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Tong M, Liu K. A commentary on 'The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials'. Int J Surg 2024; 110:5234-5235. [PMID: 38701497 PMCID: PMC11326080 DOI: 10.1097/js9.0000000000001518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/05/2024]
Affiliation(s)
- Minghao Tong
- The Second Clinical Medical College, Zhejiang Chinese Medical University
| | - Kang Liu
- Department of Osteology, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, People's Republic of China
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2
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Wang X, He W, Huang H, Han J, Wang R, Li H, Long Y, Wang G, Han X. Recent Advances in Hydrogel Technology in Delivering Mesenchymal Stem Cell for Osteoarthritis Therapy. Biomolecules 2024; 14:858. [PMID: 39062572 PMCID: PMC11274544 DOI: 10.3390/biom14070858] [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: 05/28/2024] [Revised: 07/06/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Osteoarthritis (OA), a chronic joint disease affecting over 500 million individuals globally, is characterized by the destruction of articular cartilage and joint inflammation. Conventional treatments are insufficient for repairing damaged joint tissue, necessitating novel therapeutic approaches. Mesenchymal stem cells (MSCs), with their potential for differentiation and self-renewal, hold great promise as a treatment for OA. However, challenges such as MSC viability and apoptosis in the ischemic joint environment hinder their therapeutic effectiveness. Hydrogels with biocompatibility and degradability offer a three-dimensional scaffold that support cell viability and differentiation, making them ideal for MSC delivery in OA treatment. This review discusses the pathological features of OA, the properties of MSCs, the challenges associated with MSC therapy, and methods for hydrogel preparation and functionalization. Furthermore, it highlights the advantages of hydrogel-based MSC delivery systems while providing insights into future research directions and the clinical potential of this approach.
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Affiliation(s)
- Xiangjiang Wang
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Wentao He
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Hao Huang
- Key Laboratory of Optoelectronic Devices and Systems of Ministry of Education and Guangdong Province, Collage of Physics and Optoelectronics Engineering, Shenzhen University, Shenzhen 518060, China;
| | - Jiali Han
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Ruren Wang
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Hongyi Li
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Ying Long
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Guiqing Wang
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
| | - Xianjing Han
- The Affiliated Qingyuan Hospital (Qingyuan People’s Hospital), Guangzhou Medical University, Qingyuan 511518, China; (X.W.); (W.H.); (J.H.); (R.W.); (H.L.); (Y.L.)
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3
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Zheng Q, Han Y, Dong B. A commentary on 'The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials'. Int J Surg 2024; 110:4443-4444. [PMID: 38518077 PMCID: PMC11254275 DOI: 10.1097/js9.0000000000001334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/03/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Qu Zheng
- Acupuncture and Moxibustion Massage College, Liaoning University of Traditional Chinese Medicine
- Acupuncture Biology Key Laboratory of the Education Department of Liaoning Province, Liaoning University of Traditional Chinese Medicine, Liaoning, People’s Republic of China
| | - Yiyan Han
- Acupuncture and Moxibustion Massage College, Liaoning University of Traditional Chinese Medicine
| | - Baoqiang Dong
- Acupuncture and Moxibustion Massage College, Liaoning University of Traditional Chinese Medicine
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4
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Liu C, Jia N, Zhang Y, Yang J. A commentary on 'The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials'. Int J Surg 2024; 110:3110-3111. [PMID: 38445437 DOI: 10.1097/js9.0000000000001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 02/04/2024] [Indexed: 03/07/2024]
Affiliation(s)
| | - Ning Jia
- Department of TCM Rehabilitation, The People's Hospital of Gaoming District of Foshan, Guangdong, People's Republic of China
| | - Yuanyuan Zhang
- Department of Radiology, Renmin Hospital, Hubei University of Medicine, Shiyan City
| | - Jiaen Yang
- Department of TCM Rehabilitation, The People's Hospital of Gaoming District of Foshan, Guangdong, People's Republic of China
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Lei C, Chen H, Zheng S, Pan Q, Xu J, Li Y, Liu Y. The efficacy and safety of hydrotherapy in patients with knee osteoarthritis: a meta-analysis of randomized controlled trials. Int J Surg 2024; 110:1711-1722. [PMID: 38051935 PMCID: PMC10942168 DOI: 10.1097/js9.0000000000000962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 11/20/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Currently, there is poor evidence of the effect of hydrotherapy on patients with knee osteoarthritis (OA). The authors performed a meta-analysis from randomized controlled trials to determine the efficacy and safety of a hydrotherapy program on measures of pain and knee function in individuals living with knee OA. METHODS A literature review included PubMed, EMBASE, Cochrane Library, Science Citation Index, ScienceDirect, and Ovid. Studies evaluating the efficacy of hydrotherapy for knee OA up to August 2023 were included. The research was reported based on the preferred reporting items for systematic reviews and meta-analysis guidelines to ensure the reliability and verity of results. Statistical analysis was performed using Stata/SE version 15.0. RESULTS A total of six randomized controlled trials were included for data extraction and meta-analysis. The present study revealed that there were significant differences between the two groups regarding the pain intensity at 1 week (WMD=-0.429; 95% CI: -0.679 to -0.179; P =0.001), 4 week (WMD=-0.308; 95% CI: -0.587 to -0.030; P =0.030) and 8 week (WMD=-0.724; 95% CI: -1.099 to -0.348, P <0.001). Furthermore, hydrotherapy was associated with improved outcome of the Western Ontario and McMaster Universities Arthritis index at 1 week (WMD=-3.314; 95% CI: -6.484 to -0.145, P =0.040), 4 week (WMD= -3.630; 95% CI: -6.893 to -0.366, P =0.029) and 8 week (WMD=-3.775; 95% CI: -7.315 to -0.235; P =0.037). No serious adverse events were observed in all patients who received hydrotherapy. CONCLUSION Hydrotherapy is efficacious and safe for reducing pain and improving functional status in individuals with knee OA, without increasing the risk of adverse effects.
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Affiliation(s)
| | - Haiting Chen
- Department of Emergency Medical Center, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, People’s Republic of China
| | | | - Qingyun Pan
- Department of Endocrine, The Fifth Hospital of Wuhan, Wuhan
| | - Jing Xu
- Department of Neurorehabilitation Ward 2, Taihe Hospital (Affiliated Hospital of Hubei University of Medical), Shiyan, Hubei
| | - Yuan Li
- Department of General Surgery
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Zhu S, Wang Z, Liang Q, Zhang Y, Li S, Yang L, He C. Chinese guidelines for the rehabilitation treatment of knee osteoarthritis: An CSPMR evidence-based practice guideline. J Evid Based Med 2023; 16:376-393. [PMID: 37743650 DOI: 10.1111/jebm.12555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND Knee osteoarthritis (KOA) is the most common degenerative joint disease in China, causing a huge economic burden on patients, families, and society. Standardized KOA rehabilitation treatment is an important means to prevent and treat the disease and promote the development of high-quality medical services. This guideline is updated on the basis of the 2016 and 2019 editions. METHODS Clinical questions regarding rehabilitation assessment and treatment were selected through clinical questions screening and deconstruction, and multiple rounds of Delphi questionnaire consultation. The International Classification of Functioning, Disability and Health (ICF) was used as the theoretical framework, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to grade the quality of evidence and recommendations. RESULTS The reporting of this guideline followed the standard of Reporting Items for Practice Guidelines in Healthcare (RIGHT). Taking into account patients' preferences and values and the needs of Chinese clinical practice, a total of 11 clinical questions and 28 recommendations were established. The clinical questions were grouped into two categories: KOA assessment (body function, body structure, activity and participation, quality of life, and environmental factors and clinical outcomes assessment, resulting in 9 recommendations) and KOA treatment (health education, therapeutic exercise, therapeutic modalities, occupational therapy, assistive devices, and regenerative rehabilitation approaches, resulting in 19 recommendations). CONCLUSION This is the first evidence-based guideline for KOA rehabilitation in China utilizing the ICF framework. This guideline provides key guidance for developing systematic, standardized, and precise rehabilitation protocols for KOA across various healthcare settings.
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Affiliation(s)
- Siyi Zhu
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Zhuo Wang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Qiu Liang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Yuting Zhang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
| | - Sheyu Li
- Department of Endocrinology and Metabolism and Department of Guideline and Rapid Recommendation, Cochrane China Center, MAGIC China Center, Chinese Evidence-Based Medicine Center, West China Hospital, Sichuan University, Chengdu, China
| | - Lin Yang
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Chengqi He
- Department of Rehabilitation Medicine, West China School of Medicine/West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
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Cao H, Zhou XC, Li H, Wang M, Wu W, Zou J. Exercise for osteoarthritis: A global articles bibliometric analysis from 1975 to 2021. Sci Sports 2023; 38:488-497. [DOI: 10.1016/j.scispo.2022.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
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Wang X, Li X. Regulation of pain neurotransmitters and chondrocytes metabolism mediated by voltage-gated ion channels: A narrative review. Heliyon 2023; 9:e17989. [PMID: 37501995 PMCID: PMC10368852 DOI: 10.1016/j.heliyon.2023.e17989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 05/15/2023] [Accepted: 07/04/2023] [Indexed: 07/29/2023] Open
Abstract
Osteoarthritis (OA) is one of the leading causes of chronic pain and dysfunction. It is essential to comprehend the nature of pain and cartilage degeneration and its influencing factors on OA treatment. Voltage-gated ion channels (VGICs) are essential in chondrocytes and extracellular matrix (ECM) metabolism and regulate the pain neurotransmitters between the cartilage and the central nervous system. This narrative review focused primarily on the effects of VGICs regulating pain neurotransmitters and chondrocytes metabolism, and most studies have focused on voltage-sensitive calcium channels (VSCCs), voltage-gated sodium channels (VGSCs), acid-sensing ion channels (ASICs), voltage-gated potassium channels (VGKCs), voltage-gated chloride channels (VGCCs). Various ion channels coordinate to maintain the intracellular environment's homeostasis and jointly regulate metabolic and pain under normal circumstances. In the OA model, the ion channel transport of chondrocytes is abnormal, and calcium influx is increased, which leads to increased neuronal excitability. The changes in ion channels are strongly associated with the OA disease process and individual OA risk factors. Future studies should explore how VGICs affect the metabolism of chondrocytes and their surrounding tissues, which will help clinicians and pharmacists to develop more effective targeted drugs to alleviate the progression of OA disease.
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Ihrke A. Multimodal Approach to Pain Management in Veterinary Rehabilitation. Vet Clin North Am Small Anim Pract 2023; 53:731-742. [PMID: 37019720 DOI: 10.1016/j.cvsm.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Pain recognition, assessment, and management is a primary focus and an integral part of veterinary rehabilitation. Evidence-based pain mitigation protocols will use both pharmacologic tools and nonpharmacologic methods to create a customized, safe, and effective treatment plan. A multimodal, patient-centered approach will allow for the best outcomes for pain relief and improved quality of life.
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Xu Z, Wang Y, Zhang Y, Lu Y, Wen Y. Efficacy and safety of aquatic exercise in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:330-347. [PMID: 36320162 DOI: 10.1177/02692155221134240] [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: 02/09/2023]
Abstract
OBJECTIVE To examine the efficacy and safety of aquatic exercise for people with knee osteoarthritis. DATA SOURCES PubMed, Web of Science, Embase, CENTRAL, CNKI and WanFang databases were searched from 1966 to September 2022. REVIEW METHODS Randomized controlled trials evaluating aquatic exercise for people with knee osteoarthritis compared with no exercise and land-based exercise were included. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the certainty of evidence. RESULTS Twenty-two studies with 1394 participants were included. Compared with no exercise (13 trials with 746 participants), low-to high-certainty evidence revealed that aquatic exercise yielded significant improvements in patient-reported pain (SMD -0.58, 95% CI -0.82 to -0.33), stiffness (SMD -0.57, 95% CI -1.03 to -0.11) and physical function (SMD -0.35, 95% CI -0.52 to -0.18) immediately postintervention. A sustained effect was observed only for pain at three months postintervention (SMD -0.48, 95% CI -0.91 to -0.06). The confidence intervals demonstrated that the pooled results do not exclude the minimal clinically important differences. There were no significant differences between the effects of aquatic exercise and land-based exercise (13 trials with 648 participants) on pain (SMD -0.12, 95% CI -0.29 to 0.04), stiffness (SMD -0.17, 95% CI -0.49 to 0.16) or physical function (SMD -0.13, 95% CI -0.28 to 0.02). No study reported a serious adverse event in relation to aquatic exercise. CONCLUSION Aquatic exercise provides a short-term clinical benefit that is sustained for at least three months postintervention in terms of pain in people with knee osteoarthritis.
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Affiliation(s)
- Zhen Xu
- Department of Physical Education, 12538Nankai University, Tianjin, China
| | - Yidi Wang
- China Swimming College, 47838Beijing Sport University, Beijing, China
| | - Yue Zhang
- Department of Physical Education, 12474Shanghai Jiao Tong University, Shanghai, China
| | - Yifan Lu
- School of Sports Medicine and Rehabilitation, 47838Beijing Sport University, Beijing, China.,Key Laboratory of Physical Fitness and Exercise, Ministry of Education, 47838Beijing Sport University, Beijing, China
| | - Yuhong Wen
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, 47838Beijing Sport University, Beijing, China.,School of Recreational Sports and Tourism, 47838Beijing Sport University, Beijing, China
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Yao Q, Wu X, Tao C, Gong W, Chen M, Qu M, Zhong Y, He T, Chen S, Xiao G. Osteoarthritis: pathogenic signaling pathways and therapeutic targets. Signal Transduct Target Ther 2023; 8:56. [PMID: 36737426 PMCID: PMC9898571 DOI: 10.1038/s41392-023-01330-w] [Citation(s) in RCA: 267] [Impact Index Per Article: 267.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/06/2023] [Accepted: 01/17/2023] [Indexed: 02/05/2023] Open
Abstract
Osteoarthritis (OA) is a chronic degenerative joint disorder that leads to disability and affects more than 500 million population worldwide. OA was believed to be caused by the wearing and tearing of articular cartilage, but it is now more commonly referred to as a chronic whole-joint disorder that is initiated with biochemical and cellular alterations in the synovial joint tissues, which leads to the histological and structural changes of the joint and ends up with the whole tissue dysfunction. Currently, there is no cure for OA, partly due to a lack of comprehensive understanding of the pathological mechanism of the initiation and progression of the disease. Therefore, a better understanding of pathological signaling pathways and key molecules involved in OA pathogenesis is crucial for therapeutic target design and drug development. In this review, we first summarize the epidemiology of OA, including its prevalence, incidence and burdens, and OA risk factors. We then focus on the roles and regulation of the pathological signaling pathways, such as Wnt/β-catenin, NF-κB, focal adhesion, HIFs, TGFβ/ΒΜP and FGF signaling pathways, and key regulators AMPK, mTOR, and RUNX2 in the onset and development of OA. In addition, the roles of factors associated with OA, including MMPs, ADAMTS/ADAMs, and PRG4, are discussed in detail. Finally, we provide updates on the current clinical therapies and clinical trials of biological treatments and drugs for OA. Research advances in basic knowledge of articular cartilage biology and OA pathogenesis will have a significant impact and translational value in developing OA therapeutic strategies.
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Affiliation(s)
- Qing Yao
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China.
| | - Xiaohao Wu
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Chu Tao
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Weiyuan Gong
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Mingjue Chen
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Minghao Qu
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Yiming Zhong
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Tailin He
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China
| | - Sheng Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Guozhi Xiao
- Department of Biochemistry, School of Medicine, Shenzhen Key Laboratory of Cell Microenvironment, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Southern University of Science and Technology, Shenzhen, 518055, China.
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Duan X, Wei W, Zhou P, Liu X, Yu J, Xu Y, Huang L, Yang S. Effectiveness of aquatic exercise in lower limb osteoarthritis: a meta-analysis of randomized controlled trials. Int J Rehabil Res 2022; 45:126-136. [PMID: 35437296 DOI: 10.1097/mrr.0000000000000527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to evaluate the short-term and follow-up effectiveness of aquatic training on the health status of lower limb osteoarthritis. Randomized controlled trials (RCTs) on related topics were systematically searched in PubMed, Embase, Web of Science, the Cochrane Library, Physiotherapy Evidence Database (PEDro), the China National Knowledge Infrastructure and Wanfang databases from inception to January 2021. RevMan 5.3 was used for statistical analysis, and the standardized mean difference (SMD) was used to present pooled effect sizes. As a result, 19 RCTs (1592 patients) were included. Compared with unsupervised home exercise or usual care (land-based training excluded), aquatic training showed short-term pain relief (SMD, -0.54; 95% CI, -0.81 to -0.28), physical function improvement (SMD, -0.64; 95% CI, -1.00 to -0.28), stiffness reduction (SMD, -0.40; 95% CI, -0.79 to -0.01) and improved function in sport and recreation (SMD, -0.30; 95% CI, -0.59 to -0.02). Analyses restricted to patients with knee osteoarthritis only also confirmed the positive effects of aquatic training on most dimensions excluding physical function. At medium-term follow-ups, improvements in physical function and function in sport and recreation were observed. No significant difference was observed between arms in the above four outcomes at long-term follow-ups. All studies reported no major adverse event with relation to aquatic training, and the minor adverse events were not common. It is concluded that aquatic training likely has short-term benefits on pain, physical function, stiffness and sport ability in lower limb osteoarthritis patients, but these positive effects may not last long.
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Affiliation(s)
| | - Wei Wei
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | | | - Xi Liu
- Department of Rehabilitation
| | | | - Yang Xu
- Department of Rehabilitation
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Restuccia R, Ruggieri D, Magaudda L, Talotta R. The preventive and therapeutic role of physical activity in knee osteoarthritis. Reumatismo 2022; 74. [PMID: 35506320 DOI: 10.4081/reumatismo.2022.1466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/18/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this narrative review is to discuss the results of studies investigating the role of physical activity in knee osteoarthritis (OA). We also formulated two evidence-based exercise programs that could be prescribed to patients with symptomatic knee OA or after joint replacement. The PubMed and Google Scholar databases were searched for articles related to knee OA and physical activity. A total of 86 papers written in English and published from 1957 to 2021 were selected. Adapted physical activity, even at high intensity, does not appear to trigger or exacerbate knee OA; on the contrary, it may prevent obesity or lower limb muscle weakness, both of which are considered predisposing factors for the disease. In patients already diagnosed with knee OA, scientific evidence suggests that both land-based and aquatic activities combining aerobics, strength, and endurance programs are safe and effective. Physical interventions tailored to the patient may also accelerate recovery time after knee arthroplasty. Knee OA is a painful and disabling rheumatic disease that is very common in the elderly population. Pharmacotherapy has a modest effect in controlling disease progression, possibly due to the still limited understanding of OA pathogenesis. Non-pharmacologic interventions, including dietary and lifestyle changes and physical activity, may be more effective and safer than drugs in preventing or treating knee OA.
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Affiliation(s)
- R Restuccia
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina.
| | - D Ruggieri
- Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - L Magaudda
- Postgraduate School of Sports and Physical Exercise Medicine, BIOMORF Department, University of Messina, Italy; Degree Course of Theory and Methods of Preventive and Adapted Physical Activities, BIOMORF Department, University of Messina.
| | - R Talotta
- Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Messina.
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Knee Osteoarthritis Education Interventions in Published Trials Are Typically Unclear, Not Comprehensive Enough, and Lack Robust Development: Ancillary Analysis of a Systematic Review. J Orthop Sports Phys Ther 2022; 52:276-286. [PMID: 34905960 DOI: 10.2519/jospt.2022.10771] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To summarize the content, development, and delivery of education interventions in clinical trials for people with knee osteoarthritis (OA). DESIGN Ancillary analysis of a systematic review. LITERATURE SEARCH MEDLINE, EMBASE, SPORTDiscus, CINAHL, and Web of Science were searched from inception to April 2020. STUDY SELECTION CRITERIA Randomized controlled trials involving patient education for people with knee OA. DATA SYNTHESIS Content of education interventions was matched against a predefined topic list (n = 14) and categorized as accurate and clear, partially accurate/lacks clarity, or not reported. We examined whether education interventions included skill development or stated learning objectives and if they were developed based on theory, previous research, or codesign principles. Delivery methods and mode(s) were also identified. Data were summarized descriptively. RESULTS Thirty-eight education interventions (30 trials) were included. Interventions lacked comprehensiveness (median topics per intervention = 3/14, range = 0-11). Few topics were accurately and clearly described (10%, 13/136). Sixty-one percent (n = 23/38) of interventions targeted skill development, and 34% (n = 13/38) identified learning objectives. Forty-two percent (n = 16/38) were based on theory; 45% (n = 17/38) were based on research for chronic conditions, including 32% (n = 12/38) based on OA. Eleven percent of interventions (n = 4/38) were codesigned. Education was typically facilitated through face-to-face sessions (median = 9, range = 0-55), supplemented with telephone calls and/or written materials. CONCLUSION Education interventions for people with knee OA lacked comprehensiveness plus accurate and clear descriptions of topics covered. Most interventions failed to identify learning objectives and were not based on theory, previous research, or codesign principles. J Orthop Sports Phys Ther 2022;52(5):276-286. Epub 14 Dec 2021. doi:10.2519/jospt.2022.10771.
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Ma J, Chen X, Xin J, Niu X, Liu Z, Zhao Q. Overall treatment effects of aquatic physical therapy in knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res 2022; 17:190. [PMID: 35346294 PMCID: PMC8961922 DOI: 10.1186/s13018-022-03069-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the benefits of aquatic physical therapy as a rehabilitation strategy for knee osteoarthritis patients. Methods Electronic databases systematically searched up to July 2021. Results 580 RCTs were selected. A total of thirteen studies comprising 883 participants were included in the study. For pain, meta-analyses showed that aquatic physical therapy is associated with a significant change in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain (SMD = − 1.09, 95%CI − 1.97, − 0.21, p = 0.02) and visual analog scale (VAS) (SMD = − 0.55, 95%CI − 0.98, − 0.12, p = 0.01). In addition, for physical function, meta-analyses showed that aquatic physical therapy effectively improved WOMAC physical function (SMD = − 0.57, 95%CI − 1.14, − 0.01, p = 0.05). However, our findings showed no significant improvements in symptoms of joints, quality of life (QOL), flexibility, and body composition with knee osteoarthritis. For muscle strength, we found that aquatic physical therapy can only improve knee extension muscle strength (MD = 2.11, 95%CI 0.02, 4.20, p = 0.05). Additionally, for walking ability, we observed that aquatic physical therapy effectively reduced Timed-Up-and-Go Test (TUGT) in a large degree (MD = − 0.89, 95%CI − 1.25, − 0.53, p < 0.05). Conclusions According to the findings reported in the studies analyzed in the review, aquatic physical therapy had a positive effect on the pain, physical function, knee extension muscle strength, and walking ability among people with knee osteoarthritis.
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16
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Backes R, Gauer APM, Jahnel ÉL, Azzi VJB. Women's perception about hydrotherapy in postmenopause: a qualitative study. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Introduction: The transition from reproductive to post-reproductive life is part of the female life cycle that impacts well-being, with menopause as a significant milestone. Regular physical activity should be encouraged to mitigate the symptoms of menopause and prevent age-related problems. Hydrotherapy is one such alternative, since immersion in heated water facilitates exercises that would be difficult to perform on land. Objective: Assess women’s perception about the effect of hydrotherapy on the signs and symptoms of postmenopause. Methods: A qualitative study in which participants underwent 48 hydrotherapy sessions and answered a semistructured interview. Results: The participants were eight women, aged 55.75 ± 8.55 years, menopausal for 8.5 ± 7.98 years, with vasomotor symptoms (100%), mood swings (87.5%), sleep disorders (87.5%), vaginal dryness (62.5%), low sex drive (62.5%) and chronic pain (100%). Conclusion: Women’s perception about the effects of hydrotherapy on the signs and symptoms of postmenopause include less pain and muscle tension, a decline in the signs and symptoms, better quality of life and sexual pleasure, and an improvement in biopsychosocial factors such as anxiety and stress through better social interaction.
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Affiliation(s)
- Raquel Backes
- Universidade do Oeste de Santa Catarina (UNOESC), Brazil
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Backes R, Gauer APM, Jahnel ÉL, Azzi VJB. Percepção de mulheres sobre a fisioterapia aquática na pós-menopausa: um estudo qualitativo. FISIOTERAPIA EM MOVIMENTO 2022. [DOI: 10.1590/fm.2022.356015.0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumo Introdução: A transição da vida reprodutiva para a pós-reprodutiva é considerada um dos ciclos da vida feminina que gera impactos no bem-estar da mulher, sendo a menopausa o marco significativo. A prática regular de atividade física deve ser encorajada para reduzir os sintomas da menopausa e prevenir alterações associadas ao envelhecimento. Assim, a fisioterapia aquática é uma opção de atividade física, pois a imersão em água aquecida possibilita a realização de exercícios que seriam difíceis de serem executados no solo. Objetivo: Evidenciar a percepção de mulheres sobre a fisioterapia aquática nos sinais e sintomas da pós-menopausa. Métodos: Trata-se de um estudo qualitativo, com participantes que realizaram 48 sessões de fisioterapia aquática e responderam a uma entrevista semiestruturada. Resultados: Participaram do estudo oito mulheres, 55,75 ± 8,55 anos, menopausadas há 8,5 ± 7,98 anos, com referência de alterações vasomotoras (100%), do humor (87,5%), do sono (87,5%), secura vaginal (62,5%), diminuição da libido (62,5%) e dor crônica (100%). Conclusão: A percepção das mulheres sobre os efeitos da fisioterapia aquática nos sinais e sintomas da menopausa aponta para uma diminuição do quadro álgico e da tensão muscular, diminuição dos sinais e sintomas da pós-menopausa, melhora da qualidade do sono, bem como do prazer sexual, e melhora nos fatores biopsicossociais como ansiedade e estresse, através da melhora da interação social.
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Affiliation(s)
- Raquel Backes
- Universidade do Oeste de Santa Catarina (UNOESC), Brazil
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18
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Abstract
Coronary artery disease is the leading cause of death in both men and women, yet adequate control of risk factors can largely reduce the incidence and recurrence of cardiac events. In this review, we discuss various life style and pharmacological measures for both the primary and secondary prevention of coronary artery disease. With a clear understanding of management options, health care providers have an excellent opportunity to educate patients and ameliorate a significant burden of morbidity and mortality.
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Affiliation(s)
- Lindsay Short
- Cardiology, University of California, Riverside, School of Medicine of California Riverside School of Medicine, Riverside, California,St Bernadine Medical Center, Cardiology, Internal Medicine, San Bernardino, California
| | - Van T. La
- Cardiology, University of California, Riverside, School of Medicine of California Riverside School of Medicine, Riverside, California,St Bernadine Medical Center, Cardiology, Internal Medicine, San Bernardino, California
| | - Mandira Patel
- Cardiology, University of California, Riverside, School of Medicine of California Riverside School of Medicine, Riverside, California,St Bernadine Medical Center, Cardiology, Internal Medicine, San Bernardino, California
| | - Ramdas G. Pai
- Cardiology, University of California, Riverside, School of Medicine of California Riverside School of Medicine, Riverside, California,St Bernadine Medical Center, Cardiology, Internal Medicine, San Bernardino, California,Address for correspondence Ramdas G. Pai, MD UCR School of MedicineRiversideCalifornia
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Smith JD, Schroeder AN. Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: Physical Therapy vs. Glucocorticoid Injection for Osteoarthritis of the Knee. Am J Phys Med Rehabil 2021; 100:e147-e152. [PMID: 33587453 DOI: 10.1097/phm.0000000000001715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Jeffrey D Smith
- From the Department of Physical Medicine & Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (JDS); and Department of Physical Medicine & Rehabilitation, Mayo Clinic, Minneapolis, Minnesota (ANS)
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20
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Patient education improves pain and function in people with knee osteoarthritis with better effects when combined with exercise therapy: a systematic review. J Physiother 2021; 67:177-189. [PMID: 34158270 DOI: 10.1016/j.jphys.2021.06.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 03/16/2021] [Accepted: 06/07/2021] [Indexed: 12/14/2022] Open
Abstract
QUESTION Is patient education effective as a standalone intervention or combined with other interventions for people with knee osteoarthritis? DESIGN Systematic review of randomised controlled trials. MEDLINE, EMBASE, SPORTDiscus, CINAHL and Web of Science were searched from inception to April 2020. The Cochrane Risk of Bias tool was used for included studies, and Grading of Recommendations, Assessment, Development and Evaluations (GRADE) was used to interpret certainty of results. PARTICIPANTS People with knee osteoarthritis. INTERVENTION Any patient education intervention compared with any non-pharmacological comparator. OUTCOME MEASURES Primary outcomes were self-reported pain and function. RESULTS Twenty-nine trials involving 4,107 participants were included, informing low to very-low certainty evidence. Nineteen of 28 (68%) pooled comparisons were not statistically significant. Patient education was superior to usual care for pain (SMD -0.35, 95% CI -0.56 to -0.14) and function in the short term (-0.31, 95% CI -0.62 to 0.00), but inferior to exercise therapy for pain in the short term (0.77, 95% CI 0.07 to 1.47). Combining patient education with exercise therapy produced superior outcomes compared with patient education alone for pain in the short term (0.44, 95% CI 0.19 to 0.69) and function in the short (0.81, 95% CI 0.54 to 1.08) and medium term (0.39, 95% CI 0.15 to 0.62). When using the Western Ontario and McMaster Universities Osteoarthritis Index for these comparisons, clinically important differences indicated that patient education was inferior to exercise therapy for pain in the short term (MD 1.56, 95% CI 0.14 to 2.98) and the combination of patient education and exercise therapy for function in the short term (8.94, 95% CI 6.05 to 11.82). CONCLUSION Although patient education produced statistically superior short-term pain and function outcomes compared with usual care, differences were small and may not be clinically important. Patient education should not be provided as a standalone treatment and should be combined with exercise therapy to provide statistically superior and clinically important short-term improvements in function compared with education alone. REGISTRATION PROSPERO CRD42019122004.
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21
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Raposo F, Ramos M, Lúcia Cruz A. Effects of exercise on knee osteoarthritis: A systematic review. Musculoskeletal Care 2021; 19:399-435. [PMID: 33666347 DOI: 10.1002/msc.1538] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/13/2021] [Accepted: 01/14/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Knee osteoarthritis is the most common joint disease and a major cause of functional limitation and pain in adults. The aim of this literature review is to review the existing evidence regarding the impact of exercise in people with knee osteoarthritis concerning physical and functional outcomes. The secondary aim is to provide both healthcare professionals and patients with updated and high-quality recommendations for the management of this condition. METHODS A systematic search was performed at Pubmed, Scopus and Web of Science databases, limiting the studies to English, French and Portuguese language, from 2010 to May 2020. Eligible studies were randomized control trials or clinical control trials that compared an intervention consisting of an exercise programme in adult participants with knee osteoarthritis against no intervention. RESULTS A total of 4499 studies were retrieved and 19 articles met the inclusion criteria. Beneficial effects of exercise were found on pain and strength. Regarding function, functional performance and quality of life, evidence is controversial. Both strengthening and aerobic exercise showed positive effects and both aquatic and land-based programmes presented improvement of pain, physical function and quality of life. Relatively to stretching, plyometric and proprioception training, no concrete conclusions can be taken. CONCLUSION Exercise programmes appear to be safe and effective in knee osteoarthritis patients, mainly regarding pain and strength improvement. Pilates, aerobic and strengthening exercise programmes performed for 8-12 weeks, 3-5 sessions per week; each session lasting 1 h appear to be effective. Both aquatic and land-based programmes show comparable and positive effects.
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Affiliation(s)
- Filipe Raposo
- Health Sciences Department, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Marta Ramos
- Health Sciences Department, University of Aveiro (ESSUA), Aveiro, Portugal
| | - Ana Lúcia Cruz
- Health Sciences Department, University of Aveiro (ESSUA), Aveiro, Portugal.,University Hospital of Coimbra, Coimbra, Portugal
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22
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Chung CL, Paquette MR, DiAngelo DJ. Impact of a dynamic ankle orthosis on acute pain and function in patients with mechanical foot and ankle pain. Clin Biomech (Bristol, Avon) 2021; 83:105281. [PMID: 33607504 DOI: 10.1016/j.clinbiomech.2021.105281] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 10/09/2020] [Accepted: 01/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Over two million Americans visit the doctor each year for foot and ankle pain stemming from a degenerative condition or injury. Ankle-foot orthoses can effectively manage symptoms, but traditional designs have limitations. This study investigates the acute impact of a novel "dynamic ankle-foot orthosis" ("orthosis") in populations with mechanical pain (from motion or weight-bearing). METHODS With and without the brace, participants (n = 25) performed standing, over-ground level walking, treadmill level walking, stair ascent, stair descent, single leg hold, squat, and sitting. Instrumented insoles captured in-shoe vertical forces and a visual analog scale was used to assess pain levels during each activity. Subsequently, the self-perceived impact of the orthosis on the patient's symptoms and function was ranked on a scale from -10 (most worsened) to +10 (most improved). FINDINGS Peak in-shoe force was reduced during level and stair walking (P < 0.05). Average perceived pain was 1.2 to 1.6 points lower in the orthosis than the unbraced control for the active tasks. The majority of participants reported that the brace improved their symptoms (n = 19), while a smaller group reported that the brace did not affect their symptoms (n = 5), although average function scores were improved for both groups (+2.4 to +4.5). The group of individuals with improved symptoms included cases of osteoarthritis, tendon dysfunction, chronic pain, sprains, and nerve disorders. INTERPRETATION The orthosis effectively improved pain symptoms and improved the ability of impaired individuals to complete functional activities of daily living such as level walking and stair walking.
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Affiliation(s)
- Chloe L Chung
- Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Max R Paquette
- School of Health Studies, University of Memphis, Memphis, TN, USA
| | - Denis J DiAngelo
- Department of Orthopedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN, USA.
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23
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Immediate Effects of Aquatic Therapy on Balance in Older Adults with Upper Limb Dysfunction: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249434. [PMID: 33339299 PMCID: PMC7766887 DOI: 10.3390/ijerph17249434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 11/29/2020] [Accepted: 12/02/2020] [Indexed: 01/12/2023]
Abstract
Background: Aquatic physiotherapy has been shown to be effective in developing balance, strength, and functional reach over time. When dealing with immediate effects, the literature has concentrated more on the body’s physiological response to the physical and mechanical properties of water during passive immersion. The purpose of this study was to evaluate the effects of a single 45-min active aquatic physiotherapy session on standing balance and strength, and its relationship with functional reach in persons 55 years and older with upper limb dysfunction. Methods: The intervention group (n = 12) was assessed before and after a single aquatic physiotherapy session, while the control group (n = 10) was evaluated before and after 45 min of sitting rest. Functional assessment was made using the visual analogue pain scale (points), step test (repetitions), functional reach test (cm), and global balance-standing test on a force platform (% time). A two-way repeated-measures ANOVA was applied (p < 0.05). Results: The intervention group showed non-significant improvements between measurement before and after the intervention: Pain: 6.2 ± 1.9 vs. 5.2 ± 2.3 cm, steps: 7.0 ± 2.0 vs. 7.4 ± 1.8 repetitions, reach: 9.1 ± 2.8 vs. 10.4 ± 3.8 cm, and balance: 61.7 ± 5.9 vs. 71.3 ± 18.2% time in balance on the platform. The control group showed fewer changes but had better baseline values. A comparison between groups with time showed no significant differences in these changes. Conclusions: No significant immediate effects were found for one session of aquatic physiotherapy applied to patients older than 55 years with upper limb dysfunction.
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24
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Nakata T, Doi A, Uta D, Shin MC, Yoshimura M. Free gait in a shallow pool accelerates recovery after exercise in model mice with fibromyalgia. J Exerc Rehabil 2020; 16:398-409. [PMID: 33178641 PMCID: PMC7609855 DOI: 10.12965/jer.2040672.336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/20/2020] [Indexed: 11/30/2022] Open
Abstract
This study aimed to determine the effect of pool gait exercise using fibromyalgia-induced model mice. The sensory threshold, locomotive behavior, electrocardiogram, and onset time after the gait test in shallow water using male C57BL/6J mice (weight, 30–35 g; n=21) were investigated. To induce fibromyalgia in model mice, reserpine was injected intraperitoneally into wild-type mice once a day for 3 days. Subsequently, the fibromyalgia-induced model mice were randomly classified into two groups as follows: the control group (n=11) and the pool gait group (n=10). The mice in the pool gait group walked in the same cage containing shallow warm water 5 times per week. Both groups underwent sensory thresholds and video recordings to determine locomotive behaviors weekly. Further, both heart rate and video recordings for observation of a recovery after the gait test in shallow water were undertaken (control group; n=5, pool gait group; n=5). The pool gait did not affect sensory thresholds and locomotive behavior; however, in the pool gait group, both the recovery after the test, such as onset time and gait distance, were considerably better than those of the control group. Furthermore, changes in heart rate and heart rate irregularity after the test were more apparent in the control group than in the pool gait group. The free gait in a shallow pool accelerated recovery after exercise, unlike the sensory threshold.
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Affiliation(s)
- Taiki Nakata
- Department of Rehabilitation, Kumamoto-Saiseikai Hospital, Kumamoto, Japan.,Graduate School of Health Science, Kumamoto Health Science University, Kumamoto, Japan
| | - Atsushi Doi
- Graduate School of Health Science, Kumamoto Health Science University, Kumamoto, Japan.,Department of Rehabilitation, Kumamoto Health Science University, Kumamoto, Japan
| | - Daisuke Uta
- Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, University of Toyama, Toyama, Japan
| | - Min-Chul Shin
- Graduate School of Health Science, Kumamoto Health Science University, Kumamoto, Japan.,Department of Rehabilitation, Kumamoto Health Science University, Kumamoto, Japan
| | - Megumu Yoshimura
- Department of Orthopedic Surgery, Nakamura Hospital, Fukuoka, Japan
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25
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Nakata T, Doi A, Uta D, Yoshimura M, Shin MC. Excessive exercise induces cardiac arrhythmia in a young fibromyalgia mouse model. PLoS One 2020; 15:e0239473. [PMID: 32997682 PMCID: PMC7526895 DOI: 10.1371/journal.pone.0239473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/04/2020] [Indexed: 11/18/2022] Open
Abstract
Background Fibromyalgia patients experience cardiovascular complications in addition to musculoskeletal pain. This study aimed to investigate the cardiac effects of a prolonged shallow water gait in a fibromyalgia-induced young mouse model. Methods To produce a fibromyalgia mouse model, wild-type mice were administered an intraperitoneal injection of reserpine once a day for three days, and two primary experiments were performed. First, three types of gait tests were performed before and after the reserpine injections as follows: (i) 5 minutes of free gait outside the water, (ii) 1 minute of free gait in shallow warm water, and (iii) 5 minutes of free gait in shallow warm water. Second, electrocardiogram recordings were taken before and after the three gait tests. The average heart rate and heart rate irregularity scores were analyzed. Results Exercise-induced cardiac arrhythmia was observed at 1-minute gait in shallow water during the acute stage of induced FM in young mice. Further, both cardiac arrhythmia and a decrease in HR have occurred at 5-minute gait in shallow water at the same mice. However, this phenomenon was not observed in the wild-type mice under any test conditions. Conclusion Although a short-term free gait in shallow warm water may be advantageous for increasing the motor activity of FM-model mice, we should be aware of the risk of prolonged and excessive exercise-induced cardiac arrhythmia. For gait exercises in shallow water as a treatment in FM patients. We suggest a gradual increase in exercise duration may be warranted.
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Affiliation(s)
- Taiki Nakata
- Department of Rehabilitation, Kumamoto-Saiseikai Hospital, Kumamoto, Japan
- Graduate school of Health Science, Kumamoto Health Science University, Kumamoto, Japan
| | - Atsushi Doi
- Graduate school of Health Science, Kumamoto Health Science University, Kumamoto, Japan
- Department of Rehabilitation, Kumamoto Health Science University, Kumamoto, Japan
- * E-mail:
| | - Daisuke Uta
- Department of Applied Pharmacology, Faculty of Pharmaceutical Sciences, University of Toyama, Sugitani, Toyama
| | - Megumu Yoshimura
- Department of Orthopedic Surgery, Nakamura Hospital, Fukuoka, Japan
| | - Min-Chul Shin
- Graduate school of Health Science, Kumamoto Health Science University, Kumamoto, Japan
- Department of Rehabilitation, Kumamoto Health Science University, Kumamoto, Japan
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Azizi S, Dadarkhah A, Rezasoltani Z, Raeissadat SA, Mofrad RK, Najafi S. Randomized controlled trial of aquatic exercise for treatment of knee osteoarthritis in elderly people. Interv Med Appl Sci 2020; 11:161-167. [PMCID: PMC9467329 DOI: 10.1556/1646.11.2019.19] [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: 04/30/2019] [Accepted: 06/23/2019] [Indexed: 11/19/2022] Open
Abstract
Aim The aim of this study is to assess the efficacy of aquatic exercise on pain, gait, and balance among elderly patients with knee osteoarthritis. Methods We performed a randomized controlled trial at a university hospital. Overall, 32 men with knee osteoarthritis, aged ≥ 60 years, were included. Pain, balance, and gait were evaluated before and 2 months after interventions. The group control used acetaminophen and followed lifestyle recommendations. The intervention group performed the aquatic exercise three sessions per week for 8 weeks. Results At the end of the study, mean pain scores were significantly different between the groups (p = 0.010). Within-group analyses showed that group intervention experienced significant pain relief (p = 0.019), whereas group control did not show the significant change (p = 0.493). There was significant improvement in favor of aquatic exercise with regard to static (p = 0.001) and dynamic (p = 0.001) balance, step length (p = 0.038), stride length (p < 0.001), and cadence (p < 0.001). However, we did not find a significant difference in step time and width between the two groups. Conclusions Aquatic exercise would be beneficial in decreasing subjective pain of osteoarthritis. There are some recognizable improvements in patients’ gait and balance as well.
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Affiliation(s)
- Sirous Azizi
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Afsaneh Dadarkhah
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zahra Rezasoltani
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Seyed Ahmad Raeissadat
- 2 Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
- 3 Shahid Modarres Hospital, Clinical Research and Development Center, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Reza Kazempoor Mofrad
- 4 Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sharif Najafi
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
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Foo CN, Arumugam M, Lekhraj R, Lye MS, Mohd-Sidik S, Jamil Osman Z. Effectiveness of Health-Led Cognitive Behavioral-Based Group Therapy on Pain, Functional Disability and Psychological Outcomes among Knee Osteoarthritis Patients in Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176179. [PMID: 32858791 PMCID: PMC7503685 DOI: 10.3390/ijerph17176179] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 12/22/2022]
Abstract
Background: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia. Methods: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat. Results: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI −1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing. Conclusion: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.
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Affiliation(s)
- Chai Nien Foo
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43000, Malaysia;
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
- Correspondence: (C.N.F.); (M.A.)
| | - Manohar Arumugam
- Department of Orthopaedic, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
- Correspondence: (C.N.F.); (M.A.)
| | - Rampal Lekhraj
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Munn-Sann Lye
- Department of Population Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Kajang 43000, Malaysia;
| | - Sherina Mohd-Sidik
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia;
| | - Zubaidah Jamil Osman
- Faculty of Allied Health Sciences, Cyberjaya University College of Medical Sciences, Cyberjaya 63000, Malaysia;
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Myers BJ. Isokinetic testing of muscle strength in older adults with knee osteoarthritis: An integrative review. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-201150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Randomized Controlled Trial of Aquatic Cycling for Treatment of Knee Osteoarthritis in Elderly People. TOPICS IN GERIATRIC REHABILITATION 2020. [DOI: 10.1097/tgr.0000000000000264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kittichaikarn C, Kuptniratsaikul V. Design of an Underwater Treadmill System for rehabilitation of older obese adults: a pre-post study. BMC Geriatr 2019; 19:310. [PMID: 31727018 PMCID: PMC6854739 DOI: 10.1186/s12877-019-1334-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/31/2019] [Indexed: 11/10/2022] Open
Abstract
Background Patients with knee osteoarthritis (OA) who are obese have problems performing land-based exercises. The reduced joint stress associated with aquatic exercise may benefit these patients. This study aimed to develop an underwater treadmill (UTM) machine that is affordable and suitable for use in developing countries, and to evaluate its efficacy in decreasing pain and increasing functional improvement. Methods Clinical testing of the UTM machine was performed in an outpatient setting at Siriraj Hospital during January–June 2017. Patients with knee OA, aged 50–85 years, numerical rating scale (NRS) ≥5/10, and body mass index (BMI) ≥25 kg/m 2 were recruited. The UTM exercise protocol was 30 min/session, 3 days/week, for 4 weeks. The main outcomes were NRS pain score, 6-min walk distance (6MWD), quadriceps strength (QS) and body weight. Those outcomes were evaluated at baseline and at week 4. Results The UTM was constructed with safety, ergonomically designed and user-friendly control panel with push button for emergency stopping. Thirty patients were included for clinical testing. The mean age was 62.8 years, and almost all were female. The mean BMI was 28.9 kg/m 2. Most patients (65.0%) developed bilateral knee OA, used pain medication (56.7%), and engaged in regular knee exercise (73.3%). Of the 30 enrolled patients, 6 withdrew. All of the remaining 24 patients attended all 12 sessions. The mean difference between baseline and the end of the study was − 2.3 (95% CI: − 3.0, − 1.5; p < 0.001) for NRS pain; 34.9 m (95% CI: 14.1, 55.8; p = 0.002) for 6MWD; and, 1.8 kg (95% CI, 1.1, 2.6; p < 0.001) for QS. Concerning adverse events, 4 patients (15.4%) developed muscle pain, 2 patients (7.7%) had joint pain, and 1 patient (3.9%) withdrew due to severe knee pain. Two-thirds of patients described themselves as being ‘very satisfied’ with UTM exercise, and approximately 90% of participants rated their symptoms as ‘improved’ or ‘much improved’. Conclusions 4-week exercise with UTM can significantly improve NRS pain, 6MWD, and QS. UTM could be an alternative treatment for patients with knee OA who are obese due to small size, durability, and ecofriendly design as an exercise modality.
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Affiliation(s)
- C Kittichaikarn
- Chawalit Kittichaikarn Department of Mechanical Engineering, Faculty of Engineering, Kasetsart University, 50 Ngam Wong Wan Road, Jatujak, Bangkok, 10900, Thailand
| | - V Kuptniratsaikul
- Vilai Kuptniratsaikul Department of Rehabilitation Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
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Sekome K, Maddocks S. The short-term effects of hydrotherapy on pain and self-perceived functional status in individuals living with osteoarthritis of the knee joint. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2019; 75:476. [PMID: 31392289 PMCID: PMC6676973 DOI: 10.4102/sajp.v75i1.476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 02/28/2019] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND People living with knee osteoarthritis (OA) commonly present with difficulty in walking long distances, ascending and descending stairs or rising from sitting. These functional limitations have been shown to have a negative effect on their overall activities of daily living. OBJECTIVES The aim of this study was to determine the effects of a 4-week hydrotherapy programme on measures of pain and self-perceived functional status in individuals living with knee OA. METHOD A total of 18 participants with chronic knee OA participated in this study. Participants completed 4 weeks of hydrotherapeutic intervention provided by an independent physiotherapist. Outcome measures for the study included pain assessed using the visual analogue scale (VAS) and self-perceived functional status using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Outcome measures were assessed at baseline and after the 4 weeks of intervention. RESULTS The 4-week hydrotherapy programme resulted in a significant decrease in pain and a significant improvement in self-perceived functional status in all participants. There was a statistically significant mean decrease in VAS scores of 3.72 (± 2.45), p ≤ 0.05, with a 95% confidence interval ranging from 2.506 to 4.938. There was also a statistically significant mean decrease in WOMAC scores of 29.5 (± 15.51), p ≤ 0.05. with a 95% confidence interval ranging from 21.788 to 37.212. CONCLUSION This study demonstrated that a 4-week hydrotherapeutic exercise programme results in significantly reduced pain and improved self-perceived functional status in individuals living with knee OA. CLINICAL IMPLICATIONS Four weeks of hydrotherapy exercises twice a week in a heated pool can significantly decrease pain and improve functional status in individuals with knee OA.
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Affiliation(s)
- Kganetso Sekome
- School of Therapeutic Sciences, Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa
| | - Stacey Maddocks
- School of Health Sciences, Department of Physiotherapy, University of KwaZulu-Natal, Durban, South Africa
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Lee MK, Oh JH. The Relationship Between Pain and Physical Function: Mediating Role of Sleep Quality, Depression, and Fatigue. J Gerontol Nurs 2019; 45:46-54. [PMID: 31237661 DOI: 10.3928/00989134-20190612-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 06/06/2019] [Indexed: 11/20/2022]
Abstract
The current study investigated whether osteoarthritis pain was associated with physical function and aimed to identify possible multistep indirect pathways of the association between pain and physical function through sleep quality, depression, and fatigue. Using the survey method, data were collected from 222 adults age ≥65 years diagnosed with osteoarthritis at a senior welfare center in Daejeon, Korea. Data were statistically analyzed using serial multiple mediation analysis. Study findings showed that the relationship between pain and limitation of physical function was partially mediated by sleep quality, depression, and fatigue. The experience of pain among older adults with osteoarthritis directly and most strongly led to limitations in physical functioning, and pain-induced sleep disorders, depression, and fatigue may sequentially negatively affect physical functioning. Thus, pain is a possible fundamental cause of poor, or deterioration in, physical functioning in older adults with osteoarthritis. Therefore, pain assessment and pain management should be prioritized when caring for older adults with osteoarthritis. [Journal of Gerontological Nursing, 45(7), 46-54.].
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Zhang Q, Young L, Li F. Network Meta-Analysis of Various Nonpharmacological Interventions on Pain Relief in Older Adults With Osteoarthritis. Am J Phys Med Rehabil 2019; 98:469-478. [PMID: 31094857 DOI: 10.1097/phm.0000000000001130] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To compare the effectiveness of different nonpharmacological interventions on pain relief in older adults with osteoarthritis, literature databases, bibliographies, and other relevant sources were searched. No language limitations were applied. Thirty-two trials published from 1997 to 2017 were included in the systematic review and network meta-analyses. We included only randomized controlled trials and studies that evaluated the effects of nonpharmacological interventions on alleviating pain in elderly adults (age ≥60 yrs or mean age > 65 yrs) who experience osteoarthritis, irrespective of sex. In the network meta-analysis, resistance training was ranked as the most effective among all nonpharmacological interventions (surface under the cumulative ranking = 82.9%, standardized mean difference = 1.96, confidence interval = -1.39 to 5.31). In subgroup analyses, resistance training still ranked the most effective pain reduction intervention, followed by strengthening exercise and yoga. Among female subjects with intervention adherence rate more than 90%, the most effective intervention was yoga. Strengthening exercise was superior to all other forms of interventions when comparing long-term effect of selected interventions. Among older adults with osteoarthritis, resistance training can be considered a treatment option for pain relief. Yoga is an effective intervention strategy for female elderly, and strengthening exercise has a better long-term beneficial effect.
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Affiliation(s)
- Qi Zhang
- From the School of Nursing, Jilin University, Jilin, China (QZ, FL); and College of Nursing, Augusta University, Augusta, Georgia (LY)
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Chen SC, Ding SB, Xie BC, Tian H, Lu CY. Are aquatic exercises efficacious in postmenopausal women with knee osteoarthritis? A meta-analysis of randomized controlled trials. J Sports Med Phys Fitness 2019; 59:1763-1770. [PMID: 31062542 DOI: 10.23736/s0022-4707.19.09596-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION To assess the effects of aquatic exercise in postmenopausal women with knee osteoarthritis using an up-to-date meta-analysis. EVIDENCE ACQUISITION PubMed, Cochrane Library, Embase, Scopus, Web of Science, Google Scholar, the China National Knowledge Infrastructure (CNKI), the Chinese Biomedical Database (CBM), VIP and Wanfang database were searched systematically for randomized controlled trials (RCTs) published until July 2018. The RCTs included comparing the efficacy of aquatic exercise vs. control in postmenopausal women with knee osteoarthritis, the primary outcomes were assessed by the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and the Knee injury and Osteoarthritis Outcome Score (KOOS). EVIDENCE SYNTHESIS Six RCTs comprising 432 participants. This meta-analysis revealed that aquatic exercise could significantly relieve the symptom of postmenopausal women with knee osteoarthritis. But there was no significant difference between aquatic exercise program and control group for the improvement of pain, stiffness, function outcomes, sport, activities of daily living and quality of life. CONCLUSIONS Contrary to prior reviews, our analysis demonstrated that aquatic exercise has no positive impact on pain physical function, stiffness, activities of daily living, sport and quality of life in elderly women with knee osteoarthritis. However, aquatic exercise could improve the symptoms of knee osteoarthritis. Further investigation is needed because of limited available data.
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Affiliation(s)
- Shi-Chun Chen
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Shao-Bo Ding
- Department of Pharmacy, Dongguan People's Hospital, Dongguan, China
| | - Bao-Cheng Xie
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Hao Tian
- Department of Pharmacology, Guangdong Medical University, Dongguan, China
| | - Cheng-Yu Lu
- Department of Pharmacology, Guangdong Medical University, Dongguan, China -
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Collins NJ, Hart HF, Mills KAG. Osteoarthritis year in review 2018: rehabilitation and outcomes. Osteoarthritis Cartilage 2019; 27:378-391. [PMID: 30529739 DOI: 10.1016/j.joca.2018.11.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/14/2018] [Accepted: 11/29/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Conduct a systematic review of systematic reviews and randomised controlled trials (RCTs) from the past year evaluating rehabilitation for people with osteoarthritis, and provide narrative synthesis of findings focused on core recommended treatments for osteoarthritis (exercise, education, biomechanical interventions, weight loss). DESIGN A comprehensive search strategy was used to search PubMed, EMBASE and Cochrane databases (16th May 2017 to 22nd March 2018). Search terms included 'osteoarthritis', 'rehabilitation', 'systematic review', and 'randomised controlled trial'. Inclusion criteria were: (1) RCT, or systematic review of randomised clinical trials (RCTs); (2) human participants with osteoarthritis (any joint); (3) evaluation of rehabilitation intervention; and (4) at least one patient-reported measure. Methodological quality was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) tool (systematic reviews) and PEDro rating scale (RCTs). Narrative synthesis mapped findings to core recommendations from existing osteoarthritis clinical guidelines. RESULTS From 1994 records, 13 systematic reviews and 36 RCTs were included. 73% of these evaluated knee osteoarthritis (36 studies). The remaining studies evaluated hand osteoarthritis (6 studies), hip, hip/knee and general osteoarthritis (each 2 studies), and neck osteoarthritis (1 study). Exercise was the most common intervention evaluated (31%). Updated recommendations for exercise prescription and preliminary guidance for psychological interventions are provided. CONCLUSION Level 1 and 2 osteoarthritis rehabilitation literature continues to be dominated by knee osteoarthritis studies. Consistent with current clinical guidelines, exercise should be a core treatment for osteoarthritis, but future studies should ensure that exercise programs follow published dose guidelines. There is a clear need for research on rehabilitation for hip, hand, foot/ankle, shoulder and spine osteoarthritis.
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Affiliation(s)
- N J Collins
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia; La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia.
| | - H F Hart
- La Trobe Sport and Exercise Medicine Research Centre, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia; School of Physical Therapy and Bone and Joint Institute, The University of Western Ontario, London, Ontario, Canada
| | - K A G Mills
- Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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Pazzinatto MF, de Oliveira Silva D, Azevedo FMD, Pappas E. Knee crepitus is not associated with the occurrence of total knee replacement in knee osteoarthritis - a longitudinal study with data from the Osteoarthritis Initiative. Braz J Phys Ther 2018; 23:329-336. [PMID: 30292656 DOI: 10.1016/j.bjpt.2018.09.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/13/2018] [Accepted: 09/21/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE(S) To investigate whether the presence of knee crepitus is associated with the occurrence of total knee replacement (TKR), quality of life and deficits in physical function at long-term. METHODS Setting - This observational study uses longitudinal data (up to 4-year follow-up) from the Osteoarthritis Initiative (OAI). Participants - 4566 participants. Main Outcome Measure(s) - Logistic regression models were used to test if baseline knee crepitus is associated with the occurrence of TKR. Linear mixed models with adjustment for confounding variables (age, gender, BMI and Kellgren-Lawrence grade) were used to test the association between baseline knee crepitus and longitudinal changes in the pain, self-reported physical function, quality of life and performance-based function. RESULTS The presence of knee crepitus at baseline does not predict the occurrence of TKR at 36 months (p=0.58 and 0.67 for right and left knees, respectively). The crepitus group presented a slightly knee extension strength decline from baseline to 48 months (p=0.03 for the right and 0.01 for the left knee; between group difference=2% for both right [95%CI=-0.12; -0.01] and left knees [95%CI=-0.13; -0.02]). CONCLUSION The presence of knee crepitus is not associated with the occurrence of TKR in the following three years. Knee crepitus is associated with slightly declines in knee extension strength, but this does not seem to affect physical function and quality of life at long-term.
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Affiliation(s)
- Marcella Ferraz Pazzinatto
- Physical Therapy Department, School of Science and Technology, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Australia
| | - Danilo de Oliveira Silva
- Physical Therapy Department, School of Science and Technology, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil; La Trobe Sports and Exercise Medicine Research Centre (LASEM), School of Allied Health, La Trobe University, Bundoora, Australia
| | - Fábio Mícolis de Azevedo
- Physical Therapy Department, School of Science and Technology, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil.
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
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Tanaka R, Hirohama K, Ozawa J. Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study. Braz J Phys Ther 2018; 23:266-272. [PMID: 30193850 DOI: 10.1016/j.bjpt.2018.08.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 08/07/2018] [Accepted: 08/13/2018] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To verify if the relationship between pain catastrophizing and pain worsening would be mediated by muscle weakness and disability in patients with symptomatic knee osteoarthritis. METHODS This was a cross-sectional study in a hospital out-patient setting. Convenience sampling was used with a total of 50 participants with symptomatic knee osteoarthritis. Pain and the activities of daily livings (ADL) were assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscale. Pain catastrophizing was assessed using the Coping Strategy Questionnaire (CSQ) subscale. Muscle strength of knee extension and 30-s chair stand test (30CST) were also assessed. Path analysis was performed to test the hypothetical model. Goodness of fit of models were assessed by using statistical parameters such as the chi-square value, goodness of fit index (GFI), adjusted goodness of fit index (AGFI), comparative fit index (CFI), and root mean square error of approximation (RMSEA). RESULTS The chi-square values were not significant (chi-square=0.283, p=0.594), and the indices of goodness of fit were high, implying a valid model (GFI=1.000; AGFI=0.997; CFI=1.000; RMSEA=0.000). Pain was influenced significantly by muscle strength and ADL; muscle strength was influenced significantly by ADL via 30CST; ADL was influenced by pain catastrophizing. CONCLUSION The relationship between pain catastrophizing with pain worsening are mediated by muscle weakness and disability.
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Affiliation(s)
- Ryo Tanaka
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima, Japan; Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan.
| | - Kenta Hirohama
- Department of Rehabilitation, Sakamidorii Hospital, Hiroshima, Japan
| | - Junya Ozawa
- Department of Rehabilitation, Hiroshima International University, Hiroshima, Japan
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Liu SC, Hou ZL, Tang QX, Qiao XF, Yang JH, Ji QH. Effect of knee joint function training on joint functional rehabilitation after knee replacement. Medicine (Baltimore) 2018; 97:e11270. [PMID: 29995759 PMCID: PMC6076101 DOI: 10.1097/md.0000000000011270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This retrospective study investigated the effect of knee joint function training (KJFT) on joint functional rehabilitation after knee replacement in Chinese patients with severe knee osteoarthritis (KOA).Eighty-six eligible patients with severe KOA were included. Of those, 43 patients in the intervention group received KJFT and educational program, while the other 43 patients received educational program only. Primary outcome was measured by the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Secondary outcomes were measured by the visual analogue scale (VAS), and Knee Injury and Osteoarthritis Outcome Score (KOOS). All outcomes were assessed at baseline, 1 week before and 3 months after the surgery.Patients in the intervention group showed encouraging benefit neither at 1 week before nor 3 months after the surgery in all outcome measurements, including WOMAC, VAS, and KOOS, when compared with the patients in the control group.The results of this study did not show promising effect of KJFT for joint functional rehabilitation in Chinese patients with KOA after KJR.
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MESH Headings
- Aged
- Arthroplasty, Replacement, Knee/adverse effects
- Arthroplasty, Replacement, Knee/methods
- Arthroplasty, Replacement, Knee/rehabilitation
- Exercise Therapy/methods
- Female
- Humans
- Knee Joint/physiopathology
- Male
- Osteoarthritis, Knee/surgery
- Outcome Assessment, Health Care
- Pain Measurement/methods
- Pain, Postoperative/diagnosis
- Pain, Postoperative/therapy
- Patient Education as Topic
- Quality of Life
- Range of Motion, Articular
- Recovery of Function
- Treatment Outcome
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Affiliation(s)
- Shi-chen Liu
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Zhi-ling Hou
- Department of Emergency Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Qing-xi Tang
- Department of Emergency Surgery, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Xiao-feng Qiao
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University, Jiamusi
| | - Jian-hua Yang
- Department of Orthopedics, Longgang District People's Hospital of Shenzhen, Shenzhen, Guangdong, China
| | - Qing-hui Ji
- First Ward of Orthopedics Department, First Affiliated Hospital of Jiamusi University, Jiamusi
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