOI: 10.1136/bjsports-2021-104281] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/29/2022]
Abstract
Introduction The benefits of physical activity for people living with long-term conditions (LTCs) are well established. However, the risks of physical activity are less well documented. The fear of exacerbating symptoms and causing adverse events is a persuasive barrier to physical activity in this population. This work aimed to agree clear statements for use by healthcare professionals about medical risks of physical activity for people living with LTCs through expert consensus. These statements addressed the following questions: (1) Is increasing physical activity safe for people living with one or more LTC? (2) Are the symptoms and clinical syndromes associated with common LTCs aggravated in the short or long term by increasing physical activity levels? (3) What specific risks should healthcare professionals consider when advising symptomatic people with one or more LTCs to increase their physical activity levels? Methods Statements were developed in a multistage process, guided by the Appraisal of Guidelines for Research and Evaluation tool. A patient and clinician involvement process, a rapid literature review and a steering group workshop informed the development of draft symptom and syndrome-based statements. We then tested and refined the draft statements and supporting evidence using a three-stage modified online Delphi study, incorporating a multidisciplinary expert panel with a broad range of clinical specialties. Results Twenty-eight experts completed the Delphi process. All statements achieved consensus with a final agreement between 88.5%–96.5%. Five ‘impact statements’ conclude that (1) for people living with LTCs, the benefits of physical activity far outweigh the risks, (2) despite the risks being very low, perceived risk is high, (3) person-centred conversations are essential for addressing perceived risk, (4) everybody has their own starting point and (5) people should stop and seek medical attention if they experience a dramatic increase in symptoms. In addition, eight symptom/syndrome-based statements discuss specific risks for musculoskeletal pain, fatigue, shortness of breath, cardiac chest pain, palpitations, dysglycaemia, cognitive impairment and falls and frailty. Conclusion Clear, consistent messaging on risk across healthcare will improve people living with LTCs confidence to be physically active. Addressing the fear of adverse events on an individual level will help healthcare professionals affect meaningful behavioural change in day-to-day practice. Evidence does not support routine preparticipation medical clearance for people with stable LTCs if they build up gradually from their current level. The need for medical guidance, as opposed to clearance, should be determined by individuals with specific concerns about active symptoms. As part of a system-wide approach, consistent messaging from healthcare professionals around risk will also help reduce cross-sector barriers to engagement for this population.
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Affiliation(s)
- Hamish Reid
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK.,Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield, South Yorkshire, UK
| | - Ashley Jane Ridout
- Sport and Exercise Medicine, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
| | - Simone Annabella Tomaz
- Stirling Physical Activity Research Knowledge and Learning Exchange (SPARKLE), University of Stirling, Stirling, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport Physical Education and Health Sciences, Edinburgh, UK
| | - Natasha Jones
- Moving Medicine, Faculty of Sport And Exercise Medicine, Edinburgh, UK .,Sport and Exercise Medicine, Oxford University Hospitals NHS Foundation Trust Nuffield Orthopaedic Centre, Oxford, Oxfordshire, UK
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Wu J, Qian Y, Chen C, Feng F, Pan L, Yang L, Wang C. Hesperetin Exhibits Anti-Inflammatory Effects on Chondrocytes via the AMPK Pathway to Attenuate Anterior Cruciate Ligament Transection-Induced Osteoarthritis. Front Pharmacol 2021; 12:735087. [PMID: 34603050 PMCID: PMC8481891 DOI: 10.3389/fphar.2021.735087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 08/20/2021] [Indexed: 02/03/2023] Open
Abstract
This study aimed to determine whether hesperetin (HPT) has chondroprotective effects against the TNF-α-induced inflammatory response of chondrocytes and related mechanisms and clarify the impact of HPT on osteoarthritis (OA) induced by anterior cruciate ligament transection (ACLT). Under tumor necrosis factor-α (TNF-α) stimulation, rat chondrocytes were treated with or without HPT. The CCK-8 assay was used to detect viability and cytotoxicity. RT-qPCR and Western blot were used to examine the expression of aggrecan, collagen type II, and inflammatory and proliferative genes/proteins in chondrocytes. Flow cytometry was used to check the cell cycle to determine whether HPT protects chondrocytes against the inhibitory effect of TNF-α on chondrocyte proliferation. In addition, RNA sequencing was used to discover possible molecular targets and pathways and then validate these pathways with specific protein phosphorylation levels. Finally, immunofluorescence staining was used to examine the phosphorylation of the AMP-activated protein kinase (AMPK) pathway. The results showed that HPT restored the upregulation of interleukin 1β (IL-1β), PTGS2, and MMP-13 induced by TNF-α. In addition, HPT reversed the degradation of the extracellular matrix of chondrocytes induced by TNF-α. HPT also reversed the inhibitory effect of TNF-α on chondrocyte proliferation. RNA sequencing revealed 549 differentially expressed genes (DEGs), of which 105 were upregulated and 444 were downregulated, suggesting the potential importance of the AMPK pathway. Progressive analysis showed that HPT mediated the repair of TNF-α-induced chondrocyte damage through the AMPK signaling pathway. Thus, local treatment of HPT can improve OA induced by ACLT. These findings indicated that HPT has significant protective and anti-inflammatory effects on chondrocytes through the AMPK signaling pathway, effectively preventing cartilage degradation. Given the various beneficial effects of HPT, it can be used as a potential natural drug to treat OA.
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Affiliation(s)
- Jiaqin Wu
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Yuna Qian
- Engineering Research Center of Clinical Functional Materials and Diagnosis and Treatment Devices of Zhejiang Province, Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, China
| | - Cheng Chen
- Department of Orthopaedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Fan Feng
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Lianhong Pan
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Li Yang
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
| | - Chunli Wang
- National Innovation and Attracting Talents "111" Base, Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China
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Effect of Water Amount Intake before Scuba Diving on the Risk of Decompression Sickness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147601. [PMID: 34300051 PMCID: PMC8306992 DOI: 10.3390/ijerph18147601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022]
Abstract
Background and objective: The aim of this study was to investigate the influence of pre-hydration levels on circulating bubble formation for scuba divers and to evaluate the appropriate volume of water intake for reducing the risk of decompression sickness (DCS). Materials and Methods: Twenty scuba divers were classified into four groups according to the volume of water taken in before scuba diving as follows: no-water-intake group (NWIG), 30%-water-intake group (30WIG), 50%-water intake group (50WIG), and 100%-water-intake group (100WIG). We measured the circulating bubbles using movement status by Doppler on the right and left subclavian veins and precordial regions at pre-dive, post-dive, and 30 min after diving to a depth of 30 m for a duration of 25 min at the bottom. Results: Participants belonging to the 30WIG showed the lowest frequency, percentage, and amplitude of bubbles and consequently the lowest bubble grade in the left and right subclavian veins and precordial region at post-time and 30 min after diving. Conclusions: It can be inferred that pre-hydration with 30% of the recommended daily water intake before scuba diving effectively suppressed the formation of bubbles after diving and decreased the risk of DCS.
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Impact of different physical activity types on knee joint structural degeneration assessed with 3-T MRI in overweight and obese subjects: data from the osteoarthritis initiative. Skeletal Radiol 2021; 50:1427-1440. [PMID: 33404670 PMCID: PMC8122031 DOI: 10.1007/s00256-020-03642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 09/25/2020] [Accepted: 10/05/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To assess the impact of different types of physical activity types on longitudinal knee joint structural changes over 48 months in overweight and obese subjects. MATERIALS AND METHODS We included 415 subjects with a BMI ≥ 25 kg/m2, Kellgren-Lawrence scores ≤ 3 at baseline and Whole-Organ Magnetic Resonance Imaging Score (WORMS) scores available from the Osteoarthritis Initiative cohort. Regular self-reported participation in six physical activity types was assessed: ball sports, bicycling, jogging/running, elliptical-trainer, racquet sports, and swimming. Moreover, they were classified into high- and low-impact physical activity groups. Evaluation of structural knee abnormalities was performed using WORMS obtained by two independent observers blinded to the subjects' physical activity and time point. Linear regression models were used to assess the associations between participation in different physical activity types and changes in WORMS. RESULTS No significant differences in epidemiological data were found between the groups except for gender composition, and there were no significant differences in baseline WORMS. In the cohort as a whole and most exercise groups overall WORMS significantly increased during the observational period. Highest increases compared to the remainder of the group were found in the high impact group (increase in WORMS 4.65; [95% CI] [3.94,5.35]; p = 0.040) and the racquet sports group (6.39; [95% CI] [5.13,7.60]; p ≤ 0.001). Subjects using an elliptical-trainer showed the lowest increase in WORMS (- 1.50 [- 0.21, 3.22]; p = 0.002). CONCLUSION Progression of knee joint degeneration was consistently higher in subjects engaging in high-impact and racquet sports while subjects using an elliptical-trainer showed the smallest changes in structural degeneration. This work was presented during the 2020 Radiological Society of North America Annual meeting.
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Zhuo Y, Yu R, Wu C, Zhang Y. Hydrotherapy Intervention for Patients Following Total Knee Arthroplasty: A Systematic Review. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2021. [DOI: 10.1055/a-1368-6429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Abstract
Background Hydrotherapy or aquatic exercise has long been known as a source of postoperative rehabilitation proposed in routine clinical practice. However, the effect on clinical outcome as well as the optimal timing of hydrotherapy in patients undergoing total knee arthroplasty (TKA) remain unclear. The purpose of this review was to assess the influence of aquatic physiotherapy on clinical outcomes and evaluate the role of the timing of aquatic-therapy for clinical outcomes after undergoing TKA.
Methods An extensive literature search was performed in Embase, PubMed, and the Cochrane Library for randomized controlled trials (RCTs) that evaluated the impact of hydrotherapy on patients after TKA. The methodological quality of the trials was evaluated based on the Cochrane Risk of Bias Tool.
Results All available studies on postoperative hydrotherapy after TKA were included. The primary endpoint was to evaluate the effect of hydrotherapy on clinical outcomes. The secondary outcome was to explore the role of the timing of aquatic therapy for clinical outcomes following TKA.
Conclusion Although definitive conclusions could not be reached due to insufficient data, most studies indicated that participants benefited from aquatic-therapy in muscle strength, rather than gait speed, after TKA. Currently available data demonstrated that early postoperative hydrotherapy possessed a greater potential to improve clinical outcomes in main clinical scores and quality-adjusted life years (QALYs).
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Affiliation(s)
- Youguang Zhuo
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Rongguo Yu
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Chunling Wu
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou, China
| | - Yiyuan Zhang
- Department of Orthopedics, Fuzhou Second Hospital Affiliated to Xiamen University, Fuzhou Fujian, People’s Republic of China, Fuzhou, China
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Henrykowska G, Soin J, Siermontowski P. Scuba Diving as a Form of Rehabilitation for People with Physical Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115678. [PMID: 34073170 PMCID: PMC8198635 DOI: 10.3390/ijerph18115678] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 05/21/2021] [Accepted: 05/23/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: The exploration of the potential therapeutic benefits of scuba diving for the mental and physical health of people with physical disabilities. (2) Methods: The research was conducted on a group of 240 people (men and women) with physical disabilities, using the survey designed by one of the authors. The subjective sense of physical and mental fitness was analyzed in retrospective and real terms. (3) Results: Significant increases in self-esteem, belief in our own abilities (self-confidence) and improvement in the ability to engage in social interactions were observed in the group of scuba divers with disabilities compared to individuals with disabilities not practicing diving. The respondents also declared an improvement in the efficiency of the respiratory system and stressed that a water environment increased their motor skills and relieved pain. (4) Conclusions: Diving can become one of the forms of rehabilitation for people with disabilities. There is a need for further research to expand our understanding of the benefits and possible health problems involved in diving. These activities have a huge impact on improving the quality of life of people with disabilities.
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Affiliation(s)
- Gabriela Henrykowska
- Department of Epidemiology and Public Health, Medical University of Lodz, 90-752 Lodz, Poland
- Correspondence: ; Tel.: +48-604689965
| | - Joanna Soin
- Institute of Health Sciences, Stefan Batory State University, 96-100 Skierniewice, Poland;
| | - Piotr Siermontowski
- Department Underwater Work Technology, Polish Naval Academy of the Heroes of Westerplatte, 81-103 Gdynia, Poland;
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Young JJ, Važić O, Cregg AC. Management of knee and hip osteoarthritis: an opportunity for the Canadian chiropractic profession. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2021; 65:6-13. [PMID: 34035537 PMCID: PMC8128331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Knee and hip osteoarthritis (OA) place a significant burden on the Canadian health system and are a major public health challenge. This brief commentary discusses the recently published Osteoarthritis Research Society International guideline and the American College of Rheumatology guideline for the management of OA. Special attention has been given to the role of manual therapy, exercise, and patient education for the treatment of knee and hip OA. This article also reviews the Good Life with osteoArthritis in Denmark (GLA:D®) treatment program for knee and hip OA and the implementation of this program in Canada. Lastly, the authors discuss the opportunity for the Canadian chiropractic profession to embrace treatment programs like GLA:D® and take an active role in the strengthening of the Canadian health system from a musculoskeletal perspective.
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Affiliation(s)
- James J. Young
- Center for Muscle and Joint Health, University of Southern Denmark
- Department of Research, Canadian Memorial Chiropractic College
| | - Olja Važić
- Human Health and Nutritional Science, University of Guelph
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miR-137 targets the inhibition of TCF4 to reverse the progression of osteoarthritis through the AMPK/NF-κB signaling pathway. Biosci Rep 2021; 40:224888. [PMID: 32432314 PMCID: PMC7295621 DOI: 10.1042/bsr20200466] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 12/19/2022] Open
Abstract
Purpose: To explore the regulatory mechanism of miR-137 and transcription factor 4 (TCF4) in the progression of osteoarthritis (OA). Patients and Methods: The expressions of miR-137 and TCF4 were detected in OA cartilage tissue, chondrocytes and OA rat cartilage tissue. miR-137 and TCF4 were up-regulated or down-regulated and transfected into chondrocytes and OA rat cartilage tissue. The gene expression, protein level, cell proliferation, apoptosis and inflammatory factors were detected, respectively. LPS and anterior cruciate ligament transection (ACLT) on the right knee were used to induce chondrocyte inflammation and establish rat OA model, respectively. Results: miR-137 was low expressed in cartilage tissue of OA group, while TCF4 expression and protein level were significantly higher, showing significant negative correlation. In LPS group, chondrocyte activity was significantly inhibited, cell apoptosis ability was significantly enhanced, and the levels of inflammatory factors TNF-α, IL-1β, IL-6 were significantly increased. However, the above results were significantly improved after the up-regulation of miR-137 or down-regulation of TCF4. Double luciferase report revealed that miR-137 and TCF4 had targeted relationship. LPS induced activation of AMPK/NF-κB pathway and higher level of apoptosis. AMPK/NF-κB pathway inhibitor C could inhibit activation of this pathway, and up-regulation of miR-137 or down-regulation of TCF4 could significantly weaken the regulation of LPS on the pathway and apoptosis. Analysis of OA rat model showed that over-expression of miR-137 could inhibit up-regulation of inflammatory factors and activation of AMPK/NF-κB pathway. Conclusion: miR-137 targets the inhibition of TCF4 to reverse the progression of OA through the AMPK/NF-κB signaling pathway.
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Whitaker KM, Pettee Gabriel K, Laddu D, White DK, Sidney S, Sternfeld B, Lewis CE, Jacobs DR. Bidirectional associations of accelerometer measured sedentary behavior and physical activity with knee pain, stiffness, and physical function: The CARDIA study. Prev Med Rep 2021; 22:101348. [PMID: 33816086 PMCID: PMC8005813 DOI: 10.1016/j.pmedr.2021.101348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/31/2020] [Accepted: 02/20/2021] [Indexed: 11/02/2022] Open
Abstract
The objective was to examine bidirectional associations of accelerometer estimated sedentary time and physical activity with reported knee symptoms. Participants were 2,034 adults (mean age 45.3 ± 3.6 years, 58.7% female) from CARDIA. Generalized estimating equations for logistic regression and linear mixed regression models examined associations of accelerometer estimated sedentary time, light-intensity physical activity (LPA), and moderate-to-vigorous intensity physical activity (MVPA) at baseline (2005-06) with knee discomfort, pain, stiffness, and physical function (yes/no and continuous scores from short-form WOMAC function scale) at the 5- and 10-year follow-up exams. Linear regression models examined associations between knee symptoms at the 5-year follow-up with accelerometer estimates at the 10-year follow-up. Models were adjusted for confounders; individuals with comorbidities were excluded in sensitivity analyses. A 30 min/day increment in sedentary time at baseline was associated with lower odds of knee symptoms at the 5- and 10-year follow-up (OR: 0.95, 95% CI range: 0.92-0.98), while LPA and MVPA were associated with greater odds of knee symptoms (LPA OR range: 1.04-1.05, 95% CI range: 1.01-1.09; MVPA OR range: 1.17-1.19, 95% CI range: 1.06-1.32). Report of knee symptoms at the 5-year follow-up was associated with 13.52-17.51 (95% CI range: -29.90, -0.56) fewer minutes/day of sedentary time and 14.58-17.51 (95% CI range: 2.48, 29.38) more minutes/day of LPA at the 10-year follow-up, compared to those reporting no symptoms. Many associations were no longer statistically significant when excluding individuals with comorbidities. Findings support a bidirectional association of accelerometer estimated sedentary time and physical activity with knee symptoms across midlife.
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Affiliation(s)
- Kara M Whitaker
- Department of Health and Human Physiology, Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, the University of Illinois at Chicago, Chicago, IL, USA
| | - Daniel K White
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | - Stephen Sidney
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Cora E Lewis
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.,Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Sizoo S, Akkerman M, Trommel N, Esser J, Veen-van der Velden M, Oen I, van der Vlies C, van Baar M, Nieuwenhuis M. Feasibility and acceptability of aquatic exercise therapy in burn patients – A pilot study. BURNS OPEN 2021. [DOI: 10.1016/j.burnso.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Perez-Huerta BD, Díaz-Pulido B, Pecos-Martin D, Beckwee D, Lluch-Girbes E, Fernandez-Matias R, Rubio MJB, Gallego-Izquierdo T. Effectiveness of a Program Combining Strengthening, Stretching, and Aerobic Training Exercises in a Standing versus a Sitting Position in Overweight Subjects with Knee Osteoarthritis: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9124113. [PMID: 33419242 PMCID: PMC7766867 DOI: 10.3390/jcm9124113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/11/2020] [Accepted: 12/17/2020] [Indexed: 01/21/2023] Open
Abstract
There is an increasing incidence, prevalence, and burden of knee osteoarthritis due to a global increase in obesity and an aging population. The aim of the present study was to compare the effectiveness of the addition of aerobic exercises performed in an unloaded or loaded position to a conventional exercise program in overweight subjects with knee osteoarthritis. Twenty-four subjects were randomly allocated to receive 36 sessions of 30-min duration of either sitting aerobic exercises (experimental group) or standing aerobic exercises (control group). Pain intensity, knee disability, and quality-of-life data were collected at baseline and at 12, 24, and 36 sessions. Generalized linear mixed models (GLMMs) were constructed for the analysis of the differences. Significant differences were found in the experimental group for self-reported pain and knee pain and disability at 24 and 36 sessions (p < 0.05). Significant between-group differences were observed in change in self-reported knee pain and disability and quality of life from baseline to 24th- and 36th-session measurements in favor of the experimental group. Adherence to treatment was higher in the experimental group. Adding aerobic exercises in an unloaded position to a conventional exercise program produced superior effects over time for self-reported knee pain, knee pain and disability and quality of life compared to loaded aerobic exercises in overweight subjects with knee osteoarthritis.
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Affiliation(s)
- Betsy Denisse Perez-Huerta
- Centro de Rehabilitación y Educación Especial Puebla SNDIF, Carretera a la Calera s/n Col. Lomas de San Miguel C.P., Puebla 72573, Mexico;
| | - Belén Díaz-Pulido
- Department of Physiotherapy, University of Alcalá, 28871 Madrid, Spain; (B.D.-P.); (T.G.-I.)
| | - Daniel Pecos-Martin
- Department of Physiotherapy, University of Alcalá, 28871 Madrid, Spain; (B.D.-P.); (T.G.-I.)
- Physiotherapy and Pain Research Group, University of Alcalá, 28871 Madrid, Spain
- Correspondence:
| | - David Beckwee
- Rehabilitation Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, 1090 Brussels, Belgium;
| | - Enrique Lluch-Girbes
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain;
- Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Pain in Motion Research Group, International Research Group, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Ruben Fernandez-Matias
- Research Institute of Physiotherapy and Pain, University of Alcalá, 28871 Madrid, Spain;
- Research Unit, Hospital Universitario Fundación Alcorcón, Alcorcón, 28922 Madrid, Spain
| | | | - Tomas Gallego-Izquierdo
- Department of Physiotherapy, University of Alcalá, 28871 Madrid, Spain; (B.D.-P.); (T.G.-I.)
- Physiotherapy and Pain Research Group, University of Alcalá, 28871 Madrid, Spain
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Posadzki P, Pieper D, Bajpai R, Makaruk H, Könsgen N, Neuhaus AL, Semwal M. Exercise/physical activity and health outcomes: an overview of Cochrane systematic reviews. BMC Public Health 2020; 20:1724. [PMID: 33198717 PMCID: PMC7670795 DOI: 10.1186/s12889-020-09855-3] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 11/08/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Sedentary lifestyle is a major risk factor for noncommunicable diseases such as cardiovascular diseases, cancer and diabetes. It has been estimated that approximately 3.2 million deaths each year are attributable to insufficient levels of physical activity. We evaluated the available evidence from Cochrane systematic reviews (CSRs) on the effectiveness of exercise/physical activity for various health outcomes. METHODS Overview and meta-analysis. The Cochrane Library was searched from 01.01.2000 to issue 1, 2019. No language restrictions were imposed. Only CSRs of randomised controlled trials (RCTs) were included. Both healthy individuals, those at risk of a disease, and medically compromised patients of any age and gender were eligible. We evaluated any type of exercise or physical activity interventions; against any types of controls; and measuring any type of health-related outcome measures. The AMSTAR-2 tool for assessing the methodological quality of the included studies was utilised. RESULTS Hundred and fifty CSRs met the inclusion criteria. There were 54 different conditions. Majority of CSRs were of high methodological quality. Hundred and thirty CSRs employed meta-analytic techniques and 20 did not. Limitations for studies were the most common reasons for downgrading the quality of the evidence. Based on 10 CSRs and 187 RCTs with 27,671 participants, there was a 13% reduction in mortality rates risk ratio (RR) 0.87 [95% confidence intervals (CI) 0.78 to 0.96]; I2 = 26.6%, [prediction interval (PI) 0.70, 1.07], median effect size (MES) = 0.93 [interquartile range (IQR) 0.81, 1.00]. Data from 15 CSRs and 408 RCTs with 32,984 participants showed a small improvement in quality of life (QOL) standardised mean difference (SMD) 0.18 [95% CI 0.08, 0.28]; I2 = 74.3%; PI -0.18, 0.53], MES = 0.20 [IQR 0.07, 0.39]. Subgroup analyses by the type of condition showed that the magnitude of effect size was the largest among patients with mental health conditions. CONCLUSION There is a plethora of CSRs evaluating the effectiveness of physical activity/exercise. The evidence suggests that physical activity/exercise reduces mortality rates and improves QOL with minimal or no safety concerns. TRIAL REGISTRATION Registered in PROSPERO ( CRD42019120295 ) on 10th January 2019.
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Affiliation(s)
- Pawel Posadzki
- Kleijnen Systematic Reviews Ltd., York, UK
- Nanyang Technological University, Singapore, Singapore
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany.
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire, UK
| | - Hubert Makaruk
- Jozef Pilsudski University of Physical Education in Warsaw, Faculty Physical Education and Health, Biala Podlaska, Poland
| | - Nadja Könsgen
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany
| | - Annika Lena Neuhaus
- Institute for Research in Operative Medicine, Witten/Herdecke University, Witten, Germany
| | - Monika Semwal
- Health Outcomes Division, University of Texas at Austin College of Pharmacy, Austin, USA
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