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Ionescu EV, Stanciu LE, Bujduveanu A, Minea M, Oprea D, Petcu A, Iliescu MG, Ciortea VM, Popa FL, Gheorghe E, Obada B, Oprea C. Clinical Evidence Regarding the Dynamic of Baker Cyst Dimensions after Intermittent Vacuum Therapy as Rehabilitation Treatment in Patients with Knee Osteoarthritis. J Clin Med 2023; 12:6605. [PMID: 37892743 PMCID: PMC10607906 DOI: 10.3390/jcm12206605] [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: 07/25/2023] [Revised: 08/20/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023] Open
Abstract
The Baker cyst (BC), also known as the popliteal cyst or parameniscal cyst, is a fluid-filled sac that normally develops in the back of the knee, between the semimembranosus and medial head of the gastrocnemius. We aimed to evaluate the effectiveness of physiotherapy (10 days of treatment) that associates intermittent vacuum therapy (IVT) on the lower limbs in the treatment of the BC, respectively, in its size reduction. Sixty-five patients with knee osteoarthritis using Kellgren-Lawrence criteria and the presence of BC (ultrasonography evaluation), were divided into the Control and Vacuum groups. We collected the following features: sex, age, level of education, occupation, environment, body mass index, Knee Injury and Osteoarthritis Outcome Score, Western Ontario, and McMaster Universities Osteoarthritis Index, the Functional Independence Measurement, the Fall Risk Score, and the Visual Analog Scale were recorded at baseline and after 10 days. Both groups are similar in terms of demographic features. Regarding the clinical functional parameters, the results elicit a statistically significant change in all parameters between admission and discharge, including the echo volume at BC. Physical medicine and rehabilitation increase the autonomy of patients with BC. Clinical-functional improvement begins in the first 10 days of complex rehabilitation treatment; it is statistically significant and is not different between the two groups, which brings an additional argument for the effectiveness of conservative therapy in the treatment of BC. Although IVT has not demonstrated its superiority over classical balneo-physical therapy, additional research, and long-term monitoring are needed to provide additional arguments regarding this aspect.
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Affiliation(s)
- Elena-Valentina Ionescu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
| | - Liliana-Elena Stanciu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
| | - Andreea Bujduveanu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
| | - Mihaela Minea
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
| | - Doinita Oprea
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
| | - Adina Petcu
- Faculty of Pharmacy, Ovidius University of Constanta, 1 University Alley, Campus–Corp C, 900470 Constanta, Romania;
| | - Madalina-Gabriela Iliescu
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
| | - Viorela-Mihaela Ciortea
- Department of Rehabilitation Medicine, University of Medicine and Pharmacy “Iuliu Hatieganu”, 8 Victor Babes Street, 400012 Cluj-Napoca, Romania;
| | - Florina-Ligia Popa
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, Victoriei Blvd., 550024 Sibiu, Romania;
| | - Emma Gheorghe
- Department of Dermathology, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania;
| | - Bogdan Obada
- Department of Orthopedics and Traumathology, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania;
| | - Carmen Oprea
- Balneal and Rehabilitation Sanatorium of Techirghiol, 34-40, Dr. Victor Climescu Street, 906100 Techirghiol, Romania; (E.-V.I.); (L.-E.S.); (A.B.); (M.M.); (D.O.); (C.O.)
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, “Ovidius” University of Constanta, 1 University Alley, Campus–Corp B, 900470 Constanta, Romania
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Pettersen EM, Hoel H, Torp H, Hisdal J, Seternes A. The effect of 12-week treatment with intermittent negative pressure on blood flow velocity and flowmotion, measured with a novel Doppler device (earlybird). Secondary outcomes from a randomized sham-controlled trial in patients with peripheral arterial disease. Ann Vasc Surg 2022; 86:144-157. [PMID: 35472497 DOI: 10.1016/j.avsg.2022.04.025] [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: 12/10/2021] [Revised: 03/27/2022] [Accepted: 04/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Treatment with intermittent negative pressure (INP) is proposed as an adjunct to standard care in patients with peripheral arterial disease (PAD). The aims of this study were to evaluate the applicability of a novel ultrasound Doppler device (earlybird) to assess blood flow characteristics in patients with PAD during a treatment session with INP, and whether certain flow-properties could determine whom could benefit INP treatment. METHODS Secondary outcomes of data from a randomized sham-controlled trial were explored. Patients were randomized to 12 weeks of treatment with 40 mmHg or 10 mmHg INP, for one hour twice daily. Earlybird blood flow velocity recordings were made before and after the 12-week treatment-period and consists of a 5-minute recording in rest, 3-minute during INP treatment and 5-minute recording after ended INP test-treatment. Mean blood flow velocity (vmean), relative changes in flow and frequency spectrum by Fourier-transform of the respective bandwidths of endothelial, sympathetic, and myogenic functions, were analyzed for the different series of blood flow measurements. RESULTS In total, 62 patients were eligible for analysis, where 32 patients were treated with 40 mmHg INP. The acquired recordings were of good quality and was used for descriptive analyses of flow characteristics. An immediate increase in vmean during the negative pressure periods of the INP test-treatment was observed in the 40 mmHg INP treatment group at both pre- and post-test. There was a significant difference between the treatment groups, with a difference between the medians of 13.7 (p < 0.001) at pretest and 10.7 (p < 0.001) at posttest. This finding was confirmed with spectrum analysis by Fourier-transform of the bandwidth corresponding to INP treatment. The change in amplitude corresponding to myogenic function after 12 weeks of treatment, was significantly different in favor of the 40 mmHg INP treatment group. We were not able to detect specific flow characteristics indicating whom would benefit INP-treatment. CONCLUSIONS Earlybird is an applicable tool for assessing blood flow velocity in patients with PAD. Analysis of the flow velocity recordings shows that INP induce an immediate increase in blood flow velocities during INP. The positive effects of INP may be attributed to recruitment of arterioles, and thereby increasing blood flow. In these analyses no flow characteristics was determined which could predict whom would benefit INP-treatment.
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Affiliation(s)
- Erik Mulder Pettersen
- Department of circulation and medical imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Vascular Surgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Surgery, Sørlandet Hospital Kristiansand, Kristiansand, Norway.
| | - Henrik Hoel
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Section of Vascular Investigations, Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway; Otivio AS, Oslo, Norway
| | - Hans Torp
- Department of circulation and medical imaging, Norwegian University of Science and Technology, Trondheim, Norway; CIMON Medical, NTNU Technology Transfer AS, Trondheim, Norway
| | - Jonny Hisdal
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Section of Vascular Investigations, Department of Vascular Surgery, Division of Cardiovascular and Pulmonary Diseases, Oslo University Hospital, Oslo, Norway
| | - Arne Seternes
- Department of circulation and medical imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Vascular Surgery, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
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Ibeggazene S, Pymer S, Birkett ST, Caldow E, Harwood AE. A systematic review of exercise intervention reporting quality and dose in studies of intermittent claudication. Vascular 2022; 31:477-488. [PMID: 35130092 DOI: 10.1177/17085381211070700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Exercise therapy is an important treatment option for people with intermittent claudication (IC). Appropriate reporting of exercise interventions in populations with IC within randomised controlled trials (RCTs) is important to ensure that research can be translated into clinical practice. Therefore, the purpose of our review is to evaluate the reporting of exercise interventions in RCTs of exercise therapy in patients with IC. METHODS A systematic search was performed to identify relevant trials in patients with IC published until May 2020. Studies including only participants with critical limb ischaemia or asymptomatic peripheral artery disease were excluded. Each trial was scored using the recently developed 'Consensus on Exercise Reporting Template' (CERT) which has a maximum obtainable score of 19. RESULTS Of 1489 unique records identified from the search, 73 trials were included, reporting 107 exercise interventions. Overall, the average CERT score was 10/19. The exercise equipment used, the use of supervision and a description of whether the exercise prescription was tailored or generic were the most frequently reported intervention components. The motivational strategies used, intervention adherence and intervention fidelity were the most underreported CERT components. There was no trend indicating that CERT scores were higher in more recent publications. CONCLUSIONS We have identified that important details about exercise interventions are frequently missing from the published literature. These missing data hinder replication of research findings and limit the translation of evidence into clinical practice.
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Affiliation(s)
- Saïd Ibeggazene
- College of Health, Wellbeing and Life Sciences, 7314Sheffield Hallam University, Sheffield, UK
| | - Sean Pymer
- Academic Vascular Surgical Unit, 12195Hull York Medical School, Hull, UK
| | - Stefan T Birkett
- School of Sport and Health Sciences, 6723University of Central Lancashire, Preston, UK
| | - Edward Caldow
- School of Health and Society, 7046University of Salford, Salford, UK
| | - Amy E Harwood
- Centre for Sports, Exercise and Life Sciences, 120958Coventry University, Coventry, UK
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Hoel H, Pettersen EM, Høiseth LØ, Mathiesen I, Seternes A, Seljeflot I, Hisdal J. Effects of intermittent negative pressure treatment on circulating vascular biomarkers in patients with intermittent claudication. Vasc Med 2021; 26:489-496. [PMID: 33985385 PMCID: PMC8493410 DOI: 10.1177/1358863x211007933] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The aim of this study was to investigate the effects of lower extremity intermittent negative pressure (INP) treatment for 1 hour twice daily for 12 weeks, on circulating vascular biomarkers in patients with intermittent claudication. Patients were randomized to treatment with -40 mmHg INP (treatment group), or -10 mmHg INP (sham control group). Venous blood samples were collected at baseline and after 12 weeks, and concentrations of vascular adhesion molecule-1 (VCAM-1), intracellular adhesion molecule-1 (ICAM-1), E-selectin, P-selectin, von Willebrand factor (vWF), l-arginine, asymmetric dimethylarginine (ADMA), and symmetric dimethylarginine (SDMA) were analyzed. A larger proportion of the patients in the treatment group (25/31) had a reduction in vWF levels after 12 weeks, compared to the sham control group (17/30) (p = 0.043). Within the treatment group there was a significant mean (SEM) reduction in the concentration of vWF of -11% (4) (p = 0.019), whereas there was no significant change in the levels of vWF in the sham control group (1% (6); p = 0.85). There were no significant differences in the change of any of the biomarker levels between the groups after 12 weeks of treatment. In conclusion, there were no differences in the change of the circulating levels of the measured biomarkers between the treatment group and the sham control group after 12 weeks of INP treatment. However, the observed changes in vWF might indicate a beneficial effect of INP treatment on endothelial activation and endothelial injury. Clinicaltrials.gov Identifier: NCT03640676.
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Affiliation(s)
- Henrik Hoel
- Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
- Department of Vascular Surgery, Oslo
University Hospital, Oslo, Norway
- Otivio AS, Oslo, Norway
| | - Erik Mulder Pettersen
- Department of Surgery, Sørlandet
Hospital, Kristiansand, Norway
- Department of Circulation and Medical
Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science
and Technology, Trondheim, Norway
| | | | | | - Arne Seternes
- Department of Circulation and Medical
Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science
and Technology, Trondheim, Norway
- Department of Surgery, Section for
Vascular Surgery, St Olavs Hospital, Trondheim, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
- Department of Cardiology, Center for
Clinical Heart Research, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Jonny Hisdal
- Institute of Clinical Medicine, Faculty
of Medicine, University of Oslo, Oslo, Norway
- Department of Vascular Surgery, Oslo
University Hospital, Oslo, Norway
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van Bemmelen PS. Regarding "Randomized controlled trial of vacuum therapy for intermittent claudication". J Vasc Surg 2021; 73:351-352. [PMID: 33349387 DOI: 10.1016/j.jvs.2020.07.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Paul S van Bemmelen
- Section of Vascular Surgery, Department of Surgery, Temple University, Philadelphia, Pa
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Hageman D, Gommans LNM, Scheltinga MRM, Teijink JAW. Reply. J Vasc Surg 2021; 73:352. [PMID: 33349388 DOI: 10.1016/j.jvs.2020.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/14/2020] [Indexed: 10/22/2022]
Affiliation(s)
- David Hageman
- Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Lindy N M Gommans
- Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands
| | - Marc R M Scheltinga
- Department of Vascular Surgery, Máxima Medical Center, Veldhoven, The Netherlands
| | - Joep A W Teijink
- Department of Vascular Surgery, Catharina Hospital, Eindhoven, The Netherlands; Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Hoel H, Hisdal J. The FlowOx device for the treatment of peripheral artery disease: current status and future prospects. Expert Rev Med Devices 2021; 18:217-220. [PMID: 33632040 DOI: 10.1080/17434440.2021.1895750] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Henrik Hoel
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway.,Otivio AS, Oslo, Norway
| | - Jonny Hisdal
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Vascular Surgery, Oslo University Hospital, Oslo, Norway
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A randomized controlled trial of treatment with intermittent negative pressure for intermittent claudication. J Vasc Surg 2020; 73:1750-1758.e1. [PMID: 33899743 DOI: 10.1016/j.jvs.2020.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/08/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We investigated the effects of lower extremity intermittent negative pressure (INP) treatment for 1 hour two times daily for 12 weeks on the walking distance of patients with intermittent claudication (IC). METHODS Patients with IC were randomized to treatment with -40 mm Hg INP (treatment group) or -10 mm Hg INP (sham control group). Pain-free walking distance (PWD) and maximal walking distance (MWD) on a treadmill, resting and postexercise ankle-brachial index, resting and postischemic blood flow (plethysmography), and quality of life (EQ-5D-5L and Vascuqol-6) were measured at baseline and after 12 weeks of treatment. RESULTS A total of 72 patients were randomized, and 63 had data available for the intention-to-treat analyses. The between-group comparisons showed a significant change in the PWD, favoring the treatment group over the sham control group (estimated treatment effect, 50 m; 95% confidence interval [CI], 11-89; P = .014). The PWD had increased by 68 m (P < .001) in the treatment group and 18 m (P = .064) in the sham control group. No significant difference was found in the change in the MWD between the two groups (estimated treatment effect, 42 m; 95% CI, -14 to 97; P = .139). The MWD had increased by 62 m (P = .006) in the treatment group and 20 m (P = .265) in the sham control group. For patients with a baseline PWD of <200 m (n = 56), significant changes had occurred in both PWD and MWD between the two groups, favoring the treatment group (estimated treatment effect, 42 m; 95% CI, 2-83; P = .042; and estimated treatment effect, 62 m; 95% CI, 5-118; P = .032; respectively). Both overall and for the group of patients with a PWD <200 m, no significant differences were found in the changes in the resting and postexercise ankle-brachial index, resting and postischemic blood flow, or quality of life parameters between the two groups. CONCLUSIONS Treatment with -40 mm Hg INP increased the PWD compared with sham treatment in patients with IC. For the patients with a baseline PWD of <200 m, an increase was found in both PWD and MWD compared with sham treatment.
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Scientific Surgery July 2020 BJS. Br J Surg 2020. [DOI: 10.1002/bjs.11769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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