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Khoo T, Jani M, Chinoy H. Is there a role for novel supplements in the management of fatigue in rheumatic diseases? RMD Open 2024; 10:e004529. [PMID: 39067868 DOI: 10.1136/rmdopen-2024-004529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Accepted: 07/15/2024] [Indexed: 07/30/2024] Open
Abstract
Fatigue is a common symptom of rheumatic diseases and frequently persists even when patients are in a near-remission state. In seeking options to manage troublesome symptoms such as fatigue, complementary and alternative medicines (CAM) are often used by patients despite a lack of evidence base behind such treatment strategies. CAM use is further promoted by social media and 'influencer' marketing without rigorous process to ensure scientific accuracy. One mechanism of recent interest in the CAM market is enhancing cellular pathways of nicotinamide adenine dinucleotide (NAD+), purported to restore mitochondrial function. However, clinical trials of NAD+ pathway supplements lack rigorous trial design, many declare conflicts of interest, and safety data is limited. Ultimately, CAM use by our patients is unavoidable. To adequately inform patients about CAM, we need to keep updated on both the latest scientific literature and social media trends. In so doing, we can then propose to patients how standard-of-care therapies, evidence-based lifestyle modifications and CAM might safely and effectively integrate to form a treatment plan.
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Affiliation(s)
- Thomas Khoo
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Rheumatology Units, Southern Adelaide Local Health Network and Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Meghna Jani
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, The University of Manchester, Manchester, UK
| | - Hector Chinoy
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
- Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Salford, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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2
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Pourhabibi-Zarandi F, Rafraf M, Zayeni H, Asghari-Jafarabadi M, Ebrahimi AA. The efficacy of curcumin supplementation on serum total antioxidant capacity, malondialdehyde, and disease activity in women with rheumatoid arthritis: A randomized, double-blind, placebo-controlled clinical trial. Phytother Res 2024; 38:3552-3563. [PMID: 38699839 DOI: 10.1002/ptr.8225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 03/22/2024] [Accepted: 04/19/2024] [Indexed: 05/05/2024]
Abstract
Oxidative stress plays a crucial role in the physiopathology of rheumatoid arthritis (RA), which is associated with impaired antioxidant defenses. This study aimed to investigate the effects of curcumin supplementation on serum levels of total antioxidant capacity (TAC), malondialdehyde (MDA), and disease activity in women with RA. In this clinical trial, 48 women with RA were treated with one capsule of curcumin (500 mg daily) or placebo for 8 weeks. Anthropometric measurements and fasting blood samples were collected at baseline and end of the study. Finally, we assessed the Disease Activity Score in 28 joints (DAS-28), dietary intake, and physical activity levels. While curcumin supplementation for 8 weeks significantly increased the serum levels of TAC (p < 0.05), it decreased tender joint counts, swollen joint counts, visual analog scale (VAS) for pain, and DAS-28 compared to the placebo at the end of the study (p < 0.001 for all). MDA levels significantly decreased in the curcumin group (p < 0.05). However, changes in MDA concentration were not significant between groups at the end of the trial (p = 0.145). Curcumin supplementation had a beneficial effect on increasing the serum levels of TAC and decreased DAS-28 in women with RA.
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Affiliation(s)
- Fatemeh Pourhabibi-Zarandi
- Student Research Committee, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Habib Zayeni
- Guilan Rheumatology Research Center, Department of Rheumatology, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Asghari-Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, Victoria, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali-Asghar Ebrahimi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Internal Medicine Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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3
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Santiago-Garcia AP, Gamez-Nava JI, Avalos-Salgado FA, Cerpa-Cruz S, Amaya-Cabrera EL, Gutierrez-Ureña S, Nava-Valdivia CA, Gonzalez-Vazquez S, Arevalo-Simental DE, Gomez-Camarena JJ, Ponce-Guarneros JM, Rodriguez-Jimenez NA, Saldaña-Cruz AM, Cardona-Muñoz EG, Gonzalez-Lopez L. Complementary Therapies and Their Association with Problems in Therapeutic Adherence to Conventional Synthetic DMARDs in Rheumatoid Arthritis: A Cross-Sectional Study. Healthcare (Basel) 2023; 12:49. [PMID: 38200955 PMCID: PMC10779410 DOI: 10.3390/healthcare12010049] [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: 11/16/2023] [Revised: 12/11/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
The use of complementary therapies is highly prevalent among patients with rheumatoid arthritis (RA). Nevertheless, the use of complementary medicine could involve problems in the following of scientifically accepted treatments. To date, there is limited information regarding the association of nonconventional therapies with problems regarding compliance with the treatment. Therefore, the objective of this study was to identify whether the utilization of complementary therapies is associated with a high risk of problems regarding therapeutic adherence to conventional synthetic disease-modifying anti-rheumatic drugs (cs-DMARDs) in RA patients. A survey was performed with RA patients in an outpatient rheumatology clinic in a university hospital; the use of complementary therapies, as well as their type, was identified. To assess problems with therapeutic adherence, we used the four-item Morisky-Green scale. A comprehensive assessment of clinical and therapeutic characteristics was performed. Univariable and multivariable models were performed to identify the risk of problems with therapeutic adherence in users of complementary therapies. In total, 250 RA patients were included; 92% used complementary therapies. Of them, the most frequently used were herbal medicine (65%), homeopathy (64%), and cannabis and its derivatives (51%). In the univariable logistic regression analysis, the factors associated with problems in the therapeutic adherence to cs-DMARDs were age (p = 0.019), the presence of other comorbidities (p = 0.047), and the use of complementary therapies (p = 0.042). After controlling for potential confounders, the use of complementary therapies increased the risk of problems with therapeutic adherence to cs-DMARDs (adjusted OR = 2.84, 95% CI = 1.06-7.63, p = 0.037). We concluded that the use of complementary therapies increases the risk of problems with therapeutic adherence. Therefore, for physicians and healthcare professionals, the early identification of the use of nonconventional therapies in their RA patients is required, followed by a directed discussion with their patients about the risks and benefits to which they could be exposed to complementary therapies.
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Affiliation(s)
- Aline Priscilla Santiago-Garcia
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
| | - Jorge Ivan Gamez-Nava
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Programa de Maestria en Salud Publica, Departamento de Salud Pública, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Felipe Alexis Avalos-Salgado
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
| | - Sergio Cerpa-Cruz
- Departamento de Reumatología, Hospital Civil Fray Antonio Alcalde, Guadalajara 45019, Mexico; (S.C.-C.); (E.L.A.-C.)
| | - Edna Lizeth Amaya-Cabrera
- Departamento de Reumatología, Hospital Civil Fray Antonio Alcalde, Guadalajara 45019, Mexico; (S.C.-C.); (E.L.A.-C.)
| | - Sergio Gutierrez-Ureña
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
| | - Cesar Arturo Nava-Valdivia
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
| | - Sergio Gonzalez-Vazquez
- Hospital General Regional 110 Instituto Mexicano del Seguro Social, Guadalajara 44716, Mexico;
| | - Diana Esperanza Arevalo-Simental
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
| | - Jose Jorge Gomez-Camarena
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
| | - Juan Manuel Ponce-Guarneros
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Norma Alejandra Rodriguez-Jimenez
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Ana Miriam Saldaña-Cruz
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Ernesto German Cardona-Muñoz
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
| | - Laura Gonzalez-Lopez
- Programa de Doctorado en Farmacologia, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico; (A.P.S.-G.); (J.I.G.-N.); (F.A.A.-S.); (S.G.-U.); (D.E.A.-S.); (J.J.G.-C.); (J.M.P.-G.); (N.A.R.-J.); (A.M.S.-C.)
- Research Group for Factors Related to Therapeutic Outcomes in Autoimmune Diseases, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico;
- Programa de Maestria en Salud Publica, Departamento de Salud Pública, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
- Departamento de Fisiología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara 44340, Mexico
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Kocyigit E, Kocak T. Rheumatic diseases and gut microbiota publications in 2002-2022: a Scopus‑based bibliometric analysis. Rheumatol Int 2023; 43:2115-2124. [PMID: 37584699 DOI: 10.1007/s00296-023-05408-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 08/17/2023]
Abstract
Rheumatic diseases (RDs) include a variety of autoimmune disorders defined by severe inflammation, primarily affecting the joints, tendons, ligaments, bones, and muscles. Recent research has revealed the association between rheumatic diseases and gut microbiota, thereby providing insights into the underlying mechanisms of disease pathogenesis. The objective of this study was to evaluate the quantity and quality of scientific research regarding the association between RDs and gut microbiota, as well as to elucidate the characteristics of worldwide research output in this field. The present bibliometric analysis was carried out using the Scopus database, using the keywords "rheumatology," "arthritis," and "gut microbiota." The study involved determining the number of articles, the number of active countries with journals, the identification of prolific authors, and the collection of citation data. Additionally, analyses of trends were conducted. 503 articles in all were reviewed. Collaboration networks were visualized using mapping techniques. The number of articles on RDs and gut microbiota exhibited a consistent pattern from 2002 to 2022 (p < 0.05). The five most productive countries were China (n = 128; 25.45%), the United States (n = 101; 20.07%), Italy (n = 40; 7.95%), the United Kingdom (n = 20; 3.98%), and Japan (n = 17; 3.38%). Israel, Italy, Belgium, and Portugal had the highest values regarding the number of articles per million population. Australia, Canada, and the United Kingdom were the top three countries regarding average citation count. This bibliometric analysis evaluates and synthesizes global scientific output on RDs and gut microbiota. The literature on the association between rheumatic diseases and gut microbiota is growing. Supporting researchers in countries with limited involvement in this field will contribute to its growth.
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Affiliation(s)
- Emine Kocyigit
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Ordu University, 52200, Ordu, Türkiye.
| | - Tevfik Kocak
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gümüşhane University, 29100, Gümüşhane, Türkiye
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Alnaimat F, Alduraidi H, Alhafez L, Abu Raddad L, Haddad BI, Hamdan M, Alajlouni J, Afifi FU. Rates, patterns, and predictors of complementary medicine use among patients with musculoskeletal diseases. PLoS One 2023; 18:e0287337. [PMID: 37352251 PMCID: PMC10289458 DOI: 10.1371/journal.pone.0287337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Accepted: 06/03/2023] [Indexed: 06/25/2023] Open
Abstract
AIM To investigate the extent of complementary medicine (CM) use and the most common therapies utilized by Jordanian patients with musculoskeletal (MSK) diseases. METHODS A semi-structured questionnaire was used to conduct a cross-sectional survey of outpatient orthopedic and rheumatology patients at an academic medical center in Amman, Jordan between January and September 2020. RESULTS A convenience sample of 1001 patients was interviewed (82% females). Pearson's chi-square comparisons showed that nutritional CM was used by 43.4% of patients, while 29.8% used physical CM, and 16% used both. Almost all used the nutritional or physical CM in addition to their prescribed treatment. Nutritional form use was significantly higher among females, older age groups, married people, and those who worked (p < .05). Physical form use was statistically more prevalent in older age groups and those with a higher level of education (p < .05). Family income and urban residence were not significantly associated with the use of either form of CM therapy. Olive oil was the most frequently reported nutritional type (22.9%), and cupping was the most reported physical type (41.6%). Recommendations to use CM came primarily from family members or friends (64% of nutritional CM users and 59% of physical CM users). A physician or pharmacist was cited more frequently with physical CM (24% versus 8% for the nutritional form). In contrast, media sources were cited more for nutritional than physical form (28% versus 7%). Over half of the patients believed they received the desired effect from CM. Surprisingly, only 9.5% of the patients admitted to discussing their CM use with their physician. CONCLUSION CM use is prevalent among Jordanian patients with MSK disorders. Most patients rely on family and friends for recommendations, and they rarely inform their physician of the CM use. Physicians should routinely inquire about CM to provide patients with information regarding their benefits and risks.
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Affiliation(s)
- Fatima Alnaimat
- Division of Rheumatology, Department of Internal Medicine, School of Medicine, University of Jordan, Amman, Jordan
| | - Hamza Alduraidi
- School of Nursing, The University of Jordan, Amman, Jordan
- Aqaba Medical Sciences University, Aqaba, Jordan
| | - Laila Alhafez
- School of Medicine, The University of Jordan, Amman, Jordan
| | | | - Bassem I. Haddad
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Mohammad Hamdan
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Jihad Alajlouni
- Division of Orthopedics, Department of Special Surgery, School of Medicine, University of Jordan, Amman, Jordan
| | - Fatma U. Afifi
- Department of Pharmaceutical Chemistry and Pharmacognosy, Applied Science Private University, Amman, Jordan
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Kocyigit BF, Sagtaganov Z, Yessirkepov M, Akyol A. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome. Rheumatol Int 2023; 43:617-625. [PMID: 36583800 PMCID: PMC9801164 DOI: 10.1007/s00296-022-05267-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/21/2022] [Indexed: 12/31/2022]
Abstract
A wide variety of musculoskeletal, arthritic, connective tissue, and vasculitic diseases fall under the umbrella of "rheumatic diseases". Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the three members of this disease group with relatively high prevalence. Pharmacological options are at the center of therapeutic algorithms in treating rheumatic diseases, particularly in reducing inflammation. Despite significant advances in pharmacological treatment in recent years, achieving complete treatment success in a group of patients is impossible. Therefore, patients with rheumatic diseases frequently utilize alternative treatment options, such as complementary and alternative medicine. Complementary and alternative medicine is a broad category of health practices not part of the leading health system. Patients with rheumatic diseases turn to complementary and alternative medicine for various reasons, including restricted access to some treatments due to high prices and rigorous regulations, worries about drug side effects, and symptoms that continue despite pharmacological treatment. In addition, because complementary and alternative medicine options are considered natural, they are frequently accepted as well tolerated and have few harmful effects. Ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome are the primary foci of this comprehensive review. First, we attempted to summarize the non-traditional physical medicine and complementary and alternative medicine options that can be utilized to manage these diseases. Second, we addressed the link between exercise and inflammation in rheumatic diseases. We briefly discussed the possible benefits of exercise-based approaches. In addition, we highlighted the benefits of cooperation between rheumatology and physical medicine-rehabilitation clinics.
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Affiliation(s)
- Burhan Fatih Kocyigit
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey.
| | - Zhaxybek Sagtaganov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Marlen Yessirkepov
- Department of Biology and Biochemistry, South Kazakhstan Medical Academy, Shymkent, Kazakhstan
| | - Ahmet Akyol
- Physiotherapy and Rehabilitation Application and Research Center, Hasan Kalyoncu University, Gaziantep, Turkey
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Lu PY, Wu HY, Chen LH, Liu CY, Chiou AF. The Effects of Self-Aromatherapy Massage on Pain and Sleep Quality in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial. Pain Manag Nurs 2023:S1524-9042(23)00037-1. [PMID: 36990808 DOI: 10.1016/j.pmn.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 01/24/2023] [Accepted: 02/27/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Rheumatoid arthritis is the most common form of inflammatory arthritis and can lead to pain, joint deformity, and disability, resulting in poor sleep quality and lower quality of life. The efficacy of aromatherapy massage on pain levels and sleep quality among rheumatoid arthritis patients remains unclear. AIMS To investigate the effects of aromatherapy on pain and sleep quality among rheumatoid arthritis patients. METHODS This randomized controlled trial enrolled 102 patients with rheumatoid arthritis from one regional hospital in Taoyuan, Taiwan. Patients were randomly assigned to the intervention (n = 32), placebo (n = 36), or control groups (n = 34). The intervention and placebo groups underwent self-aromatherapy hand massage guided by a self-aromatherapy hand massage manual and video for 10 minutes 3 times a week for 3 weeks. The intervention group used 5% compound essential oils, the placebo group used sweet almond oil, and the control group had no intervention. Pain, sleep quality and sleepiness were measured by using the numerical rating scale for pain, the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale at baseline and at 1, 2, and 3 weeks after the intervention. RESULTS The intervention and placebo groups had significantly decreased sleep quality and sleepiness scores from baseline to 3 weeks after aromatherapy massage. Compared with the control group, the intervention group showed statistically significant improvement in the sleep quality scores in the first weeks after aromatherapy massage (B = -1.19, 95% confidence interval [CI]: -2.35, -0.02, P =.046), but no statistically significant differences were found in the changes in pain levels from baseline to the three time points. CONCLUSIONS Aromatherapy massage is effective in improving sleep quality in rheumatoid arthritis patients. More studies are needed to evaluate the effects of aromatherapy hand massage on the pain levels of rheumatoid arthritis patients.
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Chu ECP, Cheng HY, Huang K, Yao K, Zhao J. Conservative Management of Low Back Pain and Scoliosis in a Patient With Rheumatoid Arthritis: Eight Years Follow-Up. Cureus 2023; 15:e36036. [PMID: 36919112 PMCID: PMC10008232 DOI: 10.7759/cureus.36036] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 03/14/2023] Open
Abstract
Scoliosis in patients with rheumatoid arthritis (RA) can cause significant pain and disability. RA has been extensively studied in relation to the cervical spine, yet the pathology of the thoracic and lumbar spine in RA patients has been largely overlooked. A 66-year-old woman, with longstanding RA and severe scoliosis, presented to the chiropractic clinic with a five-month history of exacerbated low back pain radiating to the right lower limb. The patient was treated with a combination of full-spine mechanical spinal distraction, spinal manipulative therapy, mechanical distraction of the cervical spine, and soft tissue treatment (scraping therapy). Thereafter, the patient recovered from the pain and radiculopathy and showed improvements in the radiological parameters, walking gait, and postural balance. Radiography was performed at the 12-month, four-year, and eight-year follow-up appointments and revealed improvements in symptoms, posture, and scoliosis. Although the treatment for RA-related scoliosis is similar to that for other types of scoliosis, due to the nature of RA, treatment should be tailored to individual patients. This case report highlights the importance of considering chiropractic therapy for the management of lumbar scoliosis in patients with RA, as a comprehensive treatment plan resulted in improved spinal balance, mobility, gait, posture, and quality of life.
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Affiliation(s)
- Eric Chun-Pu Chu
- New York Medical Group (NYMG) Chiropractic Department, EC Healthcare, Hong Kong, HKG
| | - Hay Yeung Cheng
- New York Medical Group (NYMG) Chiropractic Department, EC Healthcare, Hong Kong, HKG
| | - Kevin Huang
- New York Medical Group (NYMG) Chiropractic Department, EC Healthcare, Yuen Long, HKG
| | - Kristy Yao
- New York Medical Group (NYMG) Chiropractic Department, EC Healthcare, Taikoo, HKG
| | - Jason Zhao
- New York Medical Group (NYMG) Chiropractic Department, EC Healthcare, Hong Kong, HKG
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Feng T, Wang X, Jin Z, Qin X, Sun C, Qi B, Zhang Y, Zhu L, Wei X. Effectiveness and safety of manual therapy for knee osteoarthritis: An overview of systematic reviews and meta-analyses. Front Public Health 2023; 11:1081238. [PMID: 36908468 PMCID: PMC9999021 DOI: 10.3389/fpubh.2023.1081238] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/07/2023] [Indexed: 02/26/2023] Open
Abstract
Background Manual therapy has been used as an alternative approach to treat knee osteoarthritis (KOA) for many years. Numerous systematic reviews (SRs) or meta-analyses (MAs) were published to evaluate its effectiveness and safety. Nevertheless, the conclusions of SRs/MAs are inconsistent, and the uneven quality needs to be critically appraised. Objectives To conduct a comprehensive overview of the effectiveness and safety of manual therapy for KOA and the quality of relevant SRs/MAs, thus providing critical evidence and valuable direction for future researchers to promote the generation of advanced evidence. Methods The pre-defined search strategies were applied to eight electronic databases from inception to September 2022. Suitable SRs/MAs were included in accordance with the inclusion and exclusion criteria. The methodological quality, risk of bias, reporting quality, and evidence quality were assessed by two independent reviewers who used respectively the A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), the Risk of Bias in Systematic Reviews (ROBIS), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Version (PRISMA 2020), and Grades of Recommendations, Assessment, Development and Evaluation (GRADE) based on the method of narrative synthesis. We excluded the overlapping randomized controlled trials (RCTs) and performed a re-meta-analysis of the total effective rate. Results A total of eleven relevant SRs/MAs were included: nine SRs/MAs were rated critically low quality, and two were rated low quality by AMSTAR-2. According to ROBIS, all SRs/MAs were rated low risk in Phase 1 (assessing relevance) and Domain 1 (study eligibility criteria) of Phase 2. Three SRs/MAs (27.27%) were rated low risk in Domain 2 (identification and selection of studies). Ten SRs/MAs (90.91%) were rated low risk in Domain 3 (data collection and study appraisal). Five SRs/MAs (45.45%) were rated low risk in Domain 4 (synthesis and findings). And five SRs/MAs (45.45%) were rated low risk in Phase 3 (risk of bias in the review). By PRISMA 2020, there were some reporting deficiencies in the aspects of abstract (2/11, 18.18%), search strategy (0/11, 0%), preprocessing of merging data (0/11, 0%), heterogeneity exploration (6/11, 54.55%), sensitivity analysis (4/11, 36.36%), publication bias (5/11, 45.45%), evidence quality (3/11, 27.27%), the list of excluded references (3/11, 27.27%), protocol and registration (1/11, 9.09%), funding (1/11, 9.09%), conflict of interest (3/11, 27.27%), and approach to relevant information (0/11, 0%). In GRADE, the evidence quality was defined as moderate quality (8 items, 21.05%), low quality (16 items, 42.11%), and critically low quality (14 items, 36.84%). Among the downgraded factors, risk of bias, inconsistency, imprecision, and publication bias were the main factors. A re-meta-analysis revealed that manual therapy can increase the total effective rate in KOA patients (risk ratio = 1.15, 95% confidence interval [1.12, 1.18], p < 0.00001; I2 = 0, p = 0.84). There are four reviews that narratively report adverse effects, and no severe adverse reactions occurred in the manual therapy group. Conclusions Manual therapy may be clinically effective and safe for patients with KOA. However, this conclusion must be interpreted with caution because of the generally unsatisfactory study quality and inconsistent conclusions of the included SRs/MAs. Further rigorous and normative SRs/MAs are expected to be carried out to provide robust evidence for definitive conclusions. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/#myprospero, identifier: CRD42022364672.
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Affiliation(s)
- Tianxiao Feng
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Wang
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Zikai Jin
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaokuan Qin
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chuanrui Sun
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Baoyu Qi
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yili Zhang
- School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Liguo Zhu
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Wei
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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Canbolat Seyman Ç, Ünlü H. The Use of Complementary and Alternative Medicine and Quality of Life in Patients With Hip and Knee Osteoarthritis. Holist Nurs Pract 2022; 36:356-362. [PMID: 33741758 DOI: 10.1097/hnp.0000000000000447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The use of complementary and alternative medicine (CAM) practices was common among patients with osteoarthritis (OA) since the patients experienced severe problems. The aim of this study was to determine the prevalence of CAM use and quality of life in pre-arthroplasty patients. This study was designed as a descriptive, consecutive survey of pre-arthroplasty patients due to hip and knee OA. Data were collected by the Personal Information Form, Western Ontario and McMaster Universities (WOMAC) Index, and EQ-5D-5L quality-of-life scale. Logistic regression was used to determine the risk factors of CAM usage; 74.4% of the patients used CAM methods. The most frequently used methods of CAM were biologically based herbal therapies. All patients indicated that they did not disclose CAM methods they used to their physicians. The median EQ-5D-5L index value of the patients was 0.08 and the median WOMAC score was 96.8. Furthermore, patients with right knee OA were found to have a higher risk of using CAM. This study demonstrated that communication between patients and health care professionals is generally poor, and there is an urgent need to develop patient education to minimize the risks and maximize the benefits of using CAM.
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Affiliation(s)
- Çiğdem Canbolat Seyman
- Department of Surgical Nursing, Faculty of Nursing, Hacettepe University, Ankara, Turkey (Dr. Canbolat Seyman); and Nursing Department, Faculty of Health Science, Alaaddin Keykubat University, Alanya, Antalya, Turkey, and President of Orthopedic and Traumatology Nurses Association, Ankara, Turkey (Dr Ünlü)
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Jo HG, Seo J, Lee D. Clinical evidence construction of East Asian herbal medicine for inflammatory pain in rheumatoid arthritis based on integrative data mining approach. Pharmacol Res 2022; 185:106460. [PMID: 36152738 DOI: 10.1016/j.phrs.2022.106460] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic inflammatory disease that leads to a significant social burden. East Asian herbal medicine (EAHM) has long been used to treat RA. Therefore, a systematic study of how EAHM treatments can be developed into new drugs using specific materials is needed. METHODS Eleven databases containing literature in English, Korean, Chinese, and Japanese were searched for randomized controlled trials comparing EAHM with conventional medicine (CM). A meta-analysis was performed on the variable data to assess their effects on inflammatory pain. Subsequently, we searched for core materials and combinations of core material-based data mining methods. RESULTS A total of 186 trials involving 19,716 patients with RA met the inclusion criteria. According to the meta-analysis, EAHM had a significantly superior effect on continuous pain intensity, tender joint count, and response rate. Patients treated with EAHM had a significantly reduced incidence of adverse events compared with those treated with CM. Based on additional analysis of the EAHM formula data included in this meta-analysis, 21 core materials and five core herbal combinations were identified. CONCLUSION EAHM remedies for RA have the adequate potential for use as candidate materials for treating inflammatory pain in RA. The candidate core herbs evaluated in this study act on multiple pathways and are expected to provide pain relief, sustained inflammation suppression, immune regulation, and prevention of joint destruction. It seems worthwhile to conduct follow-up research on drug development using the core materials derived from this review.
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Affiliation(s)
- Hee-Geun Jo
- BS Healthcare Co., Ltd., 11 Teheran-ro 33-gil, Gangnam-gu, Seoul 06141, Republic of Korea; Allbarun Kyunghee Korean Medicine Clinic, 18, Pungmu-ro 146-gil, Gimpo, Gyeonggi-do, Republic of Korea; Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea.
| | - Jihye Seo
- BS Healthcare Co., Ltd., 11 Teheran-ro 33-gil, Gangnam-gu, Seoul 06141, Republic of Korea; Allbarun Kyunghee Korean Medicine Clinic, 18, Pungmu-ro 146-gil, Gimpo, Gyeonggi-do, Republic of Korea; Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea
| | - Donghun Lee
- BS Healthcare Co., Ltd., 11 Teheran-ro 33-gil, Gangnam-gu, Seoul 06141, Republic of Korea; Allbarun Kyunghee Korean Medicine Clinic, 18, Pungmu-ro 146-gil, Gimpo, Gyeonggi-do, Republic of Korea; Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam 13120, Republic of Korea.
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Complementary and Alternative Medicines Used by Individuals With Rheumatological Diseases to Cope With Sleeplessness. Holist Nurs Pract 2022; 37:45-50. [PMID: 35766827 DOI: 10.1097/hnp.0000000000000523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study aims to determine complementary and alternative medicine methods used by rheumatology patients to cope with insomnia and to evaluate their attitudes toward complementary and alternative medicine methods. This descriptive study was completed with 167 patients followed up by the rheumatology unit of a university hospital. Data were collected with the patient identification form and the Holistic Complementary and Alternative Medicine Questionnaire. The mean age of the participants was 44.76 ± 8.96 years and the mean disease duration was 52.90 ± 35.51 months. Most of the participants (69.5%) were women, with 64.1% primary school graduates. Majority of the participants (96.4%) knew complementary and alternative medicine methods, and the main source of information (51.5%) was the internet and social media. The most frequently applied method was phytotherapy (58.7%), the most frequently used plant (30.5%) was stinging nettle and the mean Holistic Complementary and Alternative Medicine Questionnaire score of the patients was 26.68 ± 3.51. Rheumatology patients frequently use complementary and alternative medicine methods to cope with insomnia symptoms and the most commonly used complementary and alternative medicine method used by patients is phytotherapy.
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Abstract
Background: Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients’ quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids. Methods: In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients’ interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids. Results: Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration > 15 years (OR, 2.98; P = 0.046). Conclusion: Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration > 15 years.
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Jo HG, Song HS, Lee D. Oral administration of East Asian herbal medicine for rheumatoid arthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28819. [PMID: 35147122 PMCID: PMC8830828 DOI: 10.1097/md.0000000000028819] [Citation(s) in RCA: 2] [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] [Received: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, inflammatory, and painful joint disease. The aim of this review is to systematically evaluate the efficacy and safety of oral administration East Asian herbal medicine monotherapy for inflammatory pain of RA, and to explore core herb material information based on collected data. METHODS A comprehensive literature search will be conducted in 11 electronic databases including PubMed, Cochrane Library, Cumulative Index to Nursing & Allied Health Literature, Excerpta Medica database, Korean Studies Information Service System, Research Information Service System Oriental Medicine Advanced Searching Integrated System, Korea Citation Index, Chinese National Knowledge Infrastructure Database, Wanfang data, citation information by NII for randomized controlled trials from their inception until October 13, 2021. Statistical analysis will be performed in the software R version 4.1.1. and R studio program using the default settings of the "meta" and "metafor" package. When heterogeneity in studies is detected, the cause will be identified through subgroup analysis. Methodological quality will be assessed independently using the revised tool for risk of bias in randomized trials (Rob 2.0). RESULTS This study will provide more comprehensive and specific evidence of East Asian herbal medicine monotherapy for RA pain management. CONCLUSIONS Based on the results of this review, it is expected that the efficacy and safety of East Asian herbal medicine for inflammatory pain of RA may be confirmed. In addition, it will be possible to derivation of a core herb material information related to this research topic through additional data mining. ETHICS AND DISSEMINATION There are no ethical issues as there are no primary data collected by directly recruiting subjects. The results of this review will be reported in a peer-reviewed scientific journal. PROSPERO REGISTRATION NUMBER CRD42021273643.
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Affiliation(s)
- Hee-Geun Jo
- Department of Bioinformatics and Statistics, Graduate School of Korea National Open University, 86 Daehak-ro, Jongro-gu, Seoul, Republic of Korea
| | - Ho-Sueb Song
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Gachon University 1342 Seongnamdae-ro, Sujeong-gu, Seongnam, Republic of Korea
| | - Donghun Lee
- Department of Herbal Pharmacology, College of Korean Medicine, Gachon University, 1342 Seongnamdae-ro, Sujeong-gu, Seongnam, Republic of Korea
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Paoloni M, Agostini F, Bernasconi S, Bona G, Cisari C, Fioranelli M, Invernizzi M, Madeo A, Matucci-Cerinic M, Migliore A, Quirino N, Ventura C, Viganò R, Bernetti A. Information Survey on the Use of Complementary and Alternative Medicine. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010125. [PMID: 35056433 PMCID: PMC8781067 DOI: 10.3390/medicina58010125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022]
Abstract
Background and Objectives: Complementary and alternative medicines (CAMs) are generally considered non-scientific and poor effective therapies. Nevertheless, CAMs are extensively used in common clinical practice in Western countries. We decided to promote a Delphi consensus to intercept the opinion of Italian physicians on CAM use in clinical practice. Materials and Methods: We run a Delphi-based consensus, interviewing anonymously 97 physicians. Of these, only 78 participate to the questionnaire. Results: Consensus about agreement and disagreement have been reached in several topics, including indication, as well as safety issues concerning CAMs. Conclusions: The use of CAMs in clinical practice still lacks evidence. Experts agree about the possibility to safely use CAMs in combination with conventional medicines to treat non-critical medical conditions.
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Affiliation(s)
- Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy; (F.A.); (A.B.)
- Correspondence:
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy; (F.A.); (A.B.)
| | - Sergio Bernasconi
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), 43126 Parma, Italy;
| | - Gianni Bona
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (G.B.); (C.C.); (M.I.)
| | - Carlo Cisari
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (G.B.); (C.C.); (M.I.)
| | - Massimo Fioranelli
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Marco Invernizzi
- Department of Health Sciences, University of Piemonte Orientale, 28100 Novara, Italy; (G.B.); (C.C.); (M.I.)
- Translational Medicine, Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Azienda Ospedaliera SS Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Antonello Madeo
- DISTU (Language, History, Philosophy and Law) Department, University of Tuscia, 01100 Viterbo, Italy;
| | - Marco Matucci-Cerinic
- Department of Experimental and Clinical Medicine, Division of Rheumatology AOUC, University of Florence, 50121 Florence, Italy;
| | - Alberto Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, 00189 Rome, Italy;
| | - Nicola Quirino
- Business School, LUISS “Guido Carli” University, 00197 Rome, Italy;
| | - Carlo Ventura
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), School of Medicine, University of Bologna, 40126 Bologna, Italy;
| | - Roberto Viganò
- Azienda Socio-Sanitaria Territoriale Gaetano Pini-CTO, 20122 Milan, Italy;
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, 00185 Rome, Italy; (F.A.); (A.B.)
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Wu Q, Zhao J, Guo W. Efficacy of massage therapy in improving outcomes in knee osteoarthritis: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 46:101522. [PMID: 34890892 DOI: 10.1016/j.ctcp.2021.101522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/14/2021] [Accepted: 11/30/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND and purpose: Massage therapy is being used for knee osteoarthritis. However, level-1 evidence is lacking. This systematic review and meta-analysis aimed to synthesize evidence on the effect of massage therapy on knee osteoarthritis. METHODS PubMed, Embase, Ovid, Springer, and Google Scholar databases were searched up to May 8, 2021 for randomized controlled trials comparing massage with controls for knee osteoarthritis. Review manager was used for a random-effect meta-analysis. Risk of bias was assessed using the Cochrane collaboration risk assessment tool and certainty of evidence using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). RESULTS Twelve studies with 737 participants were included. After 1-4 weeks of therapy, there was a significant reduction in pain and stiffness scores in the massage group and after 6-8 weeks of therapy, there was a significant reduction in stiffness and functionality scores. There was no significant difference in outcomes with long-term therapy. A statistically significant reduction in stiffness scores was seen with aromatherapy massage. Aromatherapy massage was not superior to standard massage. The overall quality of evidence according to GRADE was low to moderate for standard massage therapy and very low for aromatherapy. CONCLUSION Massage therapy may lead to some improvement in pain, stiffness, and functionality scores in the short term but not in long term. Aromatherapy massage was not found to be any better than standard massage therapy. Current evidence is limited by methodological heterogeneity amongst trials and small sample size of the studies.
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Affiliation(s)
- Qiling Wu
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Jie Zhao
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China
| | - Weili Guo
- Department of Nursing, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing, China.
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Caballero-Hernández CI, González-Chávez SA, Urenda-Quezada A, Reyes-Cordero GC, Peláez-Ballestas I, Álvarez-Hernández E, Pacheco-Tena C. Prevalence of complementary and alternative medicine despite limited perceived efficacy in patients with rheumatic diseases in Mexico: Cross-sectional study. PLoS One 2021; 16:e0257319. [PMID: 34582473 PMCID: PMC8478211 DOI: 10.1371/journal.pone.0257319] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/28/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Complementary and alternative medicine (CAM) is frequently used by patients with rheumatic diseases (RD) to improve their symptoms; however, its diversity and availability have increased notably while scientific support for its effectiveness and adverse effects is still scarce. OBJECTIVE To describe the prevalence and diversity of CAM in patients with RD in Chihuahua, Mexico. METHODS A cross-sectional study was conducted in 500 patients with RD who were interviewed about the use of CAM to treat their disease. The interview included sociodemographic aspects, characteristics of the disease, as well as a description of CAM use, including type, frequency of use, perception of the benefit, communication with the rheumatologist, among others. RESULTS The prevalence of CAM use was reported by 59.2% of patients, which informed a total of 155 different therapies. The herbal CAM group was the most used (31.4%) and included more than 50 different therapies. The use of menthol-based and arnica ointments was highly prevalent (35%). Most patients (62.3%) reported very little or no improvement in their symptoms. Only a fourth of the patients informed the rheumatologist of the use of CAM. The use of CAM was influenced by female sex, university degree, diagnosis delay, lack adherence to the rheumatologist's treatment, family history of RD, and orthopedic devices. CONCLUSION The use of CAM in our population is highly prevalent and similar to reports in different populations suggesting a widespread use in many different societies. We found high use of herbal remedies; however, there were many different types suggesting a lack of significant effect. Patients continue using CAM despite a perception of no-effectiveness. Recurrent use of CAM is explained by factors other than its efficacy.
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Affiliation(s)
| | - Susana Aideé González-Chávez
- Facultad de Medicina y Ciencias Biomédicas, Laboratorio PABIOM, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - Adelfia Urenda-Quezada
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, México
| | | | - Ingris Peláez-Ballestas
- Servicio de Reumatología, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
| | | | - César Pacheco-Tena
- Facultad de Medicina y Ciencias Biomédicas, Laboratorio PABIOM, Universidad Autónoma de Chihuahua, Chihuahua, México
- * E-mail:
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Alok S, Nessa S, Tata SS, Begum AS. Will she-won’t she: determinants of complementary and alternative medicines use among female rheumatoid arthritis patients. ADVANCES IN TRADITIONAL MEDICINE 2021. [DOI: 10.1007/s13596-021-00604-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alinaghizadeh M, Hawkins J, Abbassian A, Seif Barghi T, Ayati MH, Alizadeh Vaghasloo M. Effect of Persian acupressure (Ghamz) on Patients with Knee Osteoarthritis: A Single-Blinded Parallel Clinical Trial. Pain Manag Nurs 2021; 22:820-827. [PMID: 34261600 DOI: 10.1016/j.pmn.2021.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 05/16/2021] [Accepted: 06/03/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Many patients choose complementary and alternative medicine (CAM) to treat various conditions. Among osteoarthritis patients, acupressure is a popular CAM treatment. In Iran, Ghamz (a Persian acupressure technique) uses for musculoskeletal ailments like knee pain. AIMS To examine the potential efficacy of Ghamz on osteoarthritis outcomes. DESIGN Clinical Trial. SETTINGS Randomized, single-blind, sham-controlled clinical trial. Participants/Subjects: Eighty patients with diagnosed knee osteoarthritis, age over 35 years old. METHODS Eighty adult patients with confirmed knee osteoarthritis from three outpatient clinics were recruited. Participants were randomly assigned either to intervention or placebo groups using sham acupressure. The primary outcomes included Knee injury and Osteoarthritis Outcome Score (KOOS) parameters and pain scores measured using the visual analog scales (VAS). RESULTS Seventy-two individuals completed the trial and were included in the analysis. At baseline, there was no difference between the mean scores of both outcomes. After the intervention, the group receiving Ghamz therapy experienced an improvement in KOOS parameters, including symptoms, pain, activity daily livings, sport, recreation function, and quality of life. The mean pain score in the intervention group was significantly decreased from 5.89 at the beginning study to 4.11 at the end of the study, while the pain score did not change substantially in the sham group. These findings remained consistent after adjusting for covariates of age, weight, and pre-treatment. CONCLUSIONS This study supports evidence that Ghamz therapy provides an effective option for short-term knee pain relief in patients with knee osteoarthritis. Additional studies are recommended to confirm these findings.
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Affiliation(s)
- Maryam Alinaghizadeh
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jessie Hawkins
- Integrative Health, Franklin School of Integrative Health Sciences, Franklin, Tennessee
| | - Alireza Abbassian
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Tohid Seif Barghi
- Department of Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Hossein Ayati
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Alizadeh Vaghasloo
- Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Bhoi D, Jain D, Garg R, Iyengar KP, Hoda W, Vaishya R, Jain VK. Complementary and Alternative Modalities (CAM) for pain management in musculoskeletal diseases (MSDs). J Clin Orthop Trauma 2021; 18:171-180. [PMID: 34017678 PMCID: PMC8113975 DOI: 10.1016/j.jcot.2021.04.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/16/2021] [Accepted: 04/21/2021] [Indexed: 02/07/2023] Open
Abstract
Musculoskeletal diseases are a group of clinical conditions affecting the body's movement and remain a common source of pain affecting the quality of life. The aetio-pathological reasons for pain associated with musculoskeletal diseases can be varied and complex. Conventional medicine can treat or modify pain due to musculoskeletal diseases; however, these may be associated with some side effects and at times may not be able to relieve pain completely. These treatment modalities also have ceiling effects like doses of analgesics, the number of nerve blocks, etc. Complementary and Alternative Medicine (CAM) provides a supplementary, unconventional modality to alleviate discomfort and disability associated with these mostly chronic conditions to manage activities of daily living. These modalities have been variedly combined with conventional management for symptom control and thus improve day-to-day activities. We assess the role of commonly used CAM modalities in the management of pain arising from Musculoskeletal diseases.
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Affiliation(s)
- Debesh Bhoi
- Department of Anaesthesiology, Pain Medicine and Critical Care, AIIMS, New Delhi, 110029, India
| | - Dhruv Jain
- Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Rakesh Garg
- Department of Onco-Anaesthesiology and Palliative Medicine, Dr BRAIRCH, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Karthikeyan P. Iyengar
- Trauma and Orthopaedic Surgeon, Southport and Ormskirk NHS Trust, Southport, PR8 6PN, UK
| | - Wasimul Hoda
- Department of Superspeciality Anesthesia, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
| | - Vijay Kumar Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
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21
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Wang M, Fu W, Meng L, Liu J, Wu L, Peng Y, Li Z. SWE and SMI ultrasound techniques for monitoring needling treatment of ankylosing spondylitis: study protocol for a single-blinded randomized controlled trial. Trials 2021; 22:385. [PMID: 34099023 PMCID: PMC8182945 DOI: 10.1186/s13063-021-05344-z] [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: 01/13/2021] [Accepted: 05/29/2021] [Indexed: 12/05/2022] Open
Abstract
Background Ankylosing spondylitis (AS) is a high-incidence disease in young men that interferes with patients’ physical and mental wellbeing and overall quality of life (QoL). It is often accompanied by arthralgia, stiffness, and limited lumbar flexibility. Acupuncture is safe and effective for reducing the symptoms of AS, but the underlying mechanisms by which it does so are not fully understood. Therefore, to objectively assess acupuncture efficacy, which is critical for patients making informed decisions about appropriate treatments, we will use shear-wave elastography (SWE) and superb microvascular imaging (SMI) ultrasound techniques to evaluate elasticity of lumbar paraspinal muscles and blood flow to the sacroiliac joint (SIJ) in AS. Methods We will recruit a total of 60 participants diagnosed with AS and 30 healthy subjects. Participants will be randomly allocated 1:1 to either an acupuncture group or a sham control acupuncture group. Primary-outcome measures will be musculoskeletal ultrasound, Ankylosing Spondylitis Quality of Life Scale (ASQoL), Bath Ankylosing Spondylitis Metrology Index (BASMI), and the Visual Analogue Scale (VAS) for pain. Secondary outcome measures will be the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Function Index (BASFI), and Fatigue Scale-14 (FS-14). We will monitor the effect of acupuncture or sham acupuncture on blood flow and SIJ inflammation using SMI, lumbar-muscle stiffness using SWE and the lumbar paraspinal-muscle cross-sectional area (CSA) using a two-dimensional (2D) grayscale imaging. QoL, physical function, and fatigue will be assessed using an evaluation scale or questionnaire developed for this study, with outcomes measured by the ASQoL, BASMI, BASDAI, BASFI, and FS-14. Healthy subjects will not receive acupuncture but undergo only musculoskeletal ultrasound at baseline. Acupuncture and sham control acupuncture interventions will be conducted for 30 min, 2–3 times/week for 12 weeks. Musculoskeletal ultrasound will be conducted at baseline and post-intervention, while other outcomes will be measured at baseline, 6 weeks, and post-intervention. The statistician, outcome assessor, and participants will be blinded to treatment allocation. Discussion The results of this single-blinded, randomized trial with sham controls could help demonstrate the efficacy of acupuncture and clarify whether musculoskeletal ultrasound could be used to evaluate AS. Trial registration ClinicalTrials.gov ChiCTR2000031476. Registered 3 April 2020.
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Affiliation(s)
- Mengyu Wang
- The Second Clinical College of Guangzhou University of Chinese Medicine, 111 Dade Rd, Guangzhou, 510120, Guangdong Province, China
| | - Wen Fu
- The First Affiliated Hospital of Henan University of Chinese Medicine, 19 Renmin Rd, Zhengzhou, 450004, Henan Province, China
| | - Lingcui Meng
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Rd, Guangzhou, 510120, Guangdong Province, China
| | - Jia Liu
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Rd, Guangzhou, 510120, Guangdong Province, China
| | - Lihua Wu
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, 25 Yu'an 2nd Rd, Shenzhen, 518000, Guangdong Province, China
| | - Yingjun Peng
- The Second Clinical College of Guangzhou University of Chinese Medicine, 111 Dade Rd, Guangzhou, 510120, Guangdong Province, China
| | - Ziping Li
- The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, 111 Dade Rd, Guangzhou, 510120, Guangdong Province, China.
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22
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Kwan YH, Fong W, Ang XL, Chew XY, Yoon S, Tan CS, Tai BC, Huang Y, Bilger M, Phang JK, Tan HC, Quek SA, Eng SYC, Tan CT, Dong BQ, Koh HL, Leung YY, Ng SC, Fong KY, Thumboo J, Østbye T. Facilitators of and barriers to implementing a traditional Chinese medicine collaborative model of care for axial spondyloarthritis: a qualitative study. Acupunct Med 2021; 39:629-636. [PMID: 34049443 DOI: 10.1177/09645284211009543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Conventional therapy may be inadequate for many patients with axial spondyloarthritis (axSpA). Traditional Chinese medicine (TCM) may be a viable alternative, but its effectiveness for axSpA is unknown. We are currently conducting a pragmatic randomised controlled trial (RCT) to investigate the effectiveness of a TCM collaborative model of care (TCMCMC), which combines usual rheumatologic care with acupuncture for patients with axSpA. This nested qualitative sub-study aims to identify facilitators of and barriers to the implementation of the TCMCMC. METHODS We conducted individual in-depth interviews with participants who had completed the acupuncture regimen to elicit opinions on the facilitators of and barriers to the implementation of the TCMCMC. The interviews were transcribed and analysed using thematic analysis. RESULTS Twelve participants were included, with data saturation occurring after 10 interviews. The analysis revealed both a number of important 'facilitators' and 'barriers'. Facilitators to the implementation of the TCMCMC included effectiveness of TCM to relieve symptoms, inadequacy of conventional treatment and positive social perceptions of TCM. Barriers included scepticism towards TCM, inability of TCM to provide instant relief, needle-related discomfort, variable effectiveness of TCM influenced by physicians' skills and experience and the high cost of TCM. Recommendations to overcome barriers included further patient education about TCM. CONCLUSION Policymakers should take into account the various feasibility factors identified in this study when developing and implementing a TCMCMC. TRIAL REGISTRATION NUMBER NCT03420404 (ClinicalTrials.gov).
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Systems and Services Research, Duke-NUS Medical School, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - Xiu Yan Chew
- Department of Pharmacy, National University of Singapore, Singapore
| | - Sungwon Yoon
- Program in Health Systems and Services Research, Duke-NUS Medical School, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Youyi Huang
- Internal Medicine Residency, SingHealth, Singapore
| | - Marcel Bilger
- Health Economics and Policy Group, Vienna University of Economics and Business, Vienna, Austria
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Hui Chin Tan
- Singapore Thong Chai Medical Institution, Singapore
| | - Su-An Quek
- Singapore Thong Chai Medical Institution, Singapore
| | | | - Choy Tip Tan
- Singapore Thong Chai Medical Institution, Singapore
| | - Bao Qiang Dong
- Liaoning University of Traditional Chinese Medicine, Shenyang, People's Republic of China
| | - Hwee Ling Koh
- Department of Pharmacy, National University of Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Swee Cheng Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Julian Thumboo
- Program in Health Systems and Services Research, Duke-NUS Medical School, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore
| | - Truls Østbye
- Program in Health Systems and Services Research, Duke-NUS Medical School, Singapore
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23
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Ginnerup-Nielsen E, Christensen R, Heitmann BL, Altman RD, March L, Woolf A, Bliddal H, Henriksen M. Estimating the Prevalence of Knee Pain and the Association between Illness Perception Profiles and Self-Management Strategies in the Frederiksberg Cohort of Elderly Individuals with Knee Pain: A Cross-Sectional Study. J Clin Med 2021; 10:668. [PMID: 33572381 PMCID: PMC7916203 DOI: 10.3390/jcm10040668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 02/01/2021] [Accepted: 02/05/2021] [Indexed: 12/18/2022] Open
Abstract
Knee pain is an early sign of later incident radiographic knee osteoarthritis (OA). However, the prevalence of knee pain in the general population is unknown. Additionally, it is unknown how people with knee pain choose to self-manage the condition and if the perception of the illness affects these choices. In this study, 9086 citizens between 60-69 years old in the municipality of Frederiksberg, Copenhagen, Denmark, were surveyed, of which 4292 responded. The prevalence of knee pain was estimated, and associations between illness perceptions (brief illness perception questionnaire [B-IPQ]), self-management strategies, and knee symptoms were assessed. The prevalence of knee pain was 21.4% of which 40.5% reported to use no self-management strategies (non-users). These non-users perceived their knee pain as less threatening and reported less severe symptoms than users of self-management strategies. Further, we found that a more positive illness perception was associated with less severe knee symptoms. In conclusion, among Danes aged 60-69 years, the knee pain prevalence is 21.4%, of which 40.5% use no treatment and perceive the condition as non-threatening. These non-users with knee pain represent a subpopulation being at increased risk of developing knee OA later in life, and there is a potential preventive gain in identifying these persons.
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Affiliation(s)
- Elisabeth Ginnerup-Nielsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark; (E.G.-N.); (R.C.); (B.L.H.); (H.B.)
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark; (E.G.-N.); (R.C.); (B.L.H.); (H.B.)
- Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, University Hospital, 5000 Odense, Denmark
| | - Berit L Heitmann
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark; (E.G.-N.); (R.C.); (B.L.H.); (H.B.)
- Department of Public Health, Section for General Practice, Copenhagen University, 1014 Copenhagen, Denmark
| | - Roy D. Altman
- Division of Rheumatology and Immunology, University of California, Los Angeles, CA 90095, USA;
| | - Lyn March
- Department of Rheumatology, Royal North Shore Hospital, Institute of Bone and Joint Research, University of Sydney, St Leonards, NSW 2065, Australia;
| | - Anthony Woolf
- Bone and Joint Research Group, Royal Cornwall Hospital, Truro TR1 3HD, UK;
| | - Henning Bliddal
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark; (E.G.-N.); (R.C.); (B.L.H.); (H.B.)
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, 2000 Frederiksberg, Denmark; (E.G.-N.); (R.C.); (B.L.H.); (H.B.)
- Department of Physical and Occupational Therapy, Copenhagen University Hospital, Bispebjerg and Frederiksberg, 2400 Copenhagen, Denmark
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24
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Şentürk S, Efe Arslan D, Çetinkaya A. Association of complementary and integrative therapy use and symptoms among Turkish patients with familial Mediterranean fever. JOURNAL OF INTEGRATIVE MEDICINE-JIM 2021; 19:340-346. [PMID: 33549524 DOI: 10.1016/j.joim.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 12/31/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study explored the correlations between the use of complementary and integrative therapies (CITs) and symptoms among Turkish patients with familial Mediterranean fever (FMF). METHODS This is a cross-sectional and descriptive study. The study was conducted with 1119 FMF patients who were registered to the social networking site for Behcet's and the FMF Patients Association (Befemder) in Turkey, between January 2018 and February 2019. Data were collected using an online survey, for which a three-part questionnaire was created using a Google form. Descriptive statistics, chi-square test and logistic regression analysis were used to analyze the data. RESULTS It was determined that 53.2% of the individuals who participated in the research used various forms of CITs and that 32.8% used vitamin and mineral supplements (calcium, iron, and vitamin B12, C and D), 25.0% used nutritional supplements (fish oil and honey), and 24.6% used oral herbs (ginger, turmeric, green tea and rosemary) and mind-body methods (relaxation, respiration exercise and meditation). It was determined that the percentage of participants that used CITs was higher among women (odds ratio [OR] = 1.825; 95% confidence interval [CI] 1.421-2.344), those with joint pain (OR = 1.385; 95% CI 1.047-1.832), those with difficulty breathing (OR = 1.323; 95% CI 1.031-1.697), those with gastrointestinal symptoms (OR = 1.405; 95% CI 1.089-1.814) and those who had a family member with FMF (OR = 1.437; 95% CI 1.115-1.851). CONCLUSION More than half of the individuals used at least one type of CIT for symptom control.
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Affiliation(s)
- Sibel Şentürk
- Department of Nursing, Bucak Health School, Burdur Mehmet Akif Ersoy University, Burdur 15300, Turkey.
| | - Dilek Efe Arslan
- Department of Medical Services and Techniques, Vocational School of Health Services, Erciyes University, Kayseri 38000, Turkey
| | - Adil Çetinkaya
- Children's Emergency Service, Istanbul Education and Research Hospital, İstanbul 34000, Turkey
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25
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Roberts JA, Mandl LA. Complementary and Alternative Medicine Use in Psoriatic Arthritis Patients: a Review. Curr Rheumatol Rep 2020; 22:81. [DOI: 10.1007/s11926-020-00956-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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26
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Abstract
PURPOSE OF REVIEW Despite advances in pharmacologic management of rheumatoid arthritis (RA), complementary and alternative medicine (CAM) remains popular adjuncts to therapy among patients for ongoing symptomatology. RECENT FINDINGS Mind-body interventions are becoming increasingly popular, including yoga and meditation. Randomized controlled trials have found these interventions to be helpful regarding pain, mood, and energy in RA patients. Other CAM modalities, such as natural products, special diets, acupuncture, and body-based therapies, also continue to be used by RA patients with limited evidence for efficacy and safety. While there are numerous CAM interventions available, the data is very limited at this time with only low-quality evidence supporting various therapies. Medical providers are more open to the addition of CAM in their patients and require increased education on the topic. Additional research needs to be conducted in order to provide evidence-based recommendations to our patients.
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Affiliation(s)
- Sara Baig
- Johns Hopkins University, 5501 Hopkins Bayview Circle/Asthma & Allergy Building, Suite 1B.1, Baltimore, MD, 21224, USA
| | - Dana D DiRenzo
- Johns Hopkins University, 5501 Hopkins Bayview Circle/Asthma & Allergy Building, Suite 1B.1, Baltimore, MD, 21224, USA.
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27
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Hosono S, Fujita K, Nimura A, Akita K. Release of cervical muscular tension improved severe pruritus in moderate-to-severe atopic dermatitis: A case series. JAAD Case Rep 2020; 6:510-513. [PMID: 32490112 PMCID: PMC7256226 DOI: 10.1016/j.jdcr.2020.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Key Words
- AD, atopic dermatitis
- AEC, absolute eosinophil counts
- DLQI, Dermatology Life Quality Index
- EASI, eczema area severity index
- LDH, lactate dehydrogenase
- OMT, osteopathic manipulative treatment
- ROM, range of motion
- TARC, serum thymus and activation-regulated chemokine
- VAS, visual analog scale
- atopic dermatitis
- cervical muscular tension
- complementary and alternative therapy
- pruritus
- sIGA, static Investigator's Global Assessment
- stressor
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Affiliation(s)
- Shusaku Hosono
- Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.,Hosono Clinic, Tokyo, Japan
| | - Koji Fujita
- Department of Orthopaedic and Spinal Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akimoto Nimura
- Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiichi Akita
- Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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28
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Ng CH, Lim GRS, Fong W. Quality of English‐language videos on YouTube as a source of information on systemic lupus erythematosus. Int J Rheum Dis 2020; 23:1636-1644. [DOI: 10.1111/1756-185x.13852] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 03/26/2020] [Accepted: 03/28/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Caitlin Hsuen Ng
- Department of Rheumatology and Immunology Singapore General Hospital Singapore City Singapore
- Yong Loo Lin School of Medicine National University of Singapore Singapore City Singapore
| | - Grace Rui Si Lim
- Department of Rheumatology and Immunology Singapore General Hospital Singapore City Singapore
- Yong Loo Lin School of Medicine National University of Singapore Singapore City Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology Singapore General Hospital Singapore City Singapore
- Yong Loo Lin School of Medicine National University of Singapore Singapore City Singapore
- Duke‐NUS Medical School Singapore City Singapore
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29
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Mineral rich algae with pine bark improved pain, physical function and analgesic use in mild-knee joint osteoarthritis, compared to Glucosamine: A randomized controlled pilot trial. Complement Ther Med 2020; 50:102349. [DOI: 10.1016/j.ctim.2020.102349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/15/2020] [Accepted: 02/17/2020] [Indexed: 12/17/2022] Open
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30
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Sieczkowska SM, Coimbra DR, Vilarino GT, Andrade A. Effects of resistance training on the health-related quality of life of patients with rheumatic diseases: Systematic review with meta-analysis and meta-regression. Semin Arthritis Rheum 2020; 50:342-353. [DOI: 10.1016/j.semarthrit.2019.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/19/2019] [Accepted: 09/09/2019] [Indexed: 12/11/2022]
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31
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Effect of yoga on the quality of life of patients with rheumatic diseases: Systematic review with meta-analysis. Complement Ther Med 2019; 46:9-18. [DOI: 10.1016/j.ctim.2019.07.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 06/16/2019] [Accepted: 07/08/2019] [Indexed: 12/13/2022] Open
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32
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Ginnerup-Nielsen EM, Henriksen M, Christensen R, Heitmann BL, Altman R, March L, Woolf A, Karlsen H, Bliddal H. Prevalence of self-reported knee symptoms and management strategies among elderly individuals from Frederiksberg municipality: protocol for a prospective and pragmatic Danish cohort study. BMJ Open 2019; 9:e028087. [PMID: 31488473 PMCID: PMC6731862 DOI: 10.1136/bmjopen-2018-028087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The Global Burden of Disease 2010 study ranked osteoarthritis (OA) as a leading cause of years lived with disability. With an ageing population, increasing body weight and sedentary lifestyle, a substantial increase especially in knee OA (KOA) is expected. Management strategies for KOA include non-pharmacological, pharmacological and surgical interventions. Meanwhile, over-the-counter pain medications have been discredited as they are associated with several risks with long-term usage. By consequence, the use of exercise and all sorts of complementary and alternative medicine (CAM) for joint pain has increased. The available self-management strategies are plenty, but there is no overview of their use at a population level and whether they are used along with doctors' prescriptions or replace these. The aim of this study is to estimate the population incidence of developing knee symptoms and analyse the association between (and impact of) the use of self-reported preventive measures and knee symptoms. METHODS AND ANALYSIS This prospective cohort study pragmatically recruits individuals from the municipality of Frederiksberg, Denmark. All citizens aged 60-69 years old will be contacted annually for 10 years and asked to participate in a web-based survey. The major outcomes are self-reported knee symptoms and their association with use of various management strategies, including use of non-pharmacological treatments and CAM. Secondary outcomes include the influence of treatments on use of healthcare system and surgical procedures. Descriptive and analytic statistics (eg, logistic regression) will be used to provide summaries about the sample and observations made and the associations between self-management and development of knee symptoms. ETHICS AND DISSEMINATION This study can be implemented without permission from the Health Research Ethics Committee. Permission has been obtained from the Danish Data Protection Agency. Study findings will be disseminated in peer-reviewed journals and presented at relevant conferences. TRIAL REGISTRATION NUMBER NCT03472300.
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Affiliation(s)
| | - Marius Henriksen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Physical and Occupational Therapy, Copenhagen University Hospital Bispebjerg-Frederiksberg, Copenhagen, Denmark
| | - Robin Christensen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Rheumatology, Odense University Hospital, Odense, Denmark
| | - Berit Lilienthal Heitmann
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
- Department of Public Health, Section for General Practice, Copenhagen University, Copenhagen, Denmark
| | - Roy Altman
- Division of Rheumatology and Immunology, University of California, Los Angeles, California, USA
| | - Lyn March
- Department of Rheumatology, Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony Woolf
- Bone and Joint Research Group, Royal Cornwall Hospital, Truro, UK
| | - Hanne Karlsen
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Henning Bliddal
- The Parker Institute, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
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33
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Bodkhe R, Balakrishnan B, Taneja V. The role of microbiome in rheumatoid arthritis treatment. Ther Adv Musculoskelet Dis 2019; 11:1759720X19844632. [PMID: 31431810 PMCID: PMC6685117 DOI: 10.1177/1759720x19844632] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 03/25/2019] [Indexed: 12/15/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder with multifactorial etiology; both genetic and environmental factors are known to be involved in pathogenesis. Treatment with disease-modifying antirheumatic drugs (DMARDs) plays an essential role in controlling disease progression and symptoms. DMARDs have immunomodulatory properties and suppress immune response by interfering in various pro-inflammatory pathways. Recent evidence has shown that the gut microbiota directly and indirectly modulates the host immune system. RA has been associated with dysbiosis of the gut microbiota. Patients with RA treated with DMARDs show partial restoration of eubiotic gut microbiome. Hence, it is essential to understand the impact of DMARDs on the microbial composition and its consequent influences on the host immune system to identify novel therapies for RA. In this review, we discuss the importance of antirheumatic-drug-induced host microbiota modulations and possible probiotics that can generate eubiosis.
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Affiliation(s)
- Rahul Bodkhe
- Department of Immunology, Mayo Clinic, Rochester, MN, USA
| | | | - Veena Taneja
- Department of Immunology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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34
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Kwan YH, Fong W, Ang XL, Tan CS, Tai BC, Huang Y, Bilger M, Phang JK, Tan HC, Lee JV, Sun L, Tan CT, Dong BQ, Koh HL, Leung YY, Lui NL, Yeo SI, Ng SC, Fong KY, Thumboo J, Østbye T. Traditional Chinese medicine (TCM) collaborative care for patients with axial spondyloarthritis (AcuSpA): protocol for a pragmatic randomized controlled trial. Trials 2019; 20:46. [PMID: 30642381 PMCID: PMC6332567 DOI: 10.1186/s13063-018-3117-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 12/08/2018] [Indexed: 11/24/2022] Open
Abstract
Background Axial spondyloarthritis (AxSpA) is a chronic disease which results in fatigue, pain, and reduced quality of life (QoL). Traditional Chinese medicine (TCM), especially acupuncture, has shown promise in managing pain. Although a TCM collaborative model of care (TCMCMC) has been studied in cancer, there are no randomized controlled trials investigating TCM in AxSpA. Therefore, we will conduct a pragmatic trial to determine the clinical effectiveness, safety, and cost-effectiveness of TCMCMC for patients with AxSpA. We define TCMCMC as standard TCM history taking and physical examination, acupuncture, and TCM non-pharmacological advice and communications with rheumatologists in addition to usual rheumatologic care. The purpose of this paper is to describe the rationale for and methodology of this trial. Methods/design This pragmatic randomized controlled trial will recruit 160 patients who are diagnosed with AxSpA and have inadequate response to non-steroidal anti-inflammatory drugs (NSAIDs). Simple randomization to usual rheumatologic care or the intervention (TCMCMC) with a 1:1 allocation ratio will be used. Ten 30-min acupuncture sessions will be provided to patients assigned to the TCMCMC arm. All participants will continue to receive usual rheumatologic care. The primary endpoint — spinal pain — will be evaluated at week 6. Secondary endpoints include clinical, quality of life, and economic outcome measures. Patients will be followed up for up to 52 weeks, and adverse events will be documented. Discussion This trial may provide evidence regarding the clinical effectiveness, safety, and cost-effectiveness of a TCMCMC for patients with AxSpA. Trial registration ClinicalTrials.gov, NCT03420404. Registered on 14 February 2018. Electronic supplementary material The online version of this article (10.1186/s13063-018-3117-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Xiang Ling Ang
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Youyi Huang
- Internal Medicine Residency, SingHealth, Singapore, Singapore
| | - Marcel Bilger
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Hui Chin Tan
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Jia Ven Lee
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Limin Sun
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Choy Tip Tan
- Singapore Thong Chai Medical Institution, Singapore, Singapore
| | - Bao Qiang Dong
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, People's Republic of China
| | - Hwee Ling Koh
- Department of Pharmacy, National University of Singapore, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nai Lee Lui
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Siaw Ing Yeo
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Swee Cheng Ng
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Kok Yong Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore. .,Department of Rheumatology and Immunology, Singapore General Hospital, Academia Building, Level 4, 20 College Road, Singapore, 169856, Singapore.
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| |
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