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Karatrantou K, Pappas K, Batatolis C, Ioakimidis P, Gerodimos V. A 3-Month Modified Basketball Exercise Program as a Health-Enhancing Sport Activity for Middle-Aged Individuals. Life (Basel) 2024; 14:709. [PMID: 38929692 PMCID: PMC11205037 DOI: 10.3390/life14060709] [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: 04/17/2024] [Revised: 05/15/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024] Open
Abstract
Recreational team sports have received great acceptance lately, in different populations, indicating encouraging results in health-related quality of life. This study examined the efficacy of a 3-month basketball exercise program on selected indices of health (body mass-BM, body fat-BF, blood pressure-BP), functional capacity (flexibility of lower and upper limbs, balance), and physical fitness (maximum strength of lower limbs, trunk and handgrip, aerobic capacity) in middle-aged individuals. Forty middle-aged individuals (males and females; 40-55 years old) were randomly divided into (a) exercise (EG; n = 20) and (b) control groups (CG; n = 20). The EG followed a 3-month modified basketball exercise program (2 times/week; 24 training units), including different basketball drills with and without the ball (dribbling, passing, pivot, stops, etc.), to improve participants' health and physical fitness. Repeated measures ANOVA showed that the EG significantly increased their flexibility (17.23-74.88%; p < 0.001), static balance (44.76-54.69%; p < 0.001), and strength of lower limbs and trunk (11.67-13.13%; p < 0.001), while reducing BP (7.31-12%; p < 0.001), heart rate and RPE (5.30-34.37%; p < 0.001), and time during time-up-and-go test (-10.91%; p < 0.001). Handgrip strength, BM, and BF did not change following the program in the EG (p > 0.05). In the CG, the above variables remained stable. In conclusion, this program may be used to eliminate the detrimental effects of aging on health, functional capacity, and physical fitness parameters.
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Affiliation(s)
| | | | | | | | - Vassilis Gerodimos
- Department of Physical Education and Sports Science, University of Thessaly, 42100 Trikala, Greece; (K.K.); (K.P.); (C.B.); (P.I.)
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Hunter I, Leib R. A framework for relating natural movement to length and quality of life in human and non-human animals. J Theor Biol 2024; 576:111649. [PMID: 37866716 DOI: 10.1016/j.jtbi.2023.111649] [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: 12/01/2022] [Revised: 10/13/2023] [Accepted: 10/19/2023] [Indexed: 10/24/2023]
Abstract
Natural movement is clearly related to health, however, it is also highly complex and difficult to measure. Most attempts to measure it focus on functional movements in humans, and while this a valid and popular approach, assays focussed on particular movements cannot capture the range of natural movement that occurs outside them. It is also difficult to use current techniques to compare movement across animal species. Interspecies comparison may be useful for identifying conserved biomechanical and/ or computational principles of movement that could inform human and veterinary medicine, plus several other fields of research. It is therefore important that research develops a system for quantifying movement in freely moving animals in natural environments and relating it to length and quality of life (LQOL). The present text proposes a novel theoretical framework for doing so, based on screening movement ability (MA). MA is calculated from three major variables - Movement Quality, Movement Complexity, and Movement Quantity. These may represent the most important components of movement as it relates to LQOL, and offer insight into how and why differences in the relationship between movement and LQOL occur. A constrained version of the framework is validated in Drosophila, which suggests that MA may indeed represent a useful new paradigm for understanding the relationship between movement and length and quality of life.
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Affiliation(s)
- Iain Hunter
- Division of Neuroscience, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, School of Biological Sciences, University of Manchester, Manchester, United Kingdom.
| | - Raz Leib
- Neuromuscular Diagnostics, TUM School of Medicine and Health, Department of Health and Sport Sciences, Technical University of Munich, Georg-Brauchle-Ring 60/ 62, 80992 Munich, Germany
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Rodríguez Sánchez-Laulhé P, Luque-Romero LG, Barrero-García FJ, Biscarri-Carbonero Á, Blanquero J, Suero-Pineda A, Heredia-Rizo AM. An Exercise and Educational and Self-management Program Delivered With a Smartphone App (CareHand) in Adults With Rheumatoid Arthritis of the Hands: Randomized Controlled Trial. JMIR Mhealth Uhealth 2022; 10:e35462. [PMID: 35389367 PMCID: PMC9030995 DOI: 10.2196/35462] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 02/01/2022] [Accepted: 02/18/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a prevalent autoimmune disease that usually involves problems of the hand or wrist. Current evidence recommends a multimodal therapy including exercise, self-management, and educational strategies. To date, the efficacy of this approach, as delivered using a smartphone app, has been scarcely investigated. OBJECTIVE This study aims to assess the short- and medium-term efficacy of a digital app (CareHand) that includes a tailored home exercise program, together with educational and self-management recommendations, compared with usual care, for people with RA of the hands. METHODS A single-blinded randomized controlled trial was conducted between March 2020 and February 2021, including 36 participants with RA of the hands (women: 22/36, 61%) from 2 community health care centers. Participants were allocated to use the CareHand app, consisting of tailored exercise programs, and self-management and monitoring tools or to a control group that received a written home exercise routine and recommendations, as per the usual protocol provided at primary care settings. Both interventions lasted for 3 months (4 times a week). The primary outcome was hand function, assessed using the Michigan Hand Outcome Questionnaire (MHQ). Secondary measures included pain and stiffness intensity (visual analog scale), grip strength (dynamometer), pinch strength (pinch gauge), and upper limb function (shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire). All measures were collected at baseline and at a 3-month follow-up. Furthermore, the MHQ and self-reported stiffness were assessed 6 months after baseline, whereas pain intensity and scores on the shortened version of the Disabilities of the Arm, Shoulder, and Hand questionnaire were collected at the 1-, 3-, and 6-month follow-ups. RESULTS In total, 30 individuals, corresponding to 58 hands (CareHand group: 26/58, 45%; control group: 32/58, 55%), were included in the analysis; 53% (19/36) of the participants received disease-modifying antirheumatic drug treatment. The ANOVA demonstrated a significant time×group effect for the total score of the MHQ (F1.62,85.67=9.163; P<.001; η2=0.15) and for several of its subscales: overall hand function, work performance, pain, and satisfaction (all P<.05), with mean differences between groups for the total score of 16.86 points (95% CI 8.70-25.03) at 3 months and 17.21 points (95% CI 4.78-29.63) at 6 months. No time×group interaction was observed for the secondary measures (all P>.05). CONCLUSIONS Adults with RA of the hands who used the CareHand app reported better results in the short and medium term for overall hand function, work performance, pain, and satisfaction, compared with usual care. The findings of this study suggest that the CareHand app is a promising tool for delivering exercise therapy and self-management recommendations to this population. Results must be interpreted with caution because of the lack of efficacy of the secondary outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04263974; https://clinicaltrials.gov/ct2/show/NCT04263974. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s13063-020-04713-4.
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Affiliation(s)
- Pablo Rodríguez Sánchez-Laulhé
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.,Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, Seville, Spain
| | - Luis Gabriel Luque-Romero
- Research Unit, Distrito Sanitario Aljarafe-Sevilla Norte, Andalusian Health Service, Seville, Spain.,Normal and Pathological Cytology and Histology Department, University of Seville, Seville, Spain
| | | | | | - Jesús Blanquero
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Alejandro Suero-Pineda
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain
| | - Alberto Marcos Heredia-Rizo
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Seville, Spain.,Uncertainty, Mindfulness, Self, Spirituality (UMSS) Research Group, University of Seville, Seville, Spain
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4
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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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Effect of task-oriented training on pain, functionality, and quality of life in rheumatoid arthritis. Turk J Phys Med Rehabil 2022; 68:76-83. [PMID: 35949976 PMCID: PMC9305652 DOI: 10.5606/tftrd.2022.6666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives
The aim of this study was to demonstrate additional effects of task-oriented training (TOT) in patients with rheumatoid arthritis (RA) regarding pain, dexterity, muscle strength, and ability to perform activities of daily living (ADLs) within five weeks.
Patients and methods
Between June 2016 and February 2018, a total of 46 female RA patients (mean age: 51.17±7.9 years; range, 29 to 68 years) who were volunteer for participating in the study were randomized into two groups as follows: conventional exercise group (Group 1) and conventional + TOT group (Group 2). The exercises of Group 1 included passive range of motion (PROM), isometric grip strength exercises, and mobilization of metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints. In Group 2, in addition to conventional exercises, the patients completed an exercise program consisting of washing their faces, using forks, drinking water from a glass, sitting up, and putting on a shirt. Exercises were performed twice a week for a five-week period. Before and after the exercise programs, hand grip strength was assessed with a Jamar hand dynamometer, hand dexterity with Nine Hole Peg Test (NHPT), pain with Visual Analog Scale (VAS), and ADLs with Health Assessment Questionnaire (HAQ) and Duruöz Hand Index (DHI).
Results
There was no significant difference in NHPT and Jamar in both groups (p>0.05). Although a significant decrease was observed within the groups in VAS and HAQ scores before and after the exercise programs in both groups (p<0.05), no significant difference was found between the groups (p>0.05). The DHI showed a significant improvement in Group 2 and a significant difference was observed between the two groups (p<0.05).
Conclusion
This study shows that exercise programs may be beneficial in alleviating pain and performing daily activities. Also, adding task-oriented training to a program may facilitate ADLs in RA patients.
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Chruściak T, Wisłowska M. Assessment of Rheumatoid Hand Function as a Characteristic Feature of Rheumatoid Arthritis in Patients Treated with Methotrexate or Methotrexate with Biological Agents with and without Deformation of Hands. Curr Rheumatol Rev 2022; 18:212-223. [PMID: 35168508 DOI: 10.2174/1573397118666220215092045] [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: 01/18/2021] [Revised: 05/19/2021] [Accepted: 09/20/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The hand is an excellent work tool that provides the functional ability to mechanical work. The hand is affected in rheumatoid arthritis (RA) patients, it is a significant problem in the functional sphere as a result of deformities, the grasping function limitation and muscle strength. OBJECTIVES The aim of the study was the assessment of grip strength, endurance and manipulation abilities of rheumatoid hands with or without deformities treated with methotrexate (MTX) or MTX plus biologics (MTX+BIO). MATERIAL AND METHODS The study involved 80 RA women, (40 received MTX+BIO, 40 MTX), treated at the Rheumatology Department of the Central Clinical Hospital of Interior Affairs in Warsaw. VAS-pain, DAS28, SDAI, HAQ, HAQ hands, estimation of hand grip strength, endurance, manipulation ability were analyzed. RESULTS In group MTX+BIO values of DAS28 (3.7±1.3 vs 4.3±1.2, p=0.019), HAQ (0.72 ± 0.57 vs 1.08± 0.87, p=0.011) and HAQ-hand (0.85±0.65 vs. 1.19±0.68, p=0.024) were statistically lower than in MTX group. Hand deformations recorded in 35 (43.7%) cases, 16 (40%) in MTX group, 19 (47.5%) in MTX+BIO. Comparison of grip strength, endurance, manipulation ability showed better results in MTX+BIO group with deformities (significance level from 0.013 to 0.046) than in MTX group. Relative differences in hand function in MTX + BIO group ranged from 10.8% (maximal power grip strength) to 127.6% (minimal hand endurance), after disease duration adjustment - from 28.2% (maximal power grip strength) to 148.4% (minimal hand endurance). CONCLUSION Measuring grip strength, hand endurance, manipulation abilities are useful in RA patients with hand deformities.
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Affiliation(s)
- Tomasz Chruściak
- Rehabilitation Center, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
| | - Małgorzata Wisłowska
- Internal Disease Department, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland
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Sankar K, Michael Christudhas JC. Influence of aging, disease, exercise, and injury on human hand movements: A systematic review. Proc Inst Mech Eng H 2021; 235:1221-1256. [PMID: 34278839 DOI: 10.1177/09544119211028698] [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: 11/16/2022]
Abstract
The human hand is a versatile organ that performs a variety of activities in daily life. The coordination of digits allows them to deal with objects of various sizes and shapes with an appropriate range of motions (ROM). A systematic literature review was performed to identify the clinical and non-clinical factors which affected the normal ROM, grip strength (GS), and dexterity of hand. The overall outcomes of the systematic review showed that: the performance of the individual declined as the age progressed; the performance of the dominant hand (DH) of an individual was better compared to his/her non-dominant hand (NDH); the tasks performed by a healthy hand was more efficient compared to a diseased one; appropriate rehabilitation programs/exercise techniques after a disease or injury improved the ROM, GS, and dexterity of hand post-surgery on par to a healthy hand.
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Affiliation(s)
- Krishnakumar Sankar
- Department of Biomedical Engineering, Rajalakshmi Engineering College, Thandalam, Chennai, Tamil Nadu, India
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Gerodimos V, Karatrantou K, Kakardaki K, Ioakimidis P. Can maximal handgrip strength and endurance be improved by an 8-week specialized strength training program in older women? A randomized controlled study. HAND SURGERY & REHABILITATION 2020; 40:183-189. [PMID: 33340721 DOI: 10.1016/j.hansur.2020.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/20/2020] [Accepted: 11/26/2020] [Indexed: 11/28/2022]
Abstract
Maximal handgrip strength and endurance are important indicators of upper limb function in older adults. Up to now, there is insufficient information regarding the efficacy of specialized strength training programs for improving handgrip strength. The purpose of this study was to investigate the effectiveness of an 8-week specialized handgrip strength training program on maximal handgrip strength and endurance in healthy older women. A randomized controlled trial was performed. Thirty-six healthy older women (>65 years) were randomly divided into a training group (TG) (n = 18) and a control group (CG) (n = 18). The TG participated in an 8-week specialized handgrip strength training program using rubber balls and hand grippers (2 training sessions/week, 10-15 min, 8-15 repetitions/set, 4-6 total sets/session). Prior to and after the completion of the program, maximal handgrip strength and dynamic endurance (indices: repeated maximal repetitions and percentage change in handgrip strength between first and last 6 repetitions) were assessed in both hands. Repeated measures MANOVA results indicated that maximal handgrip strength (+9.3%-10.4%) and strength values during repeated maximal repetitions (+14% to 27%) significantly increased in TG (p < 0.001), while the percentage change in handgrip strength between the first and last 6 repetitions decreased significantly (-6%) (p < 0.05), irrespective of the tested hand. The results of this study showed that an 8-week specialized handgrip strength training program can be used effectively by athletic trainers, physical and hand therapists to counteract the detrimental effects of the aging process on maximal handgrip strength and endurance in older adults.
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Affiliation(s)
- V Gerodimos
- Department of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - K Karatrantou
- Department of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - K Kakardaki
- Department of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
| | - P Ioakimidis
- Department of Physical Education and Sport Sciences, University of Thessaly, Karies, Trikala 42100, Greece.
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Boniface G, Gandhi V, Norris M, Williamson E, Kirtley S, O’Connell NE. A systematic review exploring the evidence reported to underpin exercise dose in clinical trials of rheumatoid arthritis. Rheumatology (Oxford) 2020; 59:3147-3157. [PMID: 32780816 PMCID: PMC7590408 DOI: 10.1093/rheumatology/keaa150] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 02/06/2020] [Accepted: 03/09/2020] [Indexed: 02/07/2023] Open
Abstract
We aimed to evaluate the evidence reported to underpin exercise dose in randomised controlled trials (RCTs) using strengthening exercise in RA. We searched six different databases between 1 January 2000 and 3 April 2019. We included RCTs, where a main component of the intervention and/or control used strengthening exercise. Evidence sources cited to underpin dose were judged for their quality, consistency and applicability. Thirty-two RCTs were reviewed. Four (12.5%) piloted the intervention without using dose-escalation designs to determine optimal dose-response. Twenty (62.5%) reported no evidence underpinning dose. Where reported, quality, consistency and applicability of the underpinning evidence was a cause for methodological concern. The majority of RCTs did not report the evidence underpinning dose. When reported, the evidence was often not applicable to the clinical population. Frequently, the dose used differed to the dose reported/recommended by the underpinning evidence. Our findings illustrate exercise dose may not be optimised for use with clinical populations prior to evaluation by RCT.
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Affiliation(s)
- Graham Boniface
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), Centre for Rehabilitation Research in Oxford (RRIO), University of Oxford, Oxford
| | - Varsha Gandhi
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), Centre for Rehabilitation Research in Oxford (RRIO), University of Oxford, Oxford
| | - Meriel Norris
- Department of Clinical Sciences, Brunel University London, Uxbridge, UK
| | - Esther Williamson
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), Centre for Rehabilitation Research in Oxford (RRIO), University of Oxford, Oxford
| | - Shona Kirtley
- Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences (NDORMS), Centre for Rehabilitation Research in Oxford (RRIO), University of Oxford, Oxford
| | - Neil E O’Connell
- Department of Clinical Sciences, Brunel University London, Uxbridge, UK
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11
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Rydholm M, Wikström I, Hagel S, Jacobsson LTH, Turesson C. The Relation Between Disease Activity, Patient-Reported Outcomes, and Grip Force Over Time in Early Rheumatoid Arthritis. ACR Open Rheumatol 2019; 1:507-515. [PMID: 31777832 PMCID: PMC6857997 DOI: 10.1002/acr2.11062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/08/2019] [Indexed: 12/28/2022] Open
Abstract
Objective The objective of this study is to identify early predictors of future reduced grip force in patients with rheumatoid arthritis (RA) and to identify early predictors of grip force over time. Methods In a structured follow‐up of an inception cohort of patients with early RA, average grip force values of the dominant hand were evaluated and compared with the expected based on age‐ and sex‐specific reference values. Potential predictors of reduced grip force (less than 50% of expected) at 5 years were examined using logistic regression. Differences in percentage of expected grip force values over the study period and differences in change over time, by baseline disease parameters, were estimated using mixed linear‐effects models. Results Among 200 patients with early RA, 44% had reduced grip force 5 years after diagnosis. Baseline characteristics that predicted reduced grip force at 5 years included high scores for the Health Assessment Questionnaire Disability Index (odds ratio 1.54 per SD; 95% confidence interval 1.13‐2.11), high scores for pain and patient global assessment, and low grip force. C‐reactive protein levels, the erythrocyte sedimentation rate, the 28‐joint Disease Activity Score (DAS28), rheumatoid factor, anti–cyclic citrullinated peptide antibodies, joint counts, and synovitis of individual joints in the dominant upper extremity did not predict reduced grip force. Patients with baseline synovitis of the wrist or metacarpophalangeal joints or patients with a high DAS28 had lower estimated grip force at inclusion but also greater improvement of grip force over time. Conclusion Patient‐reported outcomes predicted reduced grip strength 5 years after diagnosis. This underlines the prognostic importance of disability in early RA. Joint counts and synovitis in individual joints may change rapidly in early RA and appear to be less predictive of long‐term hand function.
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Affiliation(s)
- Maria Rydholm
- Lund University and Skåne University Hospital, Malmö, Sweden
| | | | - Sofia Hagel
- Lund University and Skåne University Hospital, Lund, Sweden
| | - Lennart T H Jacobsson
- Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden, and Lund University, Malmö, Sweden
| | - Carl Turesson
- Lund University and Skåne University Hospital, Malmö, Sweden
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Long-Term Effect of Pulsed Nd:YAG Laser in the Treatment of Children with Juvenile Rheumatoid Arthritis: A Randomized Controlled Trial. Photomed Laser Surg 2018; 36:445-451. [DOI: 10.1089/pho.2018.4444] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Work Ability and Employment in Rheumatoid Arthritis: A Cross-Sectional Study on the Role of Muscle Strength and Lower Extremity Function. Int J Rheumatol 2018; 2018:3756207. [PMID: 30154855 PMCID: PMC6093007 DOI: 10.1155/2018/3756207] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 06/26/2018] [Indexed: 01/06/2023] Open
Abstract
Objective The aim of the present study was to assess the association between muscle strength, lower extremity function, employment status, and work ability in RA patients. Methods One hundred seropositive RA outpatients of working age were included in this cross-sectional study. Employment status was assessed by interview and work ability by the Work Ability Index-Single Item Scale (WAS). Muscle strength was determined using dynamometer measurement of isometric hand grip and knee extensor strength. Lower extremity function was measured using the short physical performance battery (SPPB). Regression models estimate the association between unemployment, work ability and muscle strength, and lower extremity function, controlling for sociodemographic and disease-related factors. Results Forty-one percent of the RA patients were not gainfully employed, and their median work ability had a good WAS value (7.00 [4.00-7.00]). Patients with better knee extensor strength (OR=1.07, 95% CI [1.02-1.12) and better physical performance (OR=1.71, 95% CI [1.18-2.49]) had a significantly better chance of gainful employment. The odds for hand grip strength remained significant when adjusted for sociodemographic (OR=1.5, 95% CI [1.00-1.09]), but not for disease-specific variables. Better hand grip strength (β=0.25, p=0.039) and better knee extensor strength (β=0.45, p=0.001) as well as better lower extremity function (SPPB) (β=0.51, p<0.001) remained significantly associated with work ability following adjustment for sociodemographic and disease-specific variables. Conclusions The association of employment status and work ability with parameters of physical fitness suggests that improvement in muscle strength and lower extremity function may positively influence work ability and employment in individuals with RA.
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Williams MA, Srikesavan C, Heine PJ, Bruce J, Brosseau L, Hoxey‐Thomas N, Lamb SE. Exercise for rheumatoid arthritis of the hand. Cochrane Database Syst Rev 2018; 7:CD003832. [PMID: 30063798 PMCID: PMC6513509 DOI: 10.1002/14651858.cd003832.pub3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Rheumatoid arthritis is an inflammatory polyarthritis that frequently affects the hands and wrists. Hand exercises are prescribed to improve mobility and strength, and thereby hand function. OBJECTIVES To determine the benefits and harms of hand exercise in adults with rheumatoid arthritis. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library), MEDLINE, Embase, CINAHL, AMED, Physiotherapy Evidence Database (PEDro), OTseeker, Web of Science, ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) up to July 2017. SELECTION CRITERIA We considered all randomised or quasi-randomised controlled trials that compared hand exercise with any non-exercise therapy. DATA COLLECTION AND ANALYSIS We used standard methodological procedures as outlined by the Cochrane Musculoskeletal Group. MAIN RESULTS We included seven studies involving 841 people (aged 20 to 94 years) in the review. Most studies used validated diagnostic criteria and involved home programmes.Very low-quality evidence (due to risk of bias and imprecision) from one study indicated uncertainty about whether exercise improves hand function in the short term (< 3 months). On a 0 to 80 points hand function test (higher scores mean better function), the exercise group (n = 11) scored 76.1 points and control group (n = 13) scored 75 points.Moderate-quality evidence (due to risk of bias) from one study indicated that exercise compared to usual care probably slightly improves hand function (mean difference (MD) 4.5, 95% confidence interval (CI) 1.58 to 7.42; n = 449) in the medium term (3 to 11 months) and in the long term (12 months or beyond) (MD 4.3, 95% CI 0.86 to 7.74; n = 438). The absolute change on a 0-to-100 hand function scale (higher scores mean better function) and number needed to treat for an additional beneficial outcome (NNTB) were 5% (95% CI 2% to 7%); 8 (95% CI 5 to 20) and 4% (95% CI 1% to 8%); 9 (95% CI 6 to 27), respectively. A 4% to 5% improvement indicates a minimal clinical benefit.Very low-quality evidence (due to risk of bias and imprecision) from two studies indicated uncertainty about whether exercise compared to no treatment improved pain (MD -27.98, 95% CI -48.93 to -7.03; n = 124) in the short term. The absolute change on a 0-to-100-millimetre scale (higher scores mean more pain) was -28% (95% CI -49% to -7%) and NNTB 2 (95% CI 2 to 11).Moderate-quality evidence (due to risk of bias) from one study indicated that there is probably little or no difference between exercise and usual care on pain in the medium (MD -2.8, 95% CI - 6.96 to 1.36; n = 445) and long term (MD -3.7, 95% CI -8.1 to 0.7; n = 437). On a 0-to-100 scale, the absolute changes were -3% (95% CI -7% to 2%) and -4% (95% CI -8% to 1%), respectively.Very low-quality evidence (due to risk of bias and imprecision) from three studies (n = 141) indicated uncertainty about whether exercise compared to no treatment improved grip strength in the short term. The standardised mean difference for the left hand was 0.44 (95% CI 0.11 to 0.78), re-expressed as 3.5 kg (95% CI 0.87 to 6.1); and for the right hand 0.46 (95% CI 0.13 to 0.8), re-expressed as 4 kg (95% CI 1.13 to 7).High-quality evidence from one study showed that exercise compared to usual care has little or no benefit on mean grip strength (in kg) of both hands in the medium term (MD 1.4, 95% CI -0.27 to 3.07; n = 400), relative change 11% (95% CI -2% to 13%); and in the long term (MD 1.2, 95% CI -0.62 to 3.02; n = 355), relative change 9% (95% CI -5% to 23%).Very low-quality evidence (due to risk of bias and imprecision) from two studies (n = 120) indicated uncertainty about whether exercise compared to no treatment improved pinch strength (in kg) in the short term. The MD and relative change for the left and right hands were 0.51 (95% CI 0.13 to 0.9) and 44% (95% CI 11% to 78%); and 0.82 (95% CI 0.43 to 1.21) and 68% (95% CI 36% to 101%).High-quality evidence from one study showed that exercise compared to usual care has little or no benefit on mean pinch strength of both hands in the medium (MD 0.3, 95% CI -0.14 to 0.74; n = 396) and long term (MD 0.4, 95% CI -0.08 to 0.88; n = 351). The relative changes were 8% (95% CI -4% to 19%) and 10% (95% CI -2% to 22%).No study evaluated the American College of Rheumatology 50 criteria.Moderate-quality evidence (due to risk of bias) from one study indicated that people who also received exercise with strategies for adherence were probably more adherent than those who received routine care alone in the medium term (risk ratio 1.31, 95% CI 1.15 to 1.48; n = 438) and NNTB 6 (95% CI 4 to 10). In the long term, the risk ratio was 1.09 (95% CI 0.93 to 1.28; n = 422).Moderate-quality evidence (due to risk of bias) from one study (n = 246) indicated no adverse events with exercising. The other six studies did not report adverse events. AUTHORS' CONCLUSIONS It is uncertain whether exercise improves hand function or pain in the short term. It probably slightly improves function but has little or no difference on pain in the medium and long term. It is uncertain whether exercise improves grip and pinch strength in the short term, and probably has little or no difference in the medium and long term. The ACR50 response is unknown. People who received exercise with adherence strategies were probably more adherent in the medium term than who did not receive exercise, but with little or no difference in the long term. Hand exercise probably does not lead to adverse events. Future research should consider hand and wrist function as their primary outcome, describe exercise following the TIDieR guidelines, and evaluate behavioural strategies.
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Affiliation(s)
- Mark A Williams
- Oxford Brookes UniversityDepartment of Sport and Health SciencesJack Straws LaneOxfordOxonUKOX3 0FL
| | - Cynthia Srikesavan
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Windmill roadOxfordUKOX3 7LD
| | - Peter J Heine
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Windmill roadOxfordUKOX3 7LD
| | - Julie Bruce
- University of WarwickWarwick Clinical Trials UnitGibbet Hill RdCoventryUKCV4 7AL
| | - Lucie Brosseau
- University of OttawaSchool of Rehabilitation Sciences, Faculty of Health Sciences451 Smyth RoadOttawaONCanadaK1H 8M5
| | - Nicolette Hoxey‐Thomas
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Windmill roadOxfordUKOX3 7LD
| | - Sarah E Lamb
- University of OxfordNuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS)Windmill roadOxfordUKOX3 7LD
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Association Between Smartphone Use and Musculoskeletal Discomfort in Adolescent Students. J Community Health 2018; 42:423-430. [PMID: 27734246 DOI: 10.1007/s10900-016-0271-x] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Despite the substantial increase in the number of adolescent smartphone users, few studies have investigated the behavioural effects of smartphone use on adolescent students as it relates to musculoskeletal discomfort. The purpose of this study was to explore the association between smartphone use and musculoskeletal discomfort in students at a Taiwanese junior college. We hypothesised that the duration of smartphone use would be associated with increased instances of musculoskeletal discomfort in these students. This cross-sectional study employed a convenience sampling method to recruit students from a junior college in southern Taiwan. All the students (n = 315) were asked to answer questionnaires on smartphone use. A descriptive analysis, stepwise regression, and logistic regression were used to examine specific components of smartphone use and their relationship to musculoskeletal discomfort. Nearly half of the participants experienced neck and shoulder discomfort. The stepwise regression results indicated that the number of body parts with discomfort (F = 6.009, p < 0.05) increased with hours spent using ancillary smartphone functions. The logistic regression analysis showed that the students who talked on the phone >3 h/day had a higher risk of upper back discomfort than did those who talked on the phone <1 h/day [odds ratio (OR) = 4.23, p < 0.05]. This study revealed that the relationship between smartphone use and musculoskeletal discomfort is related to the duration of smartphone ancillary function use. Moreover, hours spent talking on the phone was a predictor of upper back discomfort.
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Metwaly EA, Taha NM, El-Wahab Seliem HA, Desoky Sakr M. EFFECTIVENESS OF NON-PHARMACOLOGICAL NURSING INTERVENTION PROGRAM ON FEMALE PATIENTS WITH RHEUMATOID ARTHRITIS. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2017. [DOI: 10.15452/cejnm.2017.08.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Palamar D, Er G, Terlemez R, Ustun I, Can G, Saridogan M. Disease activity, handgrip strengths, and hand dexterity in patients with rheumatoid arthritis. Clin Rheumatol 2017; 36:2201-2208. [DOI: 10.1007/s10067-017-3756-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/11/2017] [Accepted: 07/07/2017] [Indexed: 12/21/2022]
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Weinstock-Zlotnick G, Mehta SP. A structured literature synthesis of wrist outcome measures: An evidence-based approach to determine use among common wrist diagnoses. J Hand Ther 2017; 29:98-110. [PMID: 27264897 DOI: 10.1016/j.jht.2016.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Structured literature synthesis. INTRODUCTION Hand therapists and researchers have numerous options when selecting outcome measures for patients with wrist pathologies. An evidence-based approach to determining which measures are used most often can inform choices. PURPOSE OF THE STUDY To describe how frequently outcome measures are used in recent randomized controlled trials of patients with wrist diagnoses. Identifying assessment design and related International Classification of Functioning, Disability and Health (ICF) domains provides additional consideration for selection. METHODS Systematic PubMed and Cumulative Index to Nursing and Allied Health Literature searches for the time frame between January 2005 and March 2015 captured measures used in randomized controlled trials researching wrist-specific fractures, ligament injuries, nerve injuries, arthritis/arthroplasty, or stress injuries/wrist pain. RESULTS Three most frequent measures used within each diagnostic category are detailed with assessment design described and ICF domain identified. Across diagnoses, grip/pinch strength and Disabilities of Arm, Shoulder and Hand were the most frequently used physical and patient-reported outcome measures, respectively. The Jebsen-Taylor Hand Function Test was the most frequently used performance measure. DISCUSSION AND CONCLUSIONS Consideration of the evidence, ICF domains, wrist diagnoses, and assessment design can help hand therapists select the measure most appropriate for use. LEVEL OF EVIDENCE 2a.
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Affiliation(s)
| | - Saurabh P Mehta
- School of Physical Therapy, Marshall University, Huntington, WV, USA; Department of Orthopedic Surgery, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, USA
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Berner C, Erlacher L, Quittan M, Fenzl KH, Dorner TE. Workability and Muscle Strength in Patients With Seropositive Rheumatoid Arthritis: Survey Study Protocol. JMIR Res Protoc 2017; 6:e36. [PMID: 28254736 PMCID: PMC5355630 DOI: 10.2196/resprot.6449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 12/31/2016] [Accepted: 02/08/2017] [Indexed: 12/21/2022] Open
Abstract
Background Rheumatoid arthritis (RA) and other rheumatic conditions not only fundamentally affect patients’ quality of life and physiological needs but are also negatively associated with work ability. The costs of poor work ability, which, in sum, are more than treatment costs, pose an economic burden to society and patients. Work ability in RA appears to be multifactorial; symptoms such as pain, swelling, and stiffness play a major role, as these directly affect functional disability. Also, RA patients typically suffer from reduced muscle strength. Lower extremity function and grip strengths especially impair their quality of life. However, the role of muscle strength and disease activity as determinants of work ability have not yet been studied. Objective The primary objective of this study is to compare work ability in working-age participants with seropositive RA and with high and low disease activity; the secondary objective is to evaluate the association of muscle strength, functional ability, and frailty with work ability. Methods This monocentric cross-sectional study will be conducted at a rheumatologic outpatient clinic and day hospital with approximately 100 seropositive RA patients aged <65 years. A clinical disease activity index as a measure for rheumatoid disease activity will be assessed during the patients’ routine visits at the clinic. Work ability, frailty, and functional disability will be evaluated with (self-reported) questionnaires as well as with physical tests (Work Ability Index/Score; Health Assessment Questionnaire Disability Index; Survey of Health, Ageing, and Retirement in Europe Frailty Instrument; Short Physical Performance Battery). Muscle strength will be determined with dynamometer measurements of isometric hand grip strength and quadriceps femoris muscle contraction strength. Sleep quality (Medical Outcomes Study Sleep Scale) and sexual functioning as physiological needs will additionally be determined with self-reported questionnaires. Results For this study funding has already been awarded and enrollment has been completed. Data are currently being evaluated. Conclusions This study will evaluate the association of work ability with modifiable parameters such as muscle strength and functional ability. It will provide further insights into work ability in RA and its associated risk factors. Any evidence of association will motivate further research, and the findings might encourage interventions focused specifically on improving muscle strength and lower extremity function to positively affect work ability. Trial Registration ClinicalTrials.gov (NCT02581852); https://clinicaltrials.gov/ct2/show/NCT02581852 (Archived by WebCite at http://www.webcitation.org/6oNcelHtQ)
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Affiliation(s)
- Carolin Berner
- Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum-Süd, Department of Rheumatology and Osteology, Vienna, Austria.,Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Ludwig Erlacher
- Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum-Süd, Department of Rheumatology and Osteology, Vienna, Austria.,Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Michael Quittan
- Kaiser Franz Josef Hospital, Sozialmedizinisches Zentrum-Süd, Department of Physical Medicine and Rehabilitation, Vienna, Austria.,Karl Landsteiner Institute for Remobilisation and Functional Health, Vienna, Austria
| | - Karl Heinrich Fenzl
- Karl Landsteiner Institute for Autoimmune Diseases and Rheumatology, Vienna, Austria
| | - Thomas Ernst Dorner
- Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria
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Mace M, Rinne P, Liardon JL, Uhomoibhi C, Bentley P, Burdet E. Elasticity improves handgrip performance and user experience during visuomotor control. ROYAL SOCIETY OPEN SCIENCE 2017; 4:160961. [PMID: 28386448 PMCID: PMC5367289 DOI: 10.1098/rsos.160961] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 01/17/2017] [Indexed: 06/07/2023]
Abstract
Passive rehabilitation devices, providing motivation and feedback, potentially offer an automated and low-cost therapy method, and can be used as simple human-machine interfaces. Here, we ask whether there is any advantage for a hand-training device to be elastic, as opposed to rigid, in terms of performance and preference. To address this question, we have developed a highly sensitive and portable digital handgrip, promoting independent and repetitive rehabilitation of grasp function based around a novel elastic force and position sensing structure. A usability study was performed on 66 healthy subjects to assess the effect of elastic versus rigid handgrip control during various visuomotor tracking tasks. The results indicate that, for tasks relying either on feedforward or on feedback control, novice users perform significantly better with the elastic handgrip, compared with the rigid equivalent (11% relative improvement, 9-14% mean range; p < 0.01). Furthermore, there was a threefold increase in the number of subjects who preferred elastic compared with rigid handgrip interaction. Our results suggest that device compliance is an important design consideration for grip training devices.
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Affiliation(s)
- Michael Mace
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Paul Rinne
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
- Division of Brain Sciences, Imperial College of Science, Technology and Medicine, London, UK
| | - Jean-Luc Liardon
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
| | - Catherine Uhomoibhi
- Division of Brain Sciences, Imperial College of Science, Technology and Medicine, London, UK
| | - Paul Bentley
- Division of Brain Sciences, Imperial College of Science, Technology and Medicine, London, UK
| | - Etienne Burdet
- Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK
- Robotics Research Centre, School of Mechanical and Aerospace Engineering, Nanyang Technological University (NTU), Singapore
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Hammond A, Prior Y. The effectiveness of home hand exercise programmes in rheumatoid arthritis: a systematic review. Br Med Bull 2016; 119:49-62. [PMID: 27365455 DOI: 10.1093/bmb/ldw024] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) commonly reduces hand function. We systematically reviewed trials to investigate effects of home hand exercise programmes on hand symptoms and function in RA. SOURCES OF DATA We searched: Medline (1946-), AMED, CINAHL, Physiotherapy Evidence Database, OT Seeker, the Cochrane Library, ISI Web of Science from inception to January 2016. AREAS OF AGREEMENT Nineteen trials were evaluated. Only three were randomized controlled trials with a low risk of bias (n = 665). Significant short-term improvements occurred in hand function, pain and grip strength, with long-term improvements in hand and upper limb function and pinch strength. AREAS OF CONTROVERSY Heterogeneity of outcome measures meant meta-analysis was not possible. GROWING POINTS Evaluation of low and moderate risk of bias trials indicated high-intensity home hand exercise programmes led to better short-term outcomes than low-intensity programmes. Such programmes are cost-effective. AREAS TIMELY FOR DEVELOPING RESEARCH Further research is required to evaluate methods of helping people with RA maintain long-term home hand exercise.
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Affiliation(s)
- Alison Hammond
- Centre for Health Sciences Research, University of Salford, Salford, UK
| | - Yeliz Prior
- Centre for Health Sciences Research, University of Salford, Salford, UK
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Bergstra SA, Murgia A, Te Velde AF, Caljouw SR. A systematic review into the effectiveness of hand exercise therapy in the treatment of rheumatoid arthritis. Clin Rheumatol 2014; 33:1539-48. [DOI: 10.1007/s10067-014-2691-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 05/05/2014] [Accepted: 05/23/2014] [Indexed: 11/30/2022]
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