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Bao Y, Liang Q, Ji J, Cheng C, Dong C, Zhao R. Effects of exercise on depression in patients with rheumatic diseases: a systematic review and meta-analysis. Z Rheumatol 2024; 83:40-47. [PMID: 37079036 DOI: 10.1007/s00393-023-01321-w] [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] [Accepted: 01/07/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To assess the effects of exercise intervention on depression in rheumatic diseases by means of a meta-analysis. METHODS The Cochrane Library, Embase, Medline, PubMed, and relevant records were searched. The qualities of randomized controlled trials were evaluated. Meta-analysis of the obtained related data was completed using RevMan 5.3. Heterogeneity was also evaluated with χ2 test and I2. RESULTS Twelve RCTs were reviewed. Compared with baseline, the meta-analysis results showed that there was significant difference in the improvement of depression assessed by HADs, BDI, CES‑D, and AIMS in patients with rheumatic diseases (post exercise vs. baseline, -0.73 [-1.05, -0.4], P < 0.0001, I2 = 0%). In subgroup analysis, although none of these trends in BDI and CES‑D subgroups were significant at P < 0.05, there were clear trends towards improvement in depression. CONCLUSION As an alternative or supplementary treatment, the effect of exercise on rheumatism is obvious. Rheumatologists can consider exercise as an integral part of the treatment of patients with rheumatism.
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Affiliation(s)
- Yanfeng Bao
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Qian Liang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
- Medical College, Nantong University, 226001, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China
| | - Juan Ji
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Chun Cheng
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
| | - Chen Dong
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Medical College, Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
| | - Rui Zhao
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
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2
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Lippi L, Ferrillo M, Turco A, Folli A, Moalli S, Refati F, Perrero L, Ammendolia A, de Sire A, Invernizzi M. Multidisciplinary Rehabilitation after Hyaluronic Acid Injections for Elderly with Knee, Hip, Shoulder, and Temporomandibular Joint Osteoarthritis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2047. [PMID: 38004096 PMCID: PMC10672933 DOI: 10.3390/medicina59112047] [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: 09/30/2023] [Revised: 11/12/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
Osteoarthritis (OA) is a prevalent degenerative joint condition characterized by cartilage deterioration, joint inflammation, and functional limitations, particularly impacting the elderly population. Rehabilitation and hyaluronic acid (HA) injections are common therapeutic approaches routinely used in clinical practice, but their synergistic potential is far from being fully characterized. Thus, the aim of this narrative review was to elucidate the multilevel benefits and synergies of integrating these two approaches in multidisciplinary OA rehabilitation. This narrative review follows the scale for the assessment of narrative review articles (SANRA) criteria and involves a comprehensive literature search from July to August 2023. Two independent reviewers screened studies, including those involving human subjects with OA, rehabilitation strategies, and outcomes following HA injection, published in English. Results: HA injections might improve joint biomechanics, reducing friction, absorbing shocks, and potentially regulating inflammation. Rehabilitation plays a pivotal role in strengthening muscles, increasing the range of motion, and enhancing overall function. Optimizing rehabilitation following HA injection might provide additional benefits in joint health. OA management requires a multidisciplinary approach integrating HA injections, rehabilitation, and personalized care. Challenges in patient adherence and healthcare resources currently exist, but emerging technologies offer opportunities to enhance patient engagement and monitoring optimizing sustainability and outcomes of patients with knee, hip, shoulder, and temporomandibular joint OA.
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Affiliation(s)
- Lorenzo Lippi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Martina Ferrillo
- Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessio Turco
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Arianna Folli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Stefano Moalli
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Fjorelo Refati
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
| | - Luca Perrero
- Neurorehabilitation Unit, Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy;
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy; (A.A.); (A.d.S.)
- Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy; (L.L.); (A.T.); (A.F.); (S.M.); (F.R.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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Rabiei P, Sheikhi B, Letafatkar A. Examining the influence of pain neuroscience education followed by a Pilates exercises program in individuals with knee osteoarthritis: a pilot randomized controlled trial. Arthritis Res Ther 2023; 25:94. [PMID: 37280700 DOI: 10.1186/s13075-023-03079-7] [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: 03/26/2023] [Accepted: 05/31/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a multifactorial form of rheumatic condition contributing to physical and psychological factors. Treatments have been provided solely and often compared with each other. An alternative view is that combined treatments addressing physical and psychological factors may result in more benefits. This study aimed to investigate the effect of pain neuroscience education (PNE) followed by Pilates exercises (PEs) in participants with knee OA, compared to PE alone. METHODS In this two-arm assessor-blind pilot randomized controlled trial, fifty-four community-dwelling adults with knee OA were randomly assigned to the PNE followed by PEs and PEs groups (27 in each group). The study was conducted between early July 2021 and early March 2022 at the university's health center. Primary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) subscales of pain and physical limitation and secondary outcomes were Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, Pain Self-Efficacy Questionnaire, and Timed "Up & Go" test covering function. The primary and secondary outcomes were measured at baseline and eight weeks post-treatment. A general linear mixed model was used for between-group comparison with a statistical significance level of 0.05. RESULTS Significant within-group differences were observed in all outcomes in both groups at post-treatment. There were no statistically between-group differences in pain (adjusted mean difference: -0.8; 95% CI -2.2 to 0.7; p = 0.288), physical limitation (adjusted mean difference: -0.4; 95% CI -4 to 3.1; p = 0.812) and function (adjusted mean difference: -0.8; 95% CI -1.8 to 0.1; p = 0.069) at eight weeks. For pain catastrophizing (adjusted mean difference: -3.9; 95% CI -7.2 to -0.6; p = 0.021), kinesiophobia (adjusted mean difference: -4.2; 95% CI -8.1 to -0.4; p = 0.032), and self-efficacy (adjusted mean difference: 6.1; 95% CI 0.7 to 11.5; p = 0.028) statistically between-group improvements were observed favoring PNE followed by PEs group after the treatment. CONCLUSIONS Combining PNE with PEs could have superior effects on psychological characteristics but not on pain, physical limitation, and function, compared to PEs alone. This pilot study emphasizes the need to investigate the combined effects of different interventions. TRIAL REGISTRATION IRCT20210701051754N1.
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Affiliation(s)
- Pouya Rabiei
- Faculty of Medicine, Université Laval, Quebec City, Canada.
- Centre Interdisciplinaire de Recherche en Réadaptation Et Intégration Sociale (Cirris), 525 Boulevard Hamel, Quebec, QC, G1M 2S8, Canada.
| | - Bahram Sheikhi
- Sports Injury and Corrective Exercises, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
| | - Amir Letafatkar
- Sports Injury and Corrective Exercises, Faculty of Physical Education and Sports Sciences, Kharazmi University, Tehran, Iran
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Martinez-Calderon J, Flores-Cortes M, Morales-Asencio JM, Pineda-Galán C, García-Rios MC, Torrontegui-Duarte M, Luque-Suarez A. Is it Possible to Reduce Pain-Related Fear in Individuals with Knee Osteoarthritis? a Systematic Review of Randomised Clinical Trials. Physiother Theory Pract 2023; 39:1106-1132. [PMID: 35200089 DOI: 10.1080/09593985.2022.2038743] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 11/26/2021] [Accepted: 01/07/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of different interventions in reducing pain-related fear outcomes in people with knee osteoarthritis who have or have not had previous knee surgery, and to analyze whether included trials reported their interventions in full detail. METHODS Systematic searches were carried out in the Cochrane CENTRAL, CINAHL, EMBASE, PEDro, PsycINFO, PubMed, and SPORTDiscus from the inception of the database up to November 2019. Searches were manually updated to July 2021. We included randomized clinical trials that evaluated pain-related fear outcomes as a primary or secondary outcome in adults with knee osteoarthritis. The Cochrane Risk of Bias Tool 2 and the GRADE approach evaluated the risk of bias and the certainty of the evidence, respectively. RESULTS Eighteen trials were included. Four trials evaluated pain-related fear as a primary outcome and all evaluated kinesiophobia in samples that had previously undergone a knee surgical procedure. These trials found that interventions based primarily on cognitive aspects (e.g. cognitive-behavioral principles) can be effective in reducing kinesiophobia. Trials evaluating pain-related fear as the secondary outcome also found that interventions that included cognitive aspects (e.g. pain neuroscience education) decreased the levels of pain-related fear (e.g. fear of falling or kinesiophobia) in patients with or without a previous knee surgery. However, serious to very serious risk of bias and imprecisions were found in included trials. Thus, the certainty of the evidence was judged as low and very low using the GRADE approach. All trials reported insufficient details to allow a complete replication of their interventions. CONCLUSIONS Interventions that include cognitive aspects may be the best option to reduce pain-related fear in people with knee osteoarthritis. However, we found a general low and very low certainty of the evidence and the findings should be considered with caution.
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Affiliation(s)
- Javier Martinez-Calderon
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Mar Flores-Cortes
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | - Jose Miguel Morales-Asencio
- Biomedical Research Institute of Malaga (Ibima), Spain
- Department of Nursing, Faculty of Health Sciences, University of Malaga, Malaga, Spain
| | | | | | | | - Alejandro Luque-Suarez
- Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, Malaga, Spain
- Biomedical Research Institute of Malaga (Ibima), Spain
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Zheng X, Wang Y, Jin X, Huang H, Chen H, Wang Y, Shang S. Factors influencing depression in community-dwelling elderly patients with osteoarthritis of the knee in China: a cross-sectional study. BMC Geriatr 2022; 22:453. [PMID: 35614451 PMCID: PMC9134602 DOI: 10.1186/s12877-022-03117-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/04/2022] [Indexed: 11/17/2022] Open
Abstract
Background Knee osteoarthritis (OA) and depression are both major health issues influencing the quality of elderly life. The aim of the present study was to explore the prevalence of depression and the factors influencing depression in community-dwelling elderly patients with OA of the knee in China. Methods We conducted a cross-sectional descriptive study. The study included 214 participants aged 60 and older diagnosed with OA of the knee. The depression of the elderly was measured by using the Geriatric Depression Scale (GDS). Participants were asked to complete a demographic questionnaire, the GDS, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the society dimension of Arthritis Impact Measurement Scales 2 (AIMS2). In addition, the participants performed a timed up and go test (TUG) and the stair-climb test (SCT). Results The average age of the participants was 69.2 ± 7.63 years old, their body mass index (BMI) was 25.2 ± 3.85, and their disease duration was 5.9 ± 7.72 years. The mean total score of the GDS was 4.43 ± 2.89, and the GDS scores correlated positively with pain (r = 0.45, P < 0.001), stiffness (r = 0.40, P < 0.001), physical function (r = 0.52, P < 0.001),TUG (r = 0.35, P < 0.001), and SCT (r = 0.47, P < 0.001) and negatively with social support (r = − 0.35, P < 0.001).Analysis using multiple regression demonstrated that physical function, social support, and SCT explained 36.8% of the variance in depression. Conclusions Our findings suggested that physical function, social support, and lower extremity strength were predictors of depressive symptoms in community-dwelling elderly people with OA of the knee. Focusing on this elderly group with increasing functional exercise, positive social interaction and support, and lower limb muscle strength training should help in the prevention of depression. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03117-0.
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Affiliation(s)
- Xiaoyan Zheng
- The Open University of China, 75 Fuxing Road, Haidian District, Beijing, 100039, China
| | - Yaya Wang
- The Open University of China, 75 Fuxing Road, Haidian District, Beijing, 100039, China
| | - Xiaoyan Jin
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Hongjie Huang
- Institute of Sports Medicine, Peking University Third Hospital, 49 Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Hongbo Chen
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Yan Wang
- The Open University of China, 75 Fuxing Road, Haidian District, Beijing, 100039, China
| | - Shaomei Shang
- School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing, 100191, China.
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Maqbool M, Fekadu G, Jiang X, Bekele F, Tolossa T, Turi E, Fetensa G, Fanta K. An up to date on clinical prospects and management of osteoarthritis. Ann Med Surg (Lond) 2021; 72:103077. [PMID: 34868573 PMCID: PMC8626656 DOI: 10.1016/j.amsu.2021.103077] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 12/19/2022] Open
Abstract
The rising prevalence of osteoarthritis (OA) in the general population has necessitated the development of novel treatment options. It is critical to recognize the joint as a separate entity participating in degenerative processes, as well as the multifaceted nature of OA. OA is incurable because there is currently no medication that can stop or reverse cartilage or bone loss. As this point of view has attracted attention, more research is being directed toward determining how the various joint components are impacted and how they contribute to OA pathogenesis. Over the next few years, several prospective therapies focusing on inflammation, cartilage metabolism, subchondral bone remodelling, cellular senescence, and the peripheral nociceptive pathway are predicted to transform the OA therapy landscape. Stem cell therapies and the use of various biomaterials to target articular cartilage (AC) and osteochondral tissues are now being investigated in considerable detail. Currently, laboratory-made cartilage tissues are on the verge of being used in clinical settings. This review focuses on the update of clinical prospects and management of osteoarthritis, as well as future possibilities for the treatment of OA. Osteoarthritis (OA) is a general term that incorporates several different joint diseases. The exact pathophysiology of OA remains unclear. OA is incurable because there is currently no medication that can stop or reverse cartilage or bone loss. Nonsteroidal anti-inflammatory drugs are the most frequently prescribed medications to alleviate arthritic discomfort. Stem cell therapies to target articular cartilage and osteochondral tissues are now under investigation.
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Affiliation(s)
- Mudasir Maqbool
- Department of Pharmaceutical Sciences, University of Kashmir, Hazratbal Srinagar, 190006, Jammu and Kashmir, India
| | - Ginenus Fekadu
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong.,School of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Xinchan Jiang
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T, Hong Kong
| | - Firomsa Bekele
- Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Ebisa Turi
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Getahun Fetensa
- School of Nursing and Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Korinan Fanta
- School of Pharmacy, Institute of Health Science, Jimma University, Jimma, Ethiopia
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Effects of exercise therapy on joint instability in patients with osteoarthritis of the knee: A systematic review. OSTEOARTHRITIS AND CARTILAGE OPEN 2020; 2:100114. [DOI: 10.1016/j.ocarto.2020.100114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/26/2020] [Indexed: 01/09/2023] Open
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8
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Hoque L, Dewolf R, Meyers D, White DK, Mazor KM, Stefan M, Crawford S, Alavi K, Yates J, Maxfield M, Lou F, Uy K, Walz M, Kapoor A. Improving stamina and mobility with preop walking in surgical patients with frailty traits -OASIS IV: randomized clinical trial study protocol. BMC Geriatr 2020; 20:394. [PMID: 33028223 PMCID: PMC7542706 DOI: 10.1186/s12877-020-01799-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022] Open
Abstract
Background Frail older surgical patients face more than a two-fold increase in postoperative complications, including myocardial infarction, deep vein thrombosis, pulmonary embolism, pneumonia, ileus, and others. Many of these complications occur because of postoperative loss of stamina and poor mobility. Preoperative exercise may better prepare these vulnerable patients for surgery. We present the protocol for our ongoing randomized trial to assess the impact of a preoperative walking intervention with remote coaching and pedometer on outcomes of stamina (six-minute walk distance- 6MWD) and mobility (postoperative steps) in older adults with frailty traits. Methods We will be conducting a randomized clinical trial with a total of 120 patients permitting up to a 33% rate of attrition, to reach a final sample size of 80 (with 40 patients for each study arm). We will include patients who are age 60 or higher, score 4 or greater on the Edmonton Frailty Scale assessment, and will be undergoing a surgical operation that requires a 2 or more night hospital stay to be eligible for our trial. Using block randomization stratified on baseline 6MWD, we will assign patients to wear a pedometer. At the end of three baseline days, an athletic trainer (AT) will provide a daily step count goal reflecting a 10–20% increase from baseline. Subsequently, the AT will call weekly to further titrate the goal or calls more frequently if the patient is not meeting the prescribed goal. Controls will receive general walking advice. Our main outcome is change in 6MWD on postoperative day (POD) 2/3 vs. baseline. We will also collect 6MWD approximately 4 weeks after surgery and daily in-hospital steps. Conclusion If changes in a 6MWD and step counts are significantly higher for the intervention group, we believe this will confirm our hypothesis that the intervention leads to decreased loss of stamina and mobility. Once confirmed, we anticipate expanding to multiple centers to assess the interventional impact on clinical endpoints. Trial registration The randomized clinical trial was registered on clinicaltrials.gov under the identifier NCT03892187 on March 27, 2019.
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Affiliation(s)
- Laboni Hoque
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA
| | - Ryan Dewolf
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA
| | - David Meyers
- University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | | | - Kathleen M Mazor
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, MA, USA
| | - Mihaela Stefan
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,Baystate Medical Center, Springfield, MA, USA
| | - Sybil Crawford
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA
| | - Karim Alavi
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Jennifer Yates
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Mark Maxfield
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Feiran Lou
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Karl Uy
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Matthias Walz
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA.,University of Massachusetts Memorial Health Care, Worcester, MA, USA
| | - Alok Kapoor
- University of Massachusetts Medical School, 365 Plantation St, Worcester, MA, 01605, USA. .,University of Massachusetts Memorial Health Care, Worcester, MA, USA. .,Meyers Primary Care Institute, a joint endeavor of University of Massachusetts Medical School, Reliant Medical Group, and Fallon Health, Worcester, MA, USA.
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9
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Worsfold C. Functional rehabilitation of the neck. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1759176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Chris Worsfold
- MSK Research Unit, University of Hertfordshire, Hatfield, Hertfordshire, UK
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Gaskin DJ, Karmarkar TD, Maurer A, Bucay‐Harari L, Casillas G, Gittens A, Jones LC, Thorpe RJ, Tolbert E, Wood JE. Potential Role of Cost and Quality of Life in Treatment Decisions for Arthritis‐Related Knee Pain in African American and Latina Women. Arthritis Care Res (Hoboken) 2020; 72:692-698. [DOI: 10.1002/acr.23903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Accepted: 04/09/2019] [Indexed: 12/31/2022]
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Molyneux J, Herrrington L, Riley B, Jones R. A single‐arm, non‐randomized investigation into the short‐term effects and follow‐up of a 4‐week lower limb exercise programme on kinesiophobia in individuals with knee osteoarthritis. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2020; 25:e1831. [DOI: 10.1002/pri.1831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 11/07/2019] [Accepted: 12/13/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Jimmy Molyneux
- Physiotherapy DepartmentBridgewater Community Healthcare Foundation Trust, Leigh Health Centre Leigh, England UK
- School of Health SciencesUniversity of Salford Greater Manchester, England UK
| | - Lee Herrrington
- School of Health SciencesUniversity of Salford Greater Manchester, England UK
| | - Ben Riley
- Physiotherapy DepartmentBridgewater Community Healthcare Foundation Trust, Leigh Health Centre Leigh, England UK
| | - Richard Jones
- School of Health SciencesUniversity of Salford Greater Manchester, England UK
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12
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Jones LC, Watkins Y, Alva D. Operation Change: A New Paradigm Addressing Behavior Change and Musculoskeletal Health Disparities. J Racial Ethn Health Disparities 2018; 5:1264-1272. [PMID: 29691790 PMCID: PMC6223886 DOI: 10.1007/s40615-018-0473-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 02/12/2018] [Accepted: 02/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In this study, we examined the implementation and efficacy of Operation Change, a community-based, culturally sensitive program to stimulate behavioral changes in activity level and improve musculoskeletal health in African-American (AA) and Hispanic/Latina (H/L) women with obesity and early-stage osteoarthritis. METHODS Sixty-two women (32 AA and 30 H/L), 40-75 years old, with nontraumatic knee pain and body mass index values > 30, participated in a 12-week program of presentations, motivational interviewing, goal setting, and physical activities. Assessments (at 0, 6, and 12 weeks) included a demographic questionnaire, physical assessment, timed 50-ft walking test, Western Ontario and McMaster Universities Arthritis Index (WOMAC), Short Form-36 Health Survey (SF-36), 8-Item Physical Health Questionnaire (PHQ-8), and motivational interview assessment. RESULTS Walking time improved significantly for H/L women (P < 0.0001) but not AA women (P = 0.0759). Both groups had significant mean weight loss (P < 0.05) with high variability among individuals. WOMAC scores for both groups indicated decreased pain (P < 0.0001) and stiffness (P < 0.0001) and improved physical functioning (P < 0.0001) by 12 weeks. SF-36 results were comparable to those of the WOMAC. PHQ-8 results improved significantly for H/L women (P < 0.0001) but not AA women (P = 0.077). Participants scored the motivational interviewing component of the program favorably. CONCLUSIONS Participation in Operation Change increased physical activity, resulting in improvements in pain and function scores. This supports a new paradigm for behavioral modification that helps AA and H/L women take an active role in living with osteoarthritis.
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Affiliation(s)
- Lynne C Jones
- Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Yashika Watkins
- College of Health Sciences, Chicago State University, Chicago, IL, USA
| | - Duanny Alva
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Walker A, Williams R, Sibley F, Stamp D, Carter A, Hurley M. Improving access to better care for people with knee and/or hip pain: service evaluation of allied health professional-led primary care. Musculoskeletal Care 2018; 16:222-232. [PMID: 28401656 DOI: 10.1002/msc.1189] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Chronic knee and hip pain is prevalent, impairing mobility, function and quality of life. Allied health professions (AHPs) are better trained and have more time than general practitioners in primary care to advise and support people to adopt healthier lifestyles (maintain healthy weight, increase physical activity) that reduce joint pain. We evaluated whether AHP-led primary care delivering person-centred, practical lifestyle coaching was a feasible, effective way to manage chronic knee and/or hip pain. METHODS At initial assessment the 'Joint Pain Advisor' assessed pain, function, quality of life, physical activity, waist circumference and body mass, taught simple self-management strategies and used behaviour change techniques (motivational interviewing, goal setting, action/coping planning) to alter participants' lifestyles. Participants were invited for 6-week and 6-month reviews, when the Advisor reassessed clinical outcomes, fed back progress and reinforced health messages. Feasibility and effectiveness of the service was evaluated using quantitative and qualitative methods. RESULTS Uptake of the service was good: 498 people used the service. Between initial assessment and reviews, participants' pain, function, quality of life, weight, waist circumference and physical activity improved (p < 0.005). Service user satisfaction was high; they reported easier access to advice and support tailored to their needs that translated into clinical benefits and a more efficient pathway reducing unnecessary consultations and investigations. Relatively few people returned for a 6-month review as they considered they had received sufficient advice. CONCLUSIONS AHP-led care is a popular, effective, efficient and sustainable way to manage joint pain, without compromising safety or quality of care.
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Affiliation(s)
- A Walker
- St George's, University of London and Kingston University, UK
- Health Innovation Network, London, UK
| | - R Williams
- Lewisham NHS Clinical Commissioning Group, UK
| | - F Sibley
- Health Innovation Network, London, UK
| | - D Stamp
- Lewisham and Greenwich NHS Trust, UK
| | - A Carter
- Health Innovation Network, London, UK
| | - M Hurley
- St George's, University of London and Kingston University, UK
- Health Innovation Network, London, UK
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Grazina R, Andrade R, Bastos R, Costa D, Pereira R, Marinhas J, Maestro A, Espregueira-Mendes J. Clinical Management in Early OA. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1059:111-135. [PMID: 29736571 DOI: 10.1007/978-3-319-76735-2_5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Knee osteoarthritis affects an important percentage of the population throughout their life. Several factors seem to be related to the development of knee osteoarthritis including genetic predisposition, gender, age, meniscal deficiency, lower limb malalignments, joint instability, cartilage defects, and increasing sports participation. The latter has contributed to a higher prevalence of early onset of knee osteoarthritis at younger ages with this active population demanding more consistent and durable outcomes. The diagnosis is complex and the common signs and symptoms are often cloaked at these early stages. Classification systems have been developed and are based on the presence of knee pain and radiographic findings coupled with magnetic resonance or arthroscopic evidence of early joint degeneration. Nonsurgical treatment is often the first-line option and is mainly based on daily life adaptations, weight loss, and exercise, with pharmacological agents having only a symptomatic role. Surgical treatment shows positive results in relieving the joint symptomatology, increasing the knee function and delaying the development to further degenerative stages. Biologic therapies are an emerging field showing early promising results; however, further high-level research is required.
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Affiliation(s)
- Rita Grazina
- Orthopaedic Surgery at Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E, Vila Nova de Gaia, Portugal
| | - Renato Andrade
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal
| | - Ricardo Bastos
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal.,Fluminense Federal University, Niteroi/Rio de Janeiro, Brazil
| | - Daniela Costa
- SMIC Dragão - Serviço Médico de Imagem Computorizada, Porto, Portugal
| | - Rogério Pereira
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Faculty of Sports, University of Porto, Porto, Portugal.,Faculty of Health Sciences, University Fernando Pessoa, Porto, Portugal
| | - José Marinhas
- Orthopaedic Surgery at Centro Hospitalar de Vila Nova de Gaia/Espinho E.P.E, Vila Nova de Gaia, Portugal.,Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal.,Dom Henrique Research Centre, Porto, Portugal
| | - António Maestro
- Real Sporting de Gijón SAD, Gijón, Spain.,FREMAP Mutua de Accidentes, Gijón, Spain
| | - João Espregueira-Mendes
- Clínica do Dragão, Espregueira-Mendes Sports Centre - FIFA Medical Centre of Excellence, Porto, Portugal. .,Dom Henrique Research Centre, Porto, Portugal. .,Orthopaedics Department of Minho University, Minho, Portugal. .,3B's Research Group-Biomaterials, Biodegradables and Biomimetics, University of Minho, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, Guimarães, Portugal. .,ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
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Areeudomwong P, Buttagat V. Reliability and Validity of the Cross-Culturally Adapted Thai Version of the Tampa Scale for Kinesiophobia in Knee Osteoarthritis Patients. Malays J Med Sci 2017; 24:61-67. [PMID: 28894405 DOI: 10.21315/mjms2017.24.2.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 01/26/2017] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The aim of this study was to develop a cross-culturally adapted Thai version of the Tampa Scale for Kinesiophobia (TSK) and investigate its reliability and validity among patients with knee osteoarthritis. METHODS The TSK was translated into Thai language and culturally adapted in line with the international standards. The Thai TSK questionnaire was then tested for internal consistency, test-retest reliability, and convergent validity by comparing it with the visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, State-Trait Anxiety Inventory, and Timed Up and Go Test. RESULTS Eighty patients with knee osteoarthritis were included in the study. The Thai version of the TSK was easily comprehended and completed within 6 minutes. The questionnaire showed a good internal consistency (α = 0.90) and high test-retest reliability {ICC (2,1) = 0.934}. Convergent validity showed high correlations with the visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, and State-Trait Anxiety Inventory (r = 0.741, 0.856, and 0.817, respectively). However, there was no significant correlation between the Thai version of the TSK scores and the Timed Up and Go Test results. CONCLUSION The Thai version of the TSK has satisfactory reliability and validity for the evaluation of pain-related fear of movement/(re)injury in patients with knee osteoarthritis.
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Affiliation(s)
- Pattanasin Areeudomwong
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand 57100.,Research Center of Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand 40002
| | - Vitsarut Buttagat
- Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand 57100.,Research Center of Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand 40002
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Abstract
Study Design Case series. Background Recent evidence suggests that traditional impairment-based rehabilitation approaches for patients with knee pain may not result in improved function or reduced disability. This case series describes a novel task-specific training approach to exercise therapy for patients with chronic knee pain and reports changes in measures of clinical outcome (pain and physical function) following participation in the training program. Case Description Seven patients with chronic knee pain aged 40 years or older were included. Each reported at least "moderate" difficulty with sit-to-stand transfers, floor transfers, and/or stair negotiation at baseline. Experienced physical therapists provided between 8 and 16 treatment sessions focusing on improving performance of difficult or painful tasks. Outcomes A majority of patients demonstrated clinically important improvements in both patient-rated outcomes (Knee injury and Osteoarthritis Outcome Score, numeric pain-rating scale, modified Arthritis Self-Efficacy Scale) and performance-based outcomes (30-second chair-rise test, timed stair-climb test, floor transfer test, Performance Assessment of Self-Care Skills). Discussion A task-specific training approach for patients with chronic knee pain was described and yielded considerable improvement in pain and function for most of the individuals in this case series. Larger studies are needed to determine how task-specific training compares with more traditional impairment-based exercise approaches for chronic knee pain. Level of Evidence Therapy, level 5. J Orthop Sports Phys Ther 2017;47(8):548-556. doi:10.2519/jospt.2017.7349.
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17
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Alahmari KA, Silvian PS, Reddy RS, Ahmad I, Kakaraparthi VN, Alam MM. Mediating role of body mass index in knee osteoarthritis. J Taibah Univ Med Sci 2017; 12:150-156. [PMID: 31435230 PMCID: PMC6695076 DOI: 10.1016/j.jtumed.2016.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 11/05/2016] [Accepted: 11/06/2016] [Indexed: 11/30/2022] Open
Abstract
Objective This study explores the role of knee circumference, body mass index (BMI), and range of motion (ROM) in predicting knee osteoarthritis (KOA). The objective is to elucidate the mediating role of BMI in influencing the relationship between age, knee circumference and pain in knee osteoarthritis, as measured with the help of the knee outcome survey (KOS) questionnaire. Methods The design used in this study was causal comparative. The study consisted of 66 patients with symptomatic KOA and 60 matched asymptomatic individuals. Result BMI was significantly and positively correlated with both pain and knee girth for the symptomatic KOA group. This finding signifies a relationship between KOA and other indicators, such as age and knee circumference. Conclusions The results of the study would indicate an important milestone in clinical rehabilitation, especially for physical therapists, enabling them to plan, modify, and design interventions to improve the health status of KOA patients.
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Affiliation(s)
- Khalid A Alahmari
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Paul S Silvian
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Ravi S Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Venkata N Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
| | - Mohammad M Alam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, KSA
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18
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Takacs J, Carpenter MG, Garland SJ, Hunt MA. Factors Associated With Dynamic Balance in People With Knee Osteoarthritis. Arch Phys Med Rehabil 2015; 96:1873-9. [DOI: 10.1016/j.apmr.2015.06.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 05/09/2015] [Accepted: 06/24/2015] [Indexed: 11/24/2022]
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Domínguez CJD, Ugalde PF, Vilchez DR, Carretero-Dios H, Estévez EC. Positive and negative affective states and disease activity in ankylosing spondylitis. Rheumatol Int 2014; 35:519-24. [PMID: 25123554 DOI: 10.1007/s00296-014-3107-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 07/25/2014] [Indexed: 11/26/2022]
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20
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Knoop J, Steultjens MPM, Roorda LD, Lems WF, van der Esch M, Thorstensson CA, Twisk JWR, Bierma-Zeinstra SMA, van der Leeden M, Dekker J. Improvement in upper leg muscle strength underlies beneficial effects of exercise therapy in knee osteoarthritis: secondary analysis from a randomised controlled trial. Physiotherapy 2014; 101:171-7. [PMID: 25280604 DOI: 10.1016/j.physio.2014.06.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 06/23/2014] [Indexed: 01/16/2023]
Abstract
OBJECTIVES Although exercise therapy is effective for reducing pain and activity limitations in patients with knee osteoarthritis (OA), the underlying mechanisms are unclear. This study aimed to evaluate if improvements in neuromuscular factors (i.e. upper leg muscle strength and knee proprioception) underlie the beneficial effects of exercise therapy in patients with knee OA. DESIGN Secondary analyses from a randomised controlled trial, with measurements at baseline, 6 weeks, 12 weeks and 38 weeks. SETTING Rehabilitation centre. PARTICIPANTS One hundred and fifty-nine patients diagnosed with knee OA. INTERVENTION Exercise therapy. MAIN OUTCOME MEASURES Changes in pain [numeric rating scale (NRS)] and activity limitations [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and get-up-and-go test] during the study period. Independent variables were changes in upper leg muscle strength and knee joint proprioception (i.e. motion sense) during the study period. Longitudinal regression analyses (generalised estimating equation) were performed to analyse associations between changes in upper leg muscle strength and knee proprioception with changes in pain and activity limitations. RESULTS Improved muscle strength was significantly associated with reductions in NRS pain {B coefficient -2.5 [95% confidence interval (CI) -3.7 to -1.4], meaning that every change of 1 unit of strength was linked to a change of -2.5 units of pain}, WOMAC physical function (-8.8, 95% CI -13.4 to -4.2) and get-up-and-go test (-1.7, 95% CI -2.4 to -1.0). Improved proprioception was not significantly associated with better outcomes of exercise therapy (P>0.05). CONCLUSIONS Upper leg muscle strengthening is one of the mechanisms underlying the beneficial effects of exercise therapy in patients with knee OA.
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Affiliation(s)
- J Knoop
- Amsterdam Rehabilitation Research Centre, Reade, The Netherlands.
| | - M P M Steultjens
- School of Health and Life Sciences, Institute for Applied Health Research, Glasgow Caledonian University, UK
| | - L D Roorda
- Amsterdam Rehabilitation Research Centre, Reade, The Netherlands
| | - W F Lems
- Jan van Breemen Research Institute, Reade, The Netherlands; Department of Rheumatology, VU University Medical Centre, The Netherlands
| | - M van der Esch
- Amsterdam Rehabilitation Research Centre, Reade, The Netherlands
| | - C A Thorstensson
- Department of Clinical Neuroscience and Physiology, University of Gothenburg, Sweden
| | - J W R Twisk
- Department of Clinical Epidemiology and Biostatistics, EMGO Institute, VU University Medical Centre, The Netherlands
| | - S M A Bierma-Zeinstra
- Department of General Practice, Department of Orthopaedics, University Medical Centre Rotterdam, Erasmus MC, The Netherlands
| | - M van der Leeden
- Amsterdam Rehabilitation Research Centre, Reade, The Netherlands; Department of Rehabilitation Medicine, EMGO Institute, VU University Medical Centre, The Netherlands
| | - J Dekker
- Department of Rehabilitation Medicine, EMGO Institute, VU University Medical Centre, The Netherlands; Department of Psychiatry, VU University Medical Centre, The Netherlands
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21
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Holla JFM, Sanchez-Ramirez DC, van der Leeden M, Ket JCF, Roorda LD, Lems WF, Steultjens MPM, Dekker J. The avoidance model in knee and hip osteoarthritis: a systematic review of the evidence. J Behav Med 2014; 37:1226-41. [PMID: 24841177 DOI: 10.1007/s10865-014-9571-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 05/07/2014] [Indexed: 01/01/2023]
Abstract
The avoidance model in patients with knee and hip osteoarthritis (OA) hypothesizes that pain and psychological distress lead to avoidance of activities, and thereby to muscle weakness and activity limitations. This paper systematically reviews the scientific evidence for the validity of this avoidance model. A qualitative data synthesis was used to identify levels of evidence. Sixty studies were included. In knee OA, strong evidence was found that avoidance of activities is associated with activity limitations via muscle weakness (mediation by muscle weakness), strong evidence was found for an association between muscle weakness and activity limitations, and weak evidence was found that pain and psychological distress are associated with muscle weakness via avoidance of activities (mediation by avoidance). In hip OA, weak evidence was found for mediation by muscle weakness; and strong evidence was found for an association between muscle weakness and activity limitations. More research is needed on the consecutive associations between pain or psychological distress, avoidance of activities and muscle weakness, and to confirm causal relationships.
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Affiliation(s)
- Jasmijn F M Holla
- Amsterdam Rehabilitation Research Center, Reade, PO Box 58271, 1040 HG, Amsterdam, The Netherlands,
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Abstract
SYNOPSIS Altered knee joint biomechanics and excessive joint loading have long been considered as important contributors to the development and progression of knee osteoarthritis. Therefore, a better understanding of how various treatment options influence the loading environment of the knee joint could have practical implications for devising more effective physical therapy management strategies. The aim of this clinical commentary was to review the pertinent biomechanical evidence supporting the use of treatment options intended to provide protection against excessive joint loading while offering symptomatic relief and functional improvements for better long-term management of patients with knee osteoarthritis. The biomechanical and clinical evidence regarding the effectiveness of knee joint offloading strategies, including contralateral cane use, laterally wedged shoe insoles, variable-stiffness shoes, valgus knee bracing, and gait-modification strategies, within the context of effective disease management is discussed. In addition, the potential role of therapeutic exercise and neuromuscular training to improve the mechanical environment of the knee joint is considered. Management strategies for treatment of joint instability and patellofemoral compartment disease are also mentioned. Based on the evidence presented as part of this clinical commentary, it is argued that special considerations for the role of knee joint biomechanics and excessive joint loading are necessary in designing effective short- and long-term management strategies for treatment of patients with knee osteoarthritis. LEVEL OF EVIDENCE Therapy, level 5.
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Alschuler KN, Molton IR, Jensen MP, Riddle DL. Prognostic value of coping strategies in a community-based sample of persons with chronic symptomatic knee osteoarthritis. Pain 2013; 154:2775-2781. [PMID: 23969326 DOI: 10.1016/j.pain.2013.08.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 08/13/2013] [Accepted: 08/14/2013] [Indexed: 11/29/2022]
Abstract
Radiographic knee osteoarthritis (OA) is a highly prevalent condition that has been the focus of a number of studies identifying factors that are prognostic of continued or worsening pain and function. Although prior prognostic studies have identified a number of demographic, physical, and psychological factors that are predictive of outcome, minimal focus has been placed on pain coping skills as prognostic factors, despite cross-sectional evidence suggesting that pain coping skills are associated with pain and function in knee OA. The present study reports on the use of pain coping skills as prognostic factors for changes in pain and/or function over a 1-year period. Participants were drawn from the Osteoarthritis Initiative, a prospective longitudinal cohort study of persons recruited from the community who either had knee OA or were at high risk for developing knee OA. Data from the Coping Strategies Questionnaire were compared against 1-year change in pain, function, or both, using established criteria for defining whether the patient got better, worse, or stayed the same over the 1-year period. Results revealed a significant effect for praying/hoping, increased behavioral activities, and pain catastrophizing as prognostic of pain outcomes; ignoring pain and praying/hoping were prognostic of function outcomes; and increased behavioral activities and pain catastrophizing were prognostic of a combined pain and function outcome. The findings provide important new evidence regarding the potential clinical relevance of a number of pain coping responses hypothesized to influence future pain and function in persons with arthritis.
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Affiliation(s)
- Kevin N Alschuler
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA, USA Department of Physical Therapy, Virginia Commonwealth University, Richmond, VA, USA
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Stemberger R, Kerschan-Schindl K. Osteoarthritis: physical medicine and rehabilitation—nonpharmacological management. Wien Med Wochenschr 2013; 163:228-35. [DOI: 10.1007/s10354-013-0181-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/15/2013] [Indexed: 12/29/2022]
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