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Payamipour S, Peeri M, Azarbayjani MA, Masrour FF. Voluntary wheel running from early adolescence reduces disease progression, and anxiety- and depression-related symptoms in an adult male mouse model of rheumatoid arthritis. J Neuroimmunol 2023; 385:578247. [PMID: 38000323 DOI: 10.1016/j.jneuroim.2023.578247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/07/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023]
Abstract
Rheumatoid arthritis (RA) is a multifactorial autoimmune disease that progressively destroys synovial joints and leads to chronic systemic inflammation. This autoimmune disorder is associated with increased anxiety- and depression-related symptoms, which reduces quality of life. Clinical and experimental evidence suggests that higher physical activity from early adolescence may prevent chronic diseases and reduce the risk of mental health problems in adulthood. This study aimed to assess whether voluntary wheel running from early adolescence can decrease clinical symptoms, anxiety- and depression-related behaviors in adult mice with rheumatoid arthritis. Adolescent male mice were exposed to voluntary wheel running until adulthood and got collagen-induced arthritis. We measured body weight, the thickness of the hind paw and knee joint (clinical signs), anxiety- and depression-related behaviors, serum testosterone, and cytokines (IFN-γ IL-1β, IL-6, TNF-α, IL-10). The findings showed that collagen-induced arthritis resulted in anxious-like behavior, increased anhedonia, elevated IL-6, IL-1β, TNF-α, and IFN-γ, and decreased testosterone levels in the serum of mice. However, no change was observed in behavioral despair. We found that higher physical activity from early adolescence significantly reduced the severity of clinical signs, anxiety- and anhedonia-like behaviors, and decreased behavioral despair in RA-induced mice. In addition, the running wheel exposure normalized RA-induced abnormalities in testosterone and inflammatory cytokines in mice. Altogether, this study suggests that higher physical activity from early adolescence may make mice less vulnerable or resistant to RA-induced clinical symptoms and anxiety- and depression-related behaviors by changing testosterone and inflammatory cytokines productions in adulthood.
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Affiliation(s)
- Sheida Payamipour
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Maghsoud Peeri
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran.
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Native Hawaiian wellbeing and transdiagnostic trauma symptoms: The protective role of physical activity in dissociation. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Acute Whole-Body Vibration Exercise Promotes Favorable Handgrip Neuromuscular Modifications in Rheumatoid Arthritis: A Cross-Over Randomized Clinical. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9774980. [PMID: 34901282 PMCID: PMC8660187 DOI: 10.1155/2021/9774980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 11/05/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
Objective Rheumatoid arthritis (RA) causes progressive changes in the musculoskeletal system compromising neuromuscular control especially in the hands. Whole-body vibration (WBV) could be an alternative for the rehabilitation in this population. This study investigated the immediate effect of WBV while in the modified push-up position on neural ratio (NR) in a single session during handgrip strength (HS) in women with stable RA. Methods Twenty-one women with RA (diagnosis of disease: ±8 years, erythrocyte sedimentation rate: ±24.8, age: 54± 11 years, BMI: 28 ± 4 kg·m−2) received three experimental interventions for five minutes in a randomized and balanced cross-over order: (1) control—seated with hands at rest, (2) sham—push-up position with hands on the vibration platform that remained disconnected, and (3) vibration—push-up position with hands on the vibration platform turned on (45 Hz, 2 mm, 159.73 m·s−2). At the baseline and immediately after the three experimental interventions, the HS, the electromyographic records (EMGrms), and range of motion (ROM) of the dominant hand were measured. The NR, i.e., the ratio between EMGrms of the flexor digitorum superficialis (FDS) muscle and HS, was also determined. The lower NR represented the greater neuromuscular efficiency (NE). Results The NR was similar at baseline in the three experimental interventions. Despite the nonsignificance of within-interventions (p = 0.0611) and interaction effect (p = 0.1907), WBV exercise reduced the NR compared with the sham and control (p = 0.0003, F = 8.86, η2 = 0.85, power = 1.00). Conclusion Acute WBV exercise under the hands promotes neuromuscular modifications during the handgrip of women with stable RA. Thus, acute WBV exercise may be used as a preparatory exercise for the rehabilitation of the hands in this population. This trial is registered with trial registration 2.544.850 (ReBEC-RBR-2n932c).
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Physical activity and rheumatoid arthritis: need for practical, precise, and personalized support - Results from an online survey. Joint Bone Spine 2021; 89:105255. [PMID: 34325048 DOI: 10.1016/j.jbspin.2021.105255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 06/30/2021] [Indexed: 11/23/2022]
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Rezaei S, Mohammadhossini S, Karimi Z, Yazdanpanah P, Zarei Nezhad M, Ghafarian Shirazi HR. Effect of 8-Week Aerobic Walking Program on Sexual Function in Women with Rheumatoid Arthritis. Int J Gen Med 2020; 13:169-176. [PMID: 32494186 PMCID: PMC7231853 DOI: 10.2147/ijgm.s252591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 04/30/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Sexual dysfunction is a little-addressed condition in patients with rheumatoid arthritis. Aerobic exercises, including walking, can help alleviate this dysfunction. This study aimed to determine the effect of an 8-week aerobic walking program on sexual function ine patients with rheumatoid arthritis. Methodology This clinical trial was conducted on 51 patients with rheumatoid arthritis. At first, patients were selected through nonprobability sampling. They were then allocated into intervention and control groups using block randomization. The walking intervention was performed based on the frequency–intensity–time–type principle forg 8 consecutive weeks. Rosen’s Female Sexual Function Index was used for data collection before, immediately after, and 4 weeks after the intervention. Data collected were analyzed with SPSS 22 using descriptive and inferential statistics and 95% CI. Findings Mean sexual function scores before, after, and 4 weeks after intervention were 17.66±4, 22.88±4.7, and 24.39±5.1 in the intervention group and 17.60±4.24, 17.27±4.66, and 17.39±4.39 in the control group, respectively. Test results showed a significant intergroup difference in mean sexual function score (p<0.05). Conclusion Based on our results, an 8-week aerobic walking program is recommended as an effective way to improve sexual function in women with rheumatoid arthritis.
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Affiliation(s)
- Sara Rezaei
- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Sima Mohammadhossini
- Department of Nursing, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Zohreh Karimi
- Department of Operating Room, School of Paramedicine, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Parviz Yazdanpanah
- Physical Medicine and Rehabilitation, Yasuj University of Medical Sciences, Yasuj, Iran
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Liu X, Tedeschi SK, Lu B, Zaccardelli A, Speyer CB, Costenbader KH, Karlson EW, Sparks JA. Long-Term Physical Activity and Subsequent Risk for Rheumatoid Arthritis Among Women: A Prospective Cohort Study. Arthritis Rheumatol 2019; 71:1460-1471. [PMID: 30920773 PMCID: PMC6717001 DOI: 10.1002/art.40899] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/21/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To evaluate the effects of long-term physical activity on subsequent risk of rheumatoid arthritis (RA) in a prospective cohort study. METHODS This study investigated physical activity and RA risk among women from the Nurses' Health Study II (1989-2015). Physical activity exposures and covariates were prospectively obtained using biennial questionnaires. Two rheumatologists independently reviewed the medical records of women who self-reported a new diagnosis of RA on biennial questionnaires and who screened positive for RA based on a supplemental survey. All incident RA cases met the 1987 American College of Rheumatology (ACR) or 2010 ACR/European League Against Rheumatism (EULAR) classification criteria for RA. The primary analysis investigated the long-term cumulative average number of hours spent in recreational physical activity 2-8 years prior to the RA diagnosis, a time span chosen to reduce the potential for reverse causation bias, since early RA affects physical activity prior to diagnosis. Estimated Cox regression hazard ratios (HRs) with 95% confidence intervals (95% CIs) were used to assess the risk of RA serologic phenotypes (all, seropositive, or seronegative) in relation to physical activity categories. The analyses were adjusted for body mass index (BMI) at age 18 years and time-varying potential confounders, and the mediating effect of updated BMI on the interaction between physical activity and RA risk was quantified. RESULTS Among the 113,366 women analyzed, 506 incident RA cases (67.0% with seropositive RA) were identified during 2,428,573 person-years of follow-up. After adjustment for confounders, including smoking, dietary quality, and BMI at age 18 years, increasing cumulative average total hours of recreational physical activity was associated with a reduced risk of RA, as follows: HR 1.00 for <1 hour/week (reference), HR 1.00 (95% CI 0.78-1.29) for 1 to <2 hours/week, HR 0.92 (95% CI 0.72-1.17) for 2 to <4 hours/week, HR 0.84 (95% CI 0.63-1.12) for 4 to <7 hours/week, and HR 0.67 (95% CI 0.47-0.98) for ≥7 hours/week (P for trend = 0.02). The proportion of the effect between physical activity and RA mediated by updated BMI was 14.0% (P = 0.002) for all RA and 20.0% (P = 0.001) for seropositive RA. CONCLUSION Higher levels of physical activity were associated with reduced RA risk. These results add to the literature implicating metabolic factors in the pathogenesis of RA.
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Affiliation(s)
- Xinyi Liu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
| | - Sara K. Tedeschi
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Bing Lu
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Alessandra Zaccardelli
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
| | - Cameron B. Speyer
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
| | - Karen H. Costenbader
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Elizabeth W. Karlson
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
| | - Jeffrey A. Sparks
- Division of Rheumatology, Immunology and Allergy, Brigham and Women’s Hospital, Boston, MA
- Harvard Medical School, Boston, MA
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O'Brien CM, Duda JL, Kitas GD, Veldhuijzen van Zanten JJCS, Metsios GS, Fenton SAM. Objective measurement of sedentary time and physical activity in people with rheumatoid arthritis: protocol for an accelerometer and activPAL TM validation study. Mediterr J Rheumatol 2019; 30:125-134. [PMID: 32185353 PMCID: PMC7045970 DOI: 10.31138/mjr.30.2.125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/20/2019] [Accepted: 06/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The accurate measurement of sedentary time and physical activity in Rheumatoid Arthritis (RA) is critical to identify important health consequences and determinants of these behaviours in this patient group. However, objective methods have not been well-validated for measurement of sedentary time and physical activity in RA. AIMS Specific objectives are to: 1) validate the ActiGraph GT3X+ accelerometer and activPAL3μTM against indirect calorimetry and direct observation respectively, and define RA-specific accelerometer cut-points, for measurement of sedentary time and physical activity in RA; 2) validate the RA-specific sedentary time accelerometer cut-points against the activPAL3μTM; 3) compare sedentary time and physical activity estimates in RA, using RA-specific vs. widely-used non-RA accelerometer cut-points. METHODS Objective 1: People with RA will wear an ActiGraph GT3X+, activPAL3μTM, heart rate monitor and indirect calorimeter, whilst being video-recorded undertaking 11 activities representative of sedentary behaviour, and light and moderate intensity physical activity. Objectives 2 and 3: People with RA will wear an ActiGraph GT3X+ and activPAL3μTM for 7 days to measure free-living sedentary time and physical activity. DISCUSSION This will be the first study to define RA-specific accelerometer cut-points, and represents the first validation of the ActiGraph accelerometer and activPALTM, for measurement of sedentary time and physical activity in RA. Findings will inform future RA studies employing these devices, ensuring more valid assessment of sedentary time and physical activity in this patient group.
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Affiliation(s)
- Ciara M O'Brien
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
| | - George D Kitas
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
| | - George S Metsios
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, West Midlands, United Kingdom
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Nessen T, Opava CH, Demmelmaier I. Physiotherapists' Adoption of a Theory-Based Skills Training Program in Guiding People with Rheumatoid Arthritis to Health-Enhancing Physical Activity. Int J Behav Med 2019; 25:438-447. [PMID: 29971578 PMCID: PMC6061243 DOI: 10.1007/s12529-018-9716-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Purpose To describe physiotherapists’ (PTs’) adoption of a theory-based skills training program preparing them to guide people with rheumatoid arthritis (RA) to health-enhancing physical activity (HEPA) within a 1-year intervention trial. Method This was a longitudinal case study. Ten female PTs (age 25–59), delivering the HEPA intervention, participated. Data were collected on five occasions over a 19-month period: once before the training course, once after 4 course days, twice during the HEPA intervention and once after the HEPA intervention. Knowledge on about physical activity (score 0–6) and behavior change techniques (BCTs) (score 0–18), fear-avoidance beliefs (score 8–48) and self-efficacy to guide behavior change (score 9–54) were assessed with a questionnaire. Structured logbooks were used to register PTs’ self-reported guiding behavior. Criteria for PTs’ adherence to the protocol were pre-set. Results PTs’ knowledge on about BCTs and their self-efficacy increased significantly (p < 0.05) from median 9 to 13 and from median 38 to 46.5, respectively. Knowledge on about physical activity was high and fear-avoidance beliefs were low before the education (median 6 and 13.5, respectively) and did not change over time. Two out of ten PTs fulfilled the pre-set criteria for adherence throughout the intervention. Conclusion The results suggest that a theory-based skills training program improves PTs’ knowledge on about behavior change techniques and their self-efficacy to guide people with RA to HEPA. PTs’ adherence to the protocol was not complete but the clinical relevance of the adherence criteria need to be validated against observed PT behavior and patient outcomes.
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Affiliation(s)
- Thomas Nessen
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, SE14183, Huddinge, Sweden
| | - Christina H Opava
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, SE14183, Huddinge, Sweden
- Department of Rheumatology, Karolinska University Hospital, Stockholm, Sweden
| | - Ingrid Demmelmaier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 23100, SE14183, Huddinge, Sweden.
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Ono Y, Miyakoshi N, Kasukawa Y, Nagasawa H, Tsuchie H, Akagawa M, Nagahata I, Yuasa Y, Sato C, Shimada Y. Effects of eldecalcitol and ibandronate on secondary osteoporosis and muscle wasting in rats with adjuvant-induced arthritis. Osteoporos Sarcopenia 2019; 4:128-133. [PMID: 30775555 PMCID: PMC6372828 DOI: 10.1016/j.afos.2018.11.085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 10/27/2018] [Accepted: 11/22/2018] [Indexed: 12/15/2022] Open
Abstract
Objectives Rheumatoid arthritis (RA) is characterized by chronic inflammation of the synovium, progressive erosion of the articular cartilage, and joint destruction. RA also causes secondary osteoporosis and muscle wasting. We investigated the effects of ibandronate (IBN), a bisphosphonate; eldecalcitol (ELD), an active vitamin D3 derivative; and combination treatment with both agents on secondary osteoporosis and muscle wasting using adjuvant-induced arthritis rats. Methods Arthritis was induced in 8-week-old male Lewis rats. Rats were randomized into 4 treatment groups and an untreated normal control group: IBN (subcutaneously, once every 2 weeks, 10 μg/kg), ELD (orally, once daily, 30 ng/kg/day), IBN + ELD, vehicle, and control. Paw thickness measurements were performed for evaluation of arthritis. The femur was scanned using dual-energy X-ray absorptiometry. Cross-sectional areas of left tibialis and anterior muscle fibers and the expression of MuRF1, atrogin-1, MyoD, and myogenin in the gastrocnemius muscle were measured to evaluate muscle wasting. Results IBN and/or ELD increased bone mineral density (BMD) in the femur. In addition, there was an additive effect of combination treatment compared with single treatments for BMD. However, IBN and/or ELD did not inhibit muscle wasting in adjuvant-induced arthritis rats. Conclusions Combination treatment with IBN and ELD may be effective for secondary osteoporosis associated with RA. Other treatments are necessary for muscle wasting associated with RA. Studies in humans are needed to confirm these findings.
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Affiliation(s)
- Yuichi Ono
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yuji Kasukawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroyuki Nagasawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Hiroyuki Tsuchie
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Manabu Akagawa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Itsuki Nagahata
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yusuke Yuasa
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Chiaki Sato
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Yoichi Shimada
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
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Weijers JM, Rongen-van Dartel SAA, van Riel PLCM. Exercise participation has increased in patients with Rheumatoid Arthritis: A cross-sectional comparison between two Dutch RA cohorts. Mediterr J Rheumatol 2018; 29:199-206. [PMID: 32185327 PMCID: PMC7045938 DOI: 10.31138/mjr.29.4.199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 10/01/2018] [Accepted: 11/26/2018] [Indexed: 01/01/2023] Open
Abstract
Objective: This study evaluates exercise participation in patients with rheumatoid arthritis (RA) and the percentage of patients that meet the recommended level of physical activity (at least 150 minutes per week moderate-intensity physical activity) in two cross-sectional questionnaires in 2013 and 2016 in two Dutch RA cohorts. Methods: In 2013, a cross-sectional study was performed among 740 patients with RA from seven outpatient clinics from the Dutch DREAM registry. Subsequently in 2016, 498 patients with RA of the outpatient clinic of the Bernhoven Hospital (member of the DREAM registry) participated in a similar study. In both years, patients filled in an identical questionnaire about exercise participation (frequency and duration). In 2016, items about self-efficacy to become more physically active were added to the questionnaire. Results: In 2016, patients with RA spent significantly more minutes per week in exercise activities compared to 2013: 180 (150–450) and 120 (60–225) minutes per week, respectively (P<0.001). The percentage of patients with RA who met the recommended physical activity level increased from 25% in 2013 to 57% in 2016. Almost half (44%) of the non-exercisers reported feeling confident to become more physically active. Conclusion: Compared to 2013, RA patients participated in 2016 more frequently and spent more minutes per week in exercise activities. This resulted in a higher percentage of patients who met the recommended physical activity level. A personalized physical activity program, with a focus on identifying barriers and setting personal goals, might further increase the physical activity level of patients with RA.
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Affiliation(s)
- Julia M Weijers
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
| | - Sanne A A Rongen-van Dartel
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,Department of Rheumatology, Bernhoven Hospital, Uden, The Netherlands
| | - Piet L C M van Riel
- Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands.,Department of Rheumatology, Bernhoven Hospital, Uden, The Netherlands
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Erdinç Gündüz N, Erdem D, Kızıl R, Solmaz D, Önen F, Ellidokuz H, Gülbahar S. Is dry heat treatment (fluidotherapy) effective in improving hand function in patients with rheumatoid arthritis? A randomized controlled trial. Clin Rehabil 2018; 33:485-493. [PMID: 30450972 DOI: 10.1177/0269215518810778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE: To evaluate the efficacy of dry heat treatment (fluidotherapy) in improving hand function in patients with rheumatoid arthritis. DESIGN: Prospective randomized controlled trial. SETTING: Departments of Physical Medicine and Rehabilitation and Rheumatology in a university hospital. SUBJECTS: Patients with rheumatoid arthritis. INTERVENTIONS: All patients were randomly divided into two groups. Group 1 underwent dry heat treatment (fluidotherapy) and Group 2 was a control group. Patients in both groups participated in a joint protection and exercise program. MAIN MEASURES: Primary outcome measures were Health Assessment Questionnaire and Duruoz Hand Index. Secondary outcome measures were pain and stiffness, Grip Ability Test, Disease Activity Score-28, and grip strength. These assessments were performed at the hospital at baseline, week 3, and week 12. RESULTS: A total of 93 participants were allocated to Group 1 ( n = 47) and Group 2 ( n = 46). The mean age of these groups was 54.19 ± 11.15 years and 53.00 ± 10.15 years, respectively ( P = 0.592). At baseline, there were no significant differences between the groups in any parameter except significantly poorer Health Assessment Questionnaire score in Group 1 ( P = 0.007). At week 3, there were no significant differences between the groups in any of the parameters ( P > 0.005). At week 12, Duruoz Hand Index scores were significantly better in Group 2 ( P = 0.039). CONCLUSION: Dry heat treatment (fluidotherapy) was not effective in improving hand function in patients with rheumatoid arthritis. Moreover, no positive effect on any other clinical parameters was observed.
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Affiliation(s)
- Nihan Erdinç Gündüz
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Didem Erdem
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ramazan Kızıl
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Dilek Solmaz
- 2 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Fatoş Önen
- 2 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Hülya Ellidokuz
- 3 Department of Biostatistics and Medical Informatics, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Selmin Gülbahar
- 1 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Mateen S, Moin S, Khan AQ, Zafar A, Fatima N, Shahzad S. Role of hydrotherapy in the amelioration of oxidant-antioxidant status in rheumatoid arthritis patients. Int J Rheum Dis 2018; 21:1822-1830. [PMID: 28612349 DOI: 10.1111/1756-185x.13118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
AIM Rheumatoid arthritis (RA) is an inflammatory autoimmune disease. Reactive oxygen species (ROS) are involved in the pathophysiology of RA. Moderate intensity exercises have been reported to have anti-oxidant and anti-inflammatory effects. The aim of this study was to evaluate the effect of hydrotherapy on oxidant-antioxidant status in RA patients. METHODS Forty RA patients and 30 age- and sex-matched healthy controls were included in this study. RA patients were subdivided into two groups: the first group (n = 20) received treatment with conventional RA drugs, while the second group (n = 20) received hydrotherapy along with the conventional drugs for a period of 12 weeks. Disease Activity Score of 28 joints (DAS-28), ROS level, protein oxidation, lipid peroxidation, DNA damage and the activities of antioxidant enzymes were evaluated before and after 12 weeks of treatment. RESULTS RA patients showed a significant change in the oxidative stress biomarkers (ROS, P < 0.01; ferric reducing antioxidant potential, P < 0.001; malondialdehyde, P < 0.01; protein carbonyl, P < 0.001; tail length, P < 0.05) and decrease in the activities of anti-oxidant enzymes (superoxide dismutase [SOD], P < 0.01; glutathione peroxidase [GPx], P < 0.001). Conventional drug treatment has not produced any significant change in these parameters. However, cotreatment of drugs with hydrotherapy has decreased protein, lipid and DNA oxidation by increasing the activities of antioxidant enzymes (SOD and GPx). CONCLUSION Our results indicate that hydrotherapy along with drugs has reduced the severity of disease (DAS-28) by ameliorating the oxidant-antioxidant status in RA patients. Thus, in addition to conventional drugs, RA patients should be advised to have hydrotherapy (moderate intensity exercise) in their treatment regimen.
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Affiliation(s)
- Somaiya Mateen
- Department of Biochemistry, Faculty of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Shagufta Moin
- Department of Biochemistry, Faculty of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Abdul Q Khan
- Department of Orthopaedic Surgery, Faculty of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Atif Zafar
- Department of Biochemistry, Faculty of Life Sciences, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Naureen Fatima
- Department of Biochemistry, Faculty of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Sumayya Shahzad
- Department of Biochemistry, Faculty of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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14
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Bartlett DB, Willis LH, Slentz CA, Hoselton A, Kelly L, Huebner JL, Kraus VB, Moss J, Muehlbauer MJ, Spielmann G, Kraus WE, Lord JM, Huffman KM. Ten weeks of high-intensity interval walk training is associated with reduced disease activity and improved innate immune function in older adults with rheumatoid arthritis: a pilot study. Arthritis Res Ther 2018; 20:127. [PMID: 29898765 PMCID: PMC6001166 DOI: 10.1186/s13075-018-1624-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic inflammatory disease in which adults have significant joint issues leading to poor health. Poor health is compounded by many factors, including exercise avoidance and increased risk of opportunistic infection. Exercise training can improve the health of patients with RA and potentially improve immune function; however, information on the effects of high-intensity interval training (HIIT) in RA is limited. We sought to determine whether 10 weeks of a walking-based HIIT program would be associated with health improvements as measured by disease activity and aerobic fitness. Further, we assessed whether HIIT was associated with improved immune function, specifically antimicrobial/bacterial functions of neutrophils and monocytes. Methods Twelve physically inactive adults aged 64 ± 7 years with either seropositive or radiographically proven (bone erosions) RA completed 10 weeks of high-intensity interval walking. Training consisted of 3 × 30-minute sessions/week of ten ≥ 60-second intervals of high intensity (80–90% VO2reserve) separated by similar bouts of lower-intensity intervals (50–60% VO2reserve). Pre- and postintervention assessments included aerobic and physical function; disease activity as measured by Disease Activity score in 28 joints (DAS28), self-perceived health, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR); plasma interleukin (IL)-1β, IL-6, chemokine (C-X-C motif) ligand (CXCL)-8, IL-10, and tumor necrosis factor (TNF)-α concentrations; and neutrophil and monocyte phenotypes and functions. Results Despite minimal body composition change, cardiorespiratory fitness increased by 9% (change in both relative and absolute aerobic capacity; p < 0.001), and resting blood pressure and heart rate were both reduced (both p < 0.05). Postintervention disease activity was reduced by 38% (DAS28; p = 0.001) with significant reductions in ESR and swollen joints as well as improved self-perceived health. Neutrophil migration toward CXCL-8 (p = 0.003), phagocytosis of Escherichia coli (p = 0.03), and ROS production (p < 0.001) all increased following training. The frequency of cluster of differentiation 14-positive (CD14+)/CD16+ monocytes was reduced (p = 0.002), with both nonclassical (CD14dim/CD16bright) and intermediate (CD14bright/CD16positive) monocytes being reduced (both p < 0.05). Following training, the cell surface expression of intermediate monocyte Toll-like receptor 2 (TLR2), TLR4, and HLA-DR was reduced (all p < 0.05), and monocyte phagocytosis of E. coli increased (p = 0.02). No changes were observed for inflammatory markers IL-1β, IL-6, CXCL-8, IL-10, CRP, or TNF-α. Conclusions We report for the first time, to our knowledge, that a high-intensity interval walking protocol in older adults with stable RA is associated with reduced disease activity, improved cardiovascular fitness, and improved innate immune functions, indicative of reduced infection risk and inflammatory potential. Importantly, the exercise program was well tolerated by these patients. Trial registration ClinicalTrials.gov, NCT02528344. Registered on 19 August 2015.
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Affiliation(s)
- David B Bartlett
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA. .,Division of Medical Oncology, Duke University School of Medicine, Durham, NC, 27701, USA. .,MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
| | - Leslie H Willis
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Cris A Slentz
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Andrew Hoselton
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Leslie Kelly
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Virginia B Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Jennifer Moss
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Michael J Muehlbauer
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | | | - William E Kraus
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Janet M Lord
- MRC-ARUK Centre for Musculoskeletal Ageing Research, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.,NIHR Birmingham Biomedical Research Centre in Inflammation, University Hospital Birmingham, Birmingham, UK
| | - Kim M Huffman
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
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15
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Kennedy NM, McKenna SG, O'Neill A, Appel Esbensen B, Swinnen TW, Nordgren B, Willemijns S, Hammer NM, Brodin N. A survey across four European countries to determine rheumatology health professionals' awareness of physical activity measures in people with inflammatory joint diseases. BMJ Open 2018; 8:e020809. [PMID: 29858419 PMCID: PMC5988051 DOI: 10.1136/bmjopen-2017-020809] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The objectives of this study were to determine rheumatology health professionals' (HPs)' awareness of and confidence in using physical activity (PA) measures in people with inflammatory joint diseases (IJDs), their own self-reported PA levels and to identify HP-related educational needs. METHODS Rheumatology HPs in Denmark, Sweden, Ireland and Belgium participated in an on-line survey. Descriptive statistics and latent class analysis (LCA) were undertaken SPSS (v21and SASv9.4) to describe data aggregates and range and to identify subclasses of groups with respect to use of PA measures. RESULTS 322 (n=322, 75.5% women) HPs responded from Denmark (n=50, 15.5%), Sweden (n=66, 20.5%), Ireland (n=28, 8.7%) and Belgium (n=178, 55.3%) and the majority of respondents (n=286, 91.7%) reported it was important to measure PA in people with IJDs. Only 28.2% of HPs used simple body worn sensors to measure PA levels in their patients. The majority were interested in on-line education on measuring PA (82.9%). LCA, used to generate classes of PA measures employed by HPs, revealed three distinct classes reflecting differences in self-reported PA levels, awareness of PA measures, further education requirements and professional background. CONCLUSIONS The majority of respondents reported that they considered measuring PA as important in people with IJDs; however, the majority lacked confidence in how to measure it. There was strong interest in further education around measuring PA. Three distinct respondent classes were identified to inform targeted education on how to measure PA.
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Affiliation(s)
- Norelee M Kennedy
- Discipline of Physiotherapy, School of Allied Health, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Sean G McKenna
- Discipline of Physiotherapy, School of Allied Health, University of Limerick, Limerick, Ireland
| | - Aoife O'Neill
- Department of Mathematics and Statistics, University of Limerick, Limerick, Ireland
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thijs Willem Swinnen
- Division of Rheumatology, UZ Leuven, Leuven, Belgium
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Birgitta Nordgren
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
| | - Sara Willemijns
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium
| | - Nanna Maria Hammer
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, Rigshospitalet, Glostrup, Denmark
| | - Nina Brodin
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Division of Physiotherapy, Orthopaedic Clinic, Danderyd University Hospital, Stockholm, Sweden
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16
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Nessen T, Opava CH, Martin C, Demmelmaier I. Physiotherapists' management of challenging situations in guiding people with rheumatoid arthritis to health-enhancing physical activity. Physiother Theory Pract 2018; 35:31-39. [PMID: 29447492 DOI: 10.1080/09593985.2018.1434847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To explore strategies used by physiotherapists (PTs) in guiding people with rheumatoid arthritis to health-enhancing physical activity (HEPA) in a group setting during a 1-year intervention study. METHODS Exploratory design with qualitative video analysis performed in three steps. Eleven female PTs were video recorded while leading support group sessions aiming at facilitating HEPA (twice-weekly exercise sessions at public gyms and 150 weekly minutes of moderately intense aerobic physical activity). RESULTS Three categories of challenging situations emerged. They occurred when the HEPA intervention participants reported barriers to performing physical activity, when they neglected to use the planning tool for physical activity as intended in the program, and when they received negative results from physical capacity tests. PTs used different strategies to manage these challenges, with main focus either on information-giving, corresponding to a traditional health professional approach, or utilizing group resources by organizing participation. CONCLUSIONS This study provides detailed descriptions of PTs' clinical behavior in video-recorded sessions. The results imply that motivated PTs can, despite their biomedical and practitioner-focused training, learn to adapt their communication strategies to different situations, altering between traditional information-giving and utilizing group resources by organizing participation.
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Affiliation(s)
- Thomas Nessen
- a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy 23100 , Karolinska Institutet , Huddinge , Sweden
| | - Christina H Opava
- a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy 23100 , Karolinska Institutet , Huddinge , Sweden
| | - Cathrin Martin
- b Department of Neuroscience, Physiotherapy , Uppsala University , Uppsala , Sweden
| | - Ingrid Demmelmaier
- a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy 23100 , Karolinska Institutet , Huddinge , Sweden
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17
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Heinze-Milne S, Bakowsky V, Giacomantonio N, Grandy SA. Effects of a 12-week cardiovascular rehabilitation programme on systemic inflammation and traditional coronary artery disease risk factors in patients with rheumatoid arthritis (CARDIA trial): a randomised controlled trial. BMJ Open 2017; 7:e018540. [PMID: 29275344 PMCID: PMC5770912 DOI: 10.1136/bmjopen-2017-018540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION Patients with systemic inflammatory diseases such as rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) above the baseline risk attributable to traditional CVD risk factors seen in the general population. Exercise in cardiac rehabilitation (CR) is designed specifically for high-risk primary prevention and those with established CVD. Even though the European League Against Rheumatism guidelines state that exercise is safe for individuals with RA and exercise can reduce CVD risk, patients with RA rarely participate in CR. Thus, little is known about CR's impact on inflammatory and CVD risk in the RA population. The purpose of this trial is to determine the feasibility of a 12-week CR programme for patients with RA and whether it decreases CVD risk without exacerbating RA. METHODS AND ANALYSIS This is a randomised controlled trial whereby 60 participants with RA will be recruited and randomly assigned to either standard of care (SOC) treatment or SOC plus a 12-week CR programme (60 min of education plus two 60 min aerobic exercise sessions/week). Exercise will be performed at 60%-80% of heart rate reserve. Outcome measures (Framingham Risk Score, resting heart rate, blood pressure, blood lipids, markers of systemic inflammation (ie, interleukin (IL) 6 and tumour necrosis factor-α (TNF-α), Clinical Disease Assessment Index, Disease Activity Score-28, physical activity levels and peak cardiorespiratory fitness) will be assessed preintervention (week-0), postintervention (week-13) and 6 months postintervention. ETHICS AND DISSEMINATION Ethical approval was obtained from the Nova Scotia Health Authority Research Ethics Board. Results will be submitted for publication in an appropriate peer-reviewed journal. TRIAL REGISTRATION NUMBER NCT01534871; Pre-results.
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Affiliation(s)
- Stefan Heinze-Milne
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
| | - Volodko Bakowsky
- Division of Rheumatology, Department of Medicine, Nova Scotia Health Authority, Halifax, Canada
| | | | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, Canada
- Division of Cardiology, Nova Scotia Health Authority, Halifax, Canada
- Department of Pharmacology, Dalhousie University, Halifax, Canada
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18
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Pereira Nunes Pinto AC, Natour J, de Moura Castro CH, Eloi M, Lombardi Junior I. Acute effect of a resistance exercise session on markers of cartilage breakdown and inflammation in women with rheumatoid arthritis. Int J Rheum Dis 2017; 20:1704-1713. [DOI: 10.1111/1756-185x.13204] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jamil Natour
- Division of Rheumatology; Escola Paulista de Medicina; São Paulo Brazil
| | | | - Marina Eloi
- Division of Rheumatology; Escola Paulista de Medicina; São Paulo Brazil
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19
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Fenton SAM, Veldhuijzen van Zanten JJCS, Kitas GD, Duda JL, Rouse PC, Yu CA, Metsios GS. Sedentary behaviour is associated with increased long-term cardiovascular risk in patients with rheumatoid arthritis independently of moderate-to-vigorous physical activity. BMC Musculoskelet Disord 2017; 18:131. [PMID: 28356089 PMCID: PMC5404687 DOI: 10.1186/s12891-017-1473-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 03/06/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Rheumatoid Arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). The physical dysfunction symptomatic of RA means people living with this disease spend large periods of the day sedentary, which may further elevate their risk of CVD. The primary aim of this study was to investigate relationships between objectively assessed sedentary behaviour patterns and light physical activity (LPA) with 10-year risk of CVD. Secondary aims were to explore the role of sedentary behaviour patterns and LPA for individual CVD risk factors and functional disability in RA. The extent to which associations were independent of moderate-to-vigorous physical activity (MVPA) engagement was also examined. METHODS Baseline data from a subsample of participants recruited to the Physical Activity in Rheumatoid Arthritis (PARA) study were used to answer current research questions. Sixty-one patients with RA (mean age (± SD) = 54.92 ± 12.39 years) provided a fasted blood sample and underwent physical assessments to evaluate factors associated with their cardiovascular health. Sedentary behaviour patterns (sedentary time, sedentary bouts, sedentary breaks), LPA and MVPA were measured via 7-days of accelerometry. Ten-year CVD risk was computed (Q-risk-score2), and functional disability determined via questionnaire. RESULTS Regressions revealed significant positive associations between sedentary time and the number of sedentary bouts per day ≥20 min with 10-year CVD risk, with the reverse true for LPA participation. Associations were independent of MVPA engagement. CONCLUSIONS Promoting LPA participation and restricting sedentary bouts to <20 min may attenuate long-term CVD risk in RA, independent of MVPA engagement. TRIAL REGISTRATION ISRCTN04121489 (retrospectively registered 19/10/2012).
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Affiliation(s)
- Sally A M Fenton
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK. .,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK.
| | - Jet J C S Veldhuijzen van Zanten
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
| | - George D Kitas
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
| | - Joan L Duda
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | | | - Chen-An Yu
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Faculty of Biological Sciences, University of Leeds, Leeds, UK
| | - George S Metsios
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.,Faculty of Health Education and Wellbeing, University of Wolverhampton, West Midlands, UK.,Department of Rheumatology, Russells Hall Hospital, Dudley Group NHS Foundation Trust, Dudley, UK
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20
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Yoshikawa N, Shimizu N, Uehara M, Oda A, Matsumiya R, Matsubara E, Kobayashi H, Hosono O, Kuribara-Souta A, Baba H, Nagamura F, Kiryu S, Tanaka H. The effects of bolus supplementation of branched-chain amino acids on skeletal muscle mass, strength, and function in patients with rheumatic disorders during glucocorticoid treatment. Mod Rheumatol 2016; 27:508-517. [PMID: 27678151 DOI: 10.1080/14397595.2016.1213480] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To test the effects of bolus supplementation of branched-chain amino acids (BCAA) on skeletal muscle mass, strength, and function in patients with rheumatic disorders taking glucocorticoid (GC). METHODS Patients with rheumatic disorders treated with prednisolone (≥10 mg/day) were randomized to ingest additional daily 12 g of BCAA (n = 9) or not (n = 9) for 12 weeks. At baseline, and 4, 8, and 12 weeks, they underwent bioelectrical impedance analysis, muscle strength and functional tests, and computed tomography analysis for cross-sectional area of mid-thigh muscle. RESULTS Disease activities of the patients were well controlled and daily GC dose was similarly reduced in both groups. Limb muscle mass was recovered in both groups. Whole-body muscle mass and muscle strength and functional mobility were increased only in BCAA (+) group. The effects of BCAA supplementation on recovering skeletal muscle mass were prominent in particular muscles including biceps femoris muscle. CONCLUSIONS This trial is the first-in-man clinical trial to demonstrate that BCAA supplementation might be safe and, at least in part, improve skeletal muscle mass, strength, and function in patients with rheumatic disorders treated with GC.
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Affiliation(s)
| | - Noriaki Shimizu
- a Department of Rheumatology and Allergy.,b Division of Rheumatology, Center for Antibody and Vaccine Therapy
| | | | - Aya Oda
- a Department of Rheumatology and Allergy
| | | | | | | | | | | | | | | | - Shigeru Kiryu
- d Department of Radiology , IMSUT Hospital, Institute of Medical Science, the University of Tokyo , Shirokanedai , Minato-ku , Tokyo , Japan
| | - Hirotoshi Tanaka
- a Department of Rheumatology and Allergy.,b Division of Rheumatology, Center for Antibody and Vaccine Therapy
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21
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Withall J, Haase AM, Walsh NE, Young A, Cramp F. Physical activity engagement in early rheumatoid arthritis: a qualitative study to inform intervention development. Physiotherapy 2016; 102:264-71. [DOI: 10.1016/j.physio.2015.07.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 07/25/2015] [Indexed: 11/30/2022]
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22
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Liao AH, Chung HY, Chen WS, Yeh MK. Efficacy of Combined Ultrasound-and-Microbubbles-Mediated Diclofenac Gel Delivery to Enhance Transdermal Permeation in Adjuvant-Induced Rheumatoid Arthritis in the Rat. ULTRASOUND IN MEDICINE & BIOLOGY 2016; 42:1976-1985. [PMID: 27181685 DOI: 10.1016/j.ultrasmedbio.2016.03.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/17/2016] [Accepted: 03/28/2016] [Indexed: 06/05/2023]
Abstract
A previous study that investigated the effect of ultrasound (US) on the transdermal permeation of the non-steroidal anti-inflammatory drug diclofenac found that therapeutic US can increase circulation in an inflamed joint and decrease arthritic pain. Transdermal drug delivery has recently been demonstrated by US combined with microbubbles (MB) contrast agent (henceforth referred to as "US-MB"). The present study evaluated the efficacy of US-MB-mediated diclofenac delivery for treating adjuvant-induced rheumatoid arthritis (RA) in rats. RA was induced by injecting 100 μL of complete Freund's adjuvant into the ankle joint of male Sprague-Dawley rats (250-300 g) that were randomly divided into five treatment groups: (i) carbopol gel alone (the control [group C]), (ii) diclofenac-carbopol gel (group D), (iii) US plus carbopol gel (group U), (iv) US plus diclofenac-carbopol gel (group DU) and (v) US-MB plus diclofenac-carbopol gel (group DUB). The ankle width was measured over 10 d using high-frequency (40-MHz) US B-mode and color Doppler-mode imaging, covering the period before and after treatment. Longitudinal US images of the induced RA showed synovitis and neovascularity. Only a small amount of neovascularity was observed after treatment. The recovery rate on day 10 was significantly higher in group DUB (97.7% ± 2.7%, mean ± standard deviation [SD]) than in groups C (1.0% ± 2.7%), D (37.5% ± 4.6%), U (75.5% ± 4.2%) and DU (87.3% ± 5.2%) (p < 0.05). The results obtained indicate that combining US and MB can increase the skin permeability and thereby enhance the delivery of diclofenac sodium gel and thereby inhibit inflammation of the tissues surrounding the arthritic ankle. Color Doppler-mode imaging revealed that US-MB treatment induced a rapid reduction in synovial neoangiogenesis in the arthritic area.
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Affiliation(s)
- Ai-Ho Liao
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan; Department of Biomedical Engineering, National Defense Medical Center, Taipei, Taiwan.
| | - Huan-Yu Chung
- Graduate Institute of Biomedical Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Wen-Shiang Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Kung Yeh
- School of Pharmacy, National Defense Medical Center, Taipei, Taiwan
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23
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Khoja SS, Almeida GJ, Chester Wasko M, Terhorst L, Piva SR. Association of Light-Intensity Physical Activity With Lower Cardiovascular Disease Risk Burden in Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016; 68:424-31. [PMID: 26314559 DOI: 10.1002/acr.22711] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 06/29/2015] [Accepted: 08/18/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To characterize physical activity (PA) in individuals with rheumatoid arthritis (RA) and to determine the associations between PA participation at light to moderate intensities and cardiovascular disease risk factors, disability, and disease activity. METHODS The cross-sectional study used data from 2 RA cohorts. PA was measured using an accelerometry-based activity monitor, recording minutes/day spent in sedentary (≤1 metabolic equivalent [MET]), very light (1.1-1.9 METs), light (2-2.9 METs), and moderate activities (≥3 METs). Cardiovascular markers included body mass index, blood pressure, insulin resistance, and lipid profile. Disability and disease activity were measured using the Health Assessment Questionnaire (HAQ) and the Disease Activity Score in 28 joints (DAS28), respectively. Associations between PA at each intensity level and health markers were assessed by multiple linear regression models, adjusted for age, sex, and cohort. RESULTS Ninety-eight subjects (mean ± SD age 58 ± 9 years, 85% female) were included. Subjects spent 9.8 hours/day being sedentary, 3.5 hours/day engaged in very light PA, 2.1 hours/day engaged in light PA, and 35 minutes/day engaged in moderate PA. Only 17% were physically active (≥150 minutes/week of moderate PA in 10-minute bouts). Regression models showed that very light, light, and moderate PA were inversely associated with most cardiovascular disease risk factors and HAQ and DAS28 scores (R(2) Δ range 0.04-0.52, P < 0.05). The associations between PA and cardiovascular disease markers were either equivalent or stronger at very light and light intensities, as compared to moderate intensity. CONCLUSION Individuals with RA are mostly active at very light and light intensities. PA at these intensity levels associates favorably with cardiovascular markers and lower disability and disease activity in RA.
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Affiliation(s)
| | | | | | | | - Sara R Piva
- University of Pittsburgh, Pittsburgh, Pennsylvania
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24
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Hernández-Hernández MV, Díaz-González F. Role of physical activity in the management and assessment of rheumatoid arthritis patients. ACTA ACUST UNITED AC 2016; 13:214-220. [PMID: 27263964 DOI: 10.1016/j.reuma.2016.04.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/18/2016] [Accepted: 04/04/2016] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting diarthrodial joints, in which patients tend to perform less physical activity (PA) than recommended. This review focuses on the existing evidence about the relationship of PA and RA, specifically how the former influences joint inflammation, disability, quality of life and pain in RA patients, and also how disease activity potentially impacts PA in these patients. METHODS A literature search of EMBASE and MEDLINE databases from January 2000 to January 2015. RESULTS The evidence indicating that PA in RA patients is safe and the benefits from regularly performing, both aerobic and resistance exercises, in these patients include improvement in: quality of life, functionality, pain and number of swollen joints. Interestingly, recent studies suggest that changes in disease activity in RA patients inversely correlate with variations in PA, as assessed by accelerometry. CONCLUSIONS The regular monitoring of PA in RA patients might facilitate a more objective evaluation of variations in disease activity, helping physicians to make general and therapeutic recommendations that will improve both the health status and the joint functionality of these patients.
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Affiliation(s)
| | - Federico Díaz-González
- Servicio de Reumatología, Hospital Universitario de Canarias, La Laguna, Spain; Departamento de Medicina Interna, Facultad de Medicina, Universidad de La Laguna, La Laguna, Spain.
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25
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van Onna M, Boonen A. The challenging interplay between rheumatoid arthritis, ageing and comorbidities. BMC Musculoskelet Disord 2016; 17:184. [PMID: 27118031 PMCID: PMC4845363 DOI: 10.1186/s12891-016-1038-3] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Accepted: 04/15/2016] [Indexed: 11/30/2022] Open
Abstract
Background The incidence of rheumatoid arthritis (RA) is expected to increase over the next 10 years in the European Union because of the increasing proportion of elderly people. As both RA and ageing are associated with emerging comorbidities such as cardiovascular disease, malignancies and osteoporosis, these factors will have a profound effect on the management of RA. In addition, both increasing age and comorbidities may independently alter commonly used RA-specific outcome measures. Discussion Age-related decline in immune cell functions (immunosenescence), such as a decrease in T-cell function, may contribute to the development of RA, as well as comorbidity. The chronic immune stimulation that occurs in RA may also lead to premature ageing and comorbidity. The interplay between RA, ageing and (emerging) comorbidities is interesting but complex. Cardiovascular disease, lung disease, malignancies, bone and muscle wasting and neuropsychiatric disease all occur more frequently in RA patients as compared to the general population. It is unclear how RA should be managed in ‘today’s world of multiple comorbidities’. Evidence that treatment of RA improves comorbidities is currently lacking, although some promising indirect observations are available. On the other hand, there is limited evidence that medication regularly prescribed for comorbidities, such as statins, might improve RA disease activity. Both ageing and comorbidity have an independent effect on commonly used outcome measures in the RA field, such as the Health Assessment Questionnaire (HAQ) and the clinical disease activity index (CDAI). Prospective studies, that also account for the presence of comorbidity in (elderly) RA patients are therefore urgently needed. To address gaps in knowledge, future research should focus on the complex interdependencies between RA, ageing and comorbidity. In addition, these findings should be integrated into daily clinical practice by developing and testing integrated and coordinated health care services. Adaptation of management recommendations is likely required. Summary The elderly RA patient who also deals with (emerging) comorbidities presents a unique challenge to treating clinicians. A paradigm shift from disease-centered to goal-oriented approach is needed to develop adequate health care services for these patients.
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Affiliation(s)
- Marloes van Onna
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, School for Public Health and Primary Care (CAPHRI), Maastricht University, P. Debyelaan 25, Maastricht, 6202 AZ, The Netherlands.
| | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, School for Public Health and Primary Care (CAPHRI), Maastricht University, P. Debyelaan 25, Maastricht, 6202 AZ, The Netherlands
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Abeyta AA, Routledge C. Fountain of youth: The impact of nostalgia on youthfulness and implications for health. SELF AND IDENTITY 2016. [DOI: 10.1080/15298868.2015.1133452] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Larkin L, Gallagher S, Fraser AD, Kennedy N. Relationship between self-efficacy, beliefs, and physical activity in inflammatory arthritis. Hong Kong Physiother J 2016; 34:33-40. [PMID: 30931025 PMCID: PMC6385135 DOI: 10.1016/j.hkpj.2015.10.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: The benefits of physical activity (PA) in inflammatory arthritis (IA) patients are well-established. However, levels of PA in the IA population are suboptimal and the psychological determinants of PA are poorly understood. Objective: The study aimed to examine the self-reported PA levels and psychological determinants of PA for the IA population. Methods: A cross-sectional study of people with rheumatoid arthritis (RA) and psoriatic arthritis (PsA) was conducted to explore the association between demographic and psychological variables such as self-efficacy and belief about PA, and levels of PA and energy expenditure (EE). PA was recorded using the Yale Physical Activity Survey (YPAS). Results: A total of 102 participants were included in the study. Participants reported low levels of PA [mean ± standard deviation (SD), 24.3 ± 18.2]. Beliefs about PA, but not self-efficacy, correlated with levels of self-report PA over the past week (r = 0.25, p = 0.01), over the past month (r = 0.21, p = 0.04), and EE (r = 0.31, p = 0.01). Conclusion: People with IA have decreased levels of PA. Beliefs about PA are associated with levels of self-report PA and EE in this population. These data provide a useful signpost for guiding and designing interventions to improve PA levels in IA populations by altering beliefs about PA.
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Affiliation(s)
- Louise Larkin
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Centre for Social Issues, Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Alexander D Fraser
- University of Limerick Medical School and University Hospitals Limerick, Limerick, Ireland
| | - Norelee Kennedy
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Konijn NPC, van Tuyl LHD, Boers M, den Uyl D, ter Wee MM, Kerstens P, Voskuyl AE, Nurmohamed M, van Schaardenburg D, Lems WF. Effective Treatment for Rapid Improvement of Both Disease Activity and Self-Reported Physical Activity in Early Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 2016. [DOI: 10.1002/acr.22668] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Maarten Boers
- VU University Medical Center and Reade; Amsterdam The Netherlands
| | - Debby den Uyl
- VU University Medical Center; Amsterdam The Netherlands
| | | | - Pit Kerstens
- Reade, Amsterdam, and Westfriesgasthuis; Hoorn The Netherlands
| | | | | | | | - Willem F. Lems
- VU University Medical Center and Reade; Amsterdam The Netherlands
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Liao AH, Chuang HC, Chung HY. Efficacy of ultrasound mediated microbubbles in diclofenac gel to enhance transdermal permeation in rheumatoid arthritis induced rat. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:3521-4. [PMID: 26737052 DOI: 10.1109/embc.2015.7319152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In previous study in the literature, the effect of ultrasound on the transdermal permeation of the nonsteroidal anti-inflammatory drug, diclofenac has been investigated. Therapeutic ultrasound can increase circulation in the inflamed joint and decrease arthritic pain. Recently, transdermal drug delivery has been demonstrated by ultrasound (US) combining with microbubbles (MBs) contrast agent. In this study, the efficiency of US-MBs mediated diclofenac delivery for adjuvant-induced rheumatoid arthritis (RA) in rats was evaluated. RA was induced by injection of 100 μl Freund's complete adjuvant into the ankle joint in SD male rats (250-300g) and were randomly divided into five groups: (1) control group (C); (2) penetrating diclofenac alone (D); (3) US alone (U); (4) US combined with penetrating diclofenac (DU); (5) US combined with MBs and penetrating diclofenac (DUB). The evaluations of ankle width were performed for 10 days by high frequency (40MHz) US B-mode and color Doppler mode imaging before and after treatment. Longitudinal US images of arthritis induced show synovitis and neovascularity. After treatment, only a little neovascularity has been observed. The recovery rate at 10th day in the group DUB (97.7±2.7 %) was significantly higher than in the group C (1.0±2.7 %), group D (37.5±4.6 %), group U (75.5±4.2 %) and group DU (87.3±5.2 %) (p <; 0.05). Our results investigated that the treatments of US and MBs can increase skin permeability to enhance diclofenac sodium delivery and inhibit inflammation of the tissues surrounded the arthritic ankle. In color Doppler imaging, after the combination treatment, the synovial neoangiogenesis in the arthritic area was reduced quickly.
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Cascão R, Vidal B, Lopes IP, Paisana E, Rino J, Moita LF, Fonseca JE. Decrease of CD68 Synovial Macrophages in Celastrol Treated Arthritic Rats. PLoS One 2015; 10:e0142448. [PMID: 26658436 PMCID: PMC4676706 DOI: 10.1371/journal.pone.0142448] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 10/21/2015] [Indexed: 01/08/2023] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic immune-mediated inflammatory disease characterized by cellular infiltration into the joints, hyperproliferation of synovial cells and bone damage. Available treatments for RA only induce remission in around 30% of the patients, have important adverse effects and its use is limited by their high cost. Therefore, compounds that can control arthritis, with an acceptable safety profile and low production costs are still an unmet need. We have shown, in vitro, that celastrol inhibits both IL-1β and TNF, which play an important role in RA, and, in vivo, that celastrol has significant anti-inflammatory properties. Our main goal in this work was to test the effect of celastrol in the number of sublining CD68 macrophages (a biomarker of therapeutic response for novel RA treatments) and on the overall synovial tissue cellularity and joint structure in the adjuvant-induced rat model of arthritis (AIA). Methods Celastrol was administered to AIA rats both in the early (4 days after disease induction) and late (11 days after disease induction) phases of arthritis development. The inflammatory score, ankle perimeter and body weight were evaluated during treatment period. Rats were sacrificed after 22 days of disease progression and blood, internal organs and paw samples were collected for toxicological blood parameters and serum proinflammatory cytokine quantification, as well as histopathological and immunohistochemical evaluation, respectively. Results Here we report that celastrol significantly decreases the number of sublining CD68 macrophages and the overall synovial inflammatory cellularity, and halted joint destruction without side effects. Conclusions Our results validate celastrol as a promising compound for the treatment of arthritis.
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MESH Headings
- Adjuvants, Immunologic
- Animals
- Anti-Inflammatory Agents/pharmacology
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, Differentiation, Myelomonocytic/genetics
- Antigens, Differentiation, Myelomonocytic/immunology
- Arthritis, Experimental/chemically induced
- Arthritis, Experimental/drug therapy
- Arthritis, Experimental/genetics
- Arthritis, Experimental/immunology
- Arthritis, Rheumatoid/drug therapy
- Arthritis, Rheumatoid/genetics
- Arthritis, Rheumatoid/immunology
- Arthritis, Rheumatoid/pathology
- Cell Count
- Female
- Gene Expression
- Humans
- Injections, Intraperitoneal
- Interleukin-1beta/genetics
- Interleukin-1beta/immunology
- Macrophages/drug effects
- Macrophages/immunology
- Macrophages/pathology
- Pentacyclic Triterpenes
- Rats
- Rats, Wistar
- Synovial Membrane/drug effects
- Synovial Membrane/immunology
- Synovial Membrane/pathology
- Treatment Outcome
- Triterpenes/pharmacology
- Tumor Necrosis Factor-alpha/genetics
- Tumor Necrosis Factor-alpha/immunology
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Affiliation(s)
- Rita Cascão
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- * E-mail:
| | - Bruno Vidal
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Inês P. Lopes
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Eunice Paisana
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - José Rino
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | | | - João E. Fonseca
- Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
- Rheumatology Department, Centro Hospitalar de Lisboa Norte, EPE, Hospital de Santa Maria, Lisbon Academic Medical Centre, Lisbon, Portugal
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Mossiat C, Laroche D, Prati C, Pozzo T, Demougeot C, Marie C. Association between arthritis score at the onset of the disease and long-term locomotor outcome in adjuvant-induced arthritis in rats. Arthritis Res Ther 2015; 17:184. [PMID: 26183428 PMCID: PMC4506462 DOI: 10.1186/s13075-015-0700-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 06/26/2015] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION To investigate the connection between the intensity of initial symptoms of inflammation and locomotor outcome in rheumatoid arthritis, we examined the relationship between long-term locomotor abnormalities and signs of inflammation at the onset of the disease in adjuvant-induced arthritis (AIA) in rats. METHODS The arthritis score and hind-paw diameter were followed from immunization to day 195 (~7 months). At this time, locomotion was recorded during forced treadmill walking using 3D motion technology before radiographic scoring of hind limb joint damage. Many locomotor parameters were analyzed including time and length parameters, limbs kinematics, lateral paw position at toe off, maximal hind-paw elevation and posture. Ankle mobility was assessed from range of motion (ROM) of the joint during locomotion. Experiments were run in AIA (n = 18) and age-matched non-AIA rats (n = 8). RESULTS All AIA rats exhibited signs of inflammation at day 14 with a peak of inflammatory symptoms at day 22 post-immunization. After the first episode of inflammation, 83 % of AIA rats demonstrated recurrent disease (from week 6 to week 23). The frequency of inflammatory episodes (1 to 5) was not linked to the arthritis score at day 22. At day 195 post-immunization, AIA rats showed significantly impaired locomotion and radiographic lesions as compared to control rats. Significant relationships were observed between most locomotion-related parameters and concurrent ROM of ankle, which correlated negatively with the radiographic score. ROM of ankle at day 195 correlated negatively with both the arthritis score and hind-paw diameter measured at day 14, 22 and 30 post-immunization. CONCLUSION Decreased ankle mobility can be considered a driver of locomotion impairment in AIA. In this model, the severity of the initial inflammatory symptoms had a good prognostic value for long-term locomotor outcome.
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Affiliation(s)
- Claude Mossiat
- INSERM U1093, University Bourgogne Franche-Comté, F-21000, Dijon, France.
| | - Davy Laroche
- INSERM U1093, University Bourgogne Franche-Comté, F-21000, Dijon, France. .,CHRU, Dijon, France.
| | - Clément Prati
- EA4267, FHU INCREASE, University Bourgogne Franche-Comté, F-25000, Besançon, France. .,CHRU, Besançon, France.
| | - Thierry Pozzo
- INSERM U1093, University Bourgogne Franche-Comté, F-21000, Dijon, France.
| | - Céline Demougeot
- EA4267, FHU INCREASE, University Bourgogne Franche-Comté, F-25000, Besançon, France.
| | - Christine Marie
- INSERM U1093, University Bourgogne Franche-Comté, F-21000, Dijon, France. .,INSERM U 1093 Cognition, Action et Plasticité Sensorimotrice, 7 boulevard Jeanne d'Arc, BP 87900, 21000, Dijon, France.
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Larkin L, Gallagher S, Cramp F, Brand C, Fraser A, Kennedy N. Behaviour change interventions to promote physical activity in rheumatoid arthritis: a systematic review. Rheumatol Int 2015; 35:1631-40. [PMID: 25994094 DOI: 10.1007/s00296-015-3292-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Accepted: 05/14/2015] [Indexed: 11/28/2022]
Abstract
Research has shown that people who have rheumatoid arthritis (RA) do not usually participate in enough physical activity to obtain the benefits of optimal physical activity levels, including quality of life, aerobic fitness and disease-related characteristics. Behaviour change theory underpins the promotion of physical activity. The aim of this systematic review was to explore behaviour change interventions which targeted physical activity behaviour in people who have RA, focusing on the theory underpinning the interventions and the behaviour change techniques utilised using specific behaviour change taxonomy. An electronic database search was conducted via EBSCOhost, PubMed, Cochrane Central Register of Controlled Trials and Web of Science databases in August 2014, using Medical Subject Headings and keywords. A manual search of reference lists was also conducted. Randomised control trials which used behaviour change techniques and targeted physical activity behaviour in adults who have RA were included. Two reviewers independently screened studies for inclusion. Methodological quality was assessed using the Cochrane risk of bias tool. Five studies with 784 participants were included in the review. Methodological quality of the studies was mixed. The studies consisted of behaviour change interventions or combined practical physical activity and behaviour change interventions and utilised a large variety of behaviour change techniques. Four studies reported increased physical activity behaviour. All studies used subjective methods of assessing physical activity with only one study utilising an objective measure. There has been varied success of behaviour change interventions in promoting physical activity behaviour in people who have RA. Further studies are required to develop and implement the optimal behaviour change intervention in this population.
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Affiliation(s)
- Louise Larkin
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
| | - Stephen Gallagher
- Department of Psychology, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Fiona Cramp
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
| | - Charles Brand
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
| | - Alexander Fraser
- University of Limerick Medical School, University of Limerick, Limerick, Ireland.,University Hospital Limerick, Limerick, Ireland
| | - Norelee Kennedy
- Department of Clinical Therapies, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
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Profile of energy expenditure in people with rheumatoid arthritis. Disabil Health J 2015; 8:514-20. [PMID: 25953350 DOI: 10.1016/j.dhjo.2015.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 01/05/2015] [Accepted: 03/13/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND No definitive conclusions have been made on the levels of physical activity in the rheumatoid arthritis (RA) population. Similarly no clear consensus has been reached on the correlates and predictors of physical activity in the population. OBJECTIVE To profile total energy expenditure (TEE), resting energy expenditure (REE) and physical activity related energy expenditure (PAEE) levels using a validated objective measurement tool and to determine demographic and health related factors which influence and predict TEE and PAEE levels in individuals with RA. METHODS Fifty nine (41 female, 18 male) individuals with RA were recruited to this cross sectional study. Energy expenditure was measured over seven days using SenseWear Armband. Correlational analysis and logistic regression were used to examine the relationship between demographic and health related factors and TEE, REE and PAEE. RESULTS A profile of energy expenditure in RA individuals was developed in terms of levels, differences between genders and differences between weekdays and weekend days. Median TEE, PAEE and REE were 2204.0, 409.5 and 1506.2 kcal/day respectively. Energy expenditure was associated with factors such as gender, age, body mass index, employment status, disease severity and smoking. CONCLUSION The findings add to the growing research assessing energy expenditure in the RA population and strengthen the position due to the use of an objective validated tool. Some recommendations on what factors are associated with energy expenditure in the RA population are made, thus unveiling ways to tailor physical activity type interventions in this group.
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Zhang ZC, Zhang SJ, Jin B, Wu Y, Yang XF, Yu B, Xie QM. Ciclamilast ameliorates adjuvant-induced arthritis in a rat model. BIOMED RESEARCH INTERNATIONAL 2015; 2015:786104. [PMID: 26000303 PMCID: PMC4426775 DOI: 10.1155/2015/786104] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Revised: 09/23/2014] [Accepted: 09/25/2014] [Indexed: 11/17/2022]
Abstract
We assessed the effect of a novel and selective phosphodiesterase 4 (PDE4) inhibitor, ciclamilast, on chronic inflammation in adjuvant-induced arthritis (AIA), a rat model of rheumatoid arthritis (RA), and acute inflammation in the rat and mouse model of carrageenan-induced paw edema and peritonitis. Our results showed that daily oral administration of ciclamilast at 1, 3, and 10 mg/kg dose-dependently inhibited the increase in hind paw volume of rats with AIA. The inhibition of paw edema was associated with inhibition of both the production of cytokines such as TNF-α, IL-1β, and IL-6 and cell infiltration assessed in subcutaneous paw tissue. Moreover, there was significantly less tissue destruction in the ciclamilast-treated rats compared to the vehicle-treated rats, as assessed by radiographic analysis and histopathological evaluation. In the two acute inflammation models, ciclamilast inhibited carrageenan-induced paw edema in rats and inflammatory cell migration into the peritoneal cavity in mice in a dose-dependent manner. These results not only suggest that ciclamilast, as a disease-modifying antirheumatic drug (DMARD), can attenuate RA but also provide proof of principle that a PDE4 inhibitor may be useful for the treatment of arthritis.
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Affiliation(s)
- Zhi-cheng Zhang
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou 310053, China
| | - Shui-juan Zhang
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou 310053, China
| | - Bo Jin
- Department of Pharmacology, Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Hangzhou 310058, China
| | - Yujin Wu
- Department of Pharmacology, Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Hangzhou 310058, China
| | - Xin-fu Yang
- Department of Pharmacology, Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Hangzhou 310058, China
| | - Bing Yu
- College of Pharmaceutical Science, Zhejiang Chinese Medical University, No. 548 Binwen Road, Hangzhou 310053, China
| | - Qiang-min Xie
- Department of Pharmacology, Zhejiang University School of Medicine, No. 866 Yuhangtang Road, Hangzhou 310058, China
- Laboratory Animal Center of Zhejiang University, Hangzhou 310058, China
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Larkin L, Kennedy N, Gallagher S. Promoting physical activity in rheumatoid arthritis: a narrative review of behaviour change theories. Disabil Rehabil 2015; 37:2359-66. [DOI: 10.3109/09638288.2015.1019011] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Prioreschi A, Tikly M, McVeigh JA. A three month controlled intervention of intermittent whole body vibration designed to improve functional ability and attenuate bone loss in patients with rheumatoid arthritis. BMC Musculoskelet Disord 2014; 15:403. [PMID: 25433517 PMCID: PMC4265489 DOI: 10.1186/1471-2474-15-403] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 11/25/2014] [Indexed: 01/08/2023] Open
Abstract
Background Rheumatoid arthritis (RA) is a chronic autoimmune condition that results in pain and disability. Patients with RA have a decreased functional ability and are forced into a sedentary lifestyle and as such, these patients often become predisposed to poor bone health. Patients with RA may also experience a decreased health related quality of life (HRQoL) due to their disease. Whole body vibration (WBV) is a form of exercise that stimulates bone loading through forced oscillation. WBV has also been shown to decrease pain and fatigue in other rheumatic diseases, as well as to increase muscle strength. This paper reports on the development of a semi randomised controlled clinical trial to assess the impact of a WBV intervention aiming to improve functional ability, attenuate bone loss, and improve habitual physical activity levels in patients with RA. Methods/Design This study is a semi randomised, controlled trial consisting of a cohort of patients with established RA assigned to either a WBV group or a CON (control) group. Patients in the WBV group will undergo three months of twice weekly intermittent WBV sessions, while the CON group will receive standard care and continue with normal daily activities. All patients will be assessed at baseline, following the three month intervention, and six months post intervention. Main outcomes will be an improvement in functional ability as assessed by the HAQ. Secondary outcomes are attenuation of loss of bone mineral density (BMD) at the hip and changes in RA disease activity, HRQoL, habitual physical activity levels and body composition. Discussion This study will provide important information regarding the effects of WBV on functional ability and BMD in patients with RA, as well as novel data regarding the potential changes in objective habitual physical activity patterns that may occur following the intervention. The sustainability of the intervention will also be assessed. Trial registration PACTR201405000823418 (19/05/2014). Electronic supplementary material The online version of this article (doi:10.1186/1471-2474-15-403) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alessandra Prioreschi
- Exercise Physiology Laboratory, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
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Lira FS, Neto JCR, Seelaender M. Exercise training as treatment in cancer cachexia. Appl Physiol Nutr Metab 2014; 39:679-86. [DOI: 10.1139/apnm-2013-0554] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Cachexia is a wasting syndrome that may accompany a plethora of diseases, including cancer, chronic obstructive pulmonary disease, aids, and rheumatoid arthritis. It is associated with central and systemic increases of pro-inflammatory factors, and with decreased quality of life, response to pharmacological treatment, and survival. At the moment, there is no single therapy able to reverse cachexia many symptoms, which include disruption of intermediary metabolism, endocrine dysfunction, compromised hypothalamic appetite control, and impaired immune function, among other. Growing evidence, nevertheless, shows that chronic exercise, employed as a tool to counteract systemic inflammation, may represent a low-cost, safe alternative for the prevention/attenuation of cancer cachexia. Despite the well-documented capacity of chronic exercise to counteract sustained disease-related inflammation, few studies address the effect of exercise training in cancer cachexia. The aim of the present review was hence to discuss the results of cachexia treatment with endurance training. As opposed to resistance exercise, endurance exercise may be performed devoid of equipment, is well tolerated by patients, and an anti-inflammatory effect may be observed even at low-intensity. The decrease in inflammatory status induced by endurance protocols is paralleled by recovery of various metabolic pathways. The mechanisms underlying the response to the treatment are considered.
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Affiliation(s)
- Fábio Santos Lira
- Immunometabolism Research Group, Department of Physical Education, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - José Cesar Rosa Neto
- Immunometabolism Research Group, Institute of Biomedical Sciences, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Marília Seelaender
- Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of São Paulo (USP), Av. Lineu Prestes, 1524, CEP 05508-900, Butantã, São Paulo, SP, Brazil
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Brorsson S, Nilsdotter A, Thorstensson C, Bremander A. Differences in muscle activity during hand-dexterity tasks between women with arthritis and a healthy reference group. BMC Musculoskelet Disord 2014; 15:154. [PMID: 24886491 PMCID: PMC4060090 DOI: 10.1186/1471-2474-15-154] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 04/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Impaired hand function is common in patients with arthritis and it affects performance of daily activities; thus, hand exercises are recommended. There is little information on the extent to which the disease affects activation of the flexor and extensor muscles during these hand-dexterity tasks. The purpose of this study was to compare muscle activation during such tasks in subjects with arthritis and in a healthy reference group. METHODS Muscle activation was measured in m. extensor digitorium communis (EDC) and in m. flexor carpi radialis (FCR) with surface electromyography (EMG) in women with rheumatoid arthritis (RA, n = 20), hand osteoarthritis (HOA, n = 16) and in a healthy reference group (n = 20) during the performance of four daily activity tasks and four hand exercises. Maximal voluntary isometric contraction (MVIC) was measured to enable intermuscular comparisons, and muscle activation is presented as %MVIC. RESULTS The arthritis group used a higher %MVIC than the reference group in both FCR and EDC when cutting with a pair of scissors, pulling up a zipper and-for the EDC-also when writing with a pen and using a key (p < 0.02). The exercise "rolling dough with flat hands" required the lowest %MVIC and may be less effective in improving muscle strength. CONCLUSIONS Women with arthritis tend to use higher levels of muscle activation in daily tasks than healthy women, and wrist extensors and flexors appear to be equally affected. It is important that hand training programs reflect real-life situations and focus also on extensor strength.
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Affiliation(s)
- Sofia Brorsson
- Health and Welfare, Dala Sports Academy, Dalarna University, SE-781 88 Falun, Sweden.
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From clinical expert to guide: experiences from coaching people with rheumatoid arthritis to increased physical activity. Phys Ther 2014; 94:644-53. [PMID: 24415773 DOI: 10.2522/ptj.20130393] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Physical activity levels in people with rheumatoid arthritis are lower than what are recommended for a healthful lifestyle. To support physical activity, health care professionals may use behavioral change techniques based on a biopsychosocial perspective. Investigating the implementation process may be relevant for understanding how these techniques translate to practice. OBJECTIVES The study objective was to explore the experiences of physical therapists using behavioral change techniques to coach people with rheumatoid arthritis to health-enhancing physical activity in a 2-year trial, the Physical Activity in Rheumatoid Arthritis 2010 study. DESIGN This was an exploratory study with qualitative content analysis. METHODS Semistructured interviews were conducted with all 12 physical therapists in the study. They were asked about their experiences with an educational program and with their delivery of a health-enhancing physical activity intervention. Codes, subcategories, categories, and an overarching theme were derived from the transcribed interviews by use of qualitative content analysis. RESULTS The overarching theme (from clinical expert to guide) was based on 3 main categories: challenges in the coaching role, growing into the coaching role, and coach education and support. Early in the process, the physical therapists encountered challenges that needed to be addressed for a smoother transition into their coaching role. Assisted by education and support, they gradually adopted practices that facilitated their use of behavioral change techniques and promoted growth into the role of coach. CONCLUSIONS Adapting to a new role is a challenging process for health care professionals; it requires relevant education and support. The experiences identified in the present study may inform future educational programs targeting the skills of health care professionals in promoting various health-related behaviors.
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Ward L, Stebbings S, Athens J, Cherkin D, David Baxter G. Yoga for pain and sleep quality in rheumatoid arthritis: study protocol for a pilot randomized controlled trial. PHYSICAL THERAPY REVIEWS 2014. [DOI: 10.1179/1743288x14y.0000000139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ryan JL, Mullins LL, Ramsey RR, Bonner MS, Jarvis JN, Gillaspy SR, Chaney JM. Caregiver demand and parent distress in juvenile rheumatic disease: the mediating effect of parent attitude toward illness. J Clin Psychol Med Settings 2014; 20:351-60. [PMID: 23613109 DOI: 10.1007/s10880-013-9365-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Parents of youth with juvenile rheumatic diseases (JRD) often take on illness management responsibilities that can become burdensome, potentially resulting in poor parent adjustment outcomes. However, not all caregivers will experience increased distress as a result of variability in stress appraisals. The current study examined the role of parent illness attitudes in the relation between perceived caregiver demand and parental distress. Youth (N = 70) ages 7-18 years diagnosed with a JRD and their parents were recruited from a pediatric rheumatology clinic. Parents completed measures of caregiver demand, parental distress, and illness attitudes. Hierarchical regression revealed a relationship between caregiver demand and parental distress. A significant relationship was also found between caregiver demand and parent illness attitudes, as well as parent illness attitudes and parental distress. Thus, parent illness attitudes mediated the relationship between caregiver demand and parental distress. Techniques aimed at altering negative illness attitudes may help parents cope with their caregiving responsibilities.
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Affiliation(s)
- Jamie L Ryan
- Department of Psychology, Oklahoma State University, 116 North Murray Hall, Stillwater, OK 74078, USA.
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Rajasekaran N, Tran R, Pascual C, Xie X, Mellins ED. Reduced locomotor activity correlates with increased severity of arthritis in a mouse model of antibody-induced arthritis. ACTA ACUST UNITED AC 2014; 4:62-68. [PMID: 25506517 DOI: 10.4236/ojra.2014.41010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by synovial hyperplasia and progressive cartilage and bone destruction that leads to a substantial loss of general functions and/or a decline in physical activities such as walking speed in humans. The K/BxN serum transfer arthritis in mice shares many immunological and pathological features with human RA. Very few studies are available in mice that investigate the changes in physical activity in relation to arthritis development. In this study we investigate the effect of arthritis on the locomotor activity of mice during K/BxN sera transfer arthritis. METHODS Arthritis was induced in Balb/c mice by injecting intraperitoneally with 200ul of K/BxN sera; Balb/c mice injected with phosphate buffered saline (PBS) served as control. Progress of arthritis was estimated by daily measurements of joint thickness. Each mouse's locomotor activity (travel distance and travel time) was assessed every day for duration of 20 minute period using the SmartCage™ platform. Data were analyzed using the SmartCage™ analysis software (CageScore™). RESULTS Arthritic Balb/c mice showed a reduction in distance covered and travel speed when compared to arthritis-free, control Balb/c mice. Maximum decline in locomotor activity was observed during the peak period of the disease and correlated to the increase in joint thickness in the arthritic mice. CONCLUSION This report demonstrates that measuring locomotor activity of mice during progression of K/BxN sera-induced arthritis using the SmartCage™ platform offers a quantitative method to assess physical activity in mice during arthritis.
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Affiliation(s)
- Narendiran Rajasekaran
- Department of Pediatrics, Program in immunology, Stanford University Medical Center, Stanford, CA-94305
| | - Ricky Tran
- Department of Pediatrics, Program in immunology, Stanford University Medical Center, Stanford, CA-94305
| | | | - Xinmin Xie
- AfaSci Research Laboratory, Redwood City, CA 94063
| | - Elizabeth D Mellins
- Department of Pediatrics, Program in immunology, Stanford University Medical Center, Stanford, CA-94305
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Hernandez-Hernandez V, Ferraz-Amaro I, Diaz-Gonzalez F. Influence of disease activity on the physical activity of rheumatoid arthritis patients. Rheumatology (Oxford) 2013; 53:722-31. [DOI: 10.1093/rheumatology/ket422] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Campos APR, Silva CM, Castro SSD, Graminha CV. Depressão e qualidade de vida em indivíduos com artrite reumatoide e indivíduos com saúde estável: um estudo comparativo. FISIOTERAPIA E PESQUISA 2013. [DOI: 10.1590/s1809-29502013000400016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi verificar a ocorrência de depressão e alterações da qualidade de vida (QV) em indivíduos com artrite reumatoide (AR).Participaram da pesquisa 60 indivíduos, divididos em 2 grupos com 30 cada, sendo o Grupo Teste composto por indivíduos com AR e o Grupo Controle composto por indivíduos com saúde estável. A QV foi avaliada pelo Medical Outcomes Study 36-Item Short-Form Healthy Survey (SF-36) e a depressão, pela Escala de Depressão de Beck (BDS). Para estabelecer comparações entre os grupos quanto aos escores de cada domínio do SF-36, utilizamos o teste de Mann-Whitney e, para os dados do "estado de saúde em geral" do SF-36, o teste do χ². Para comparar os grupos quanto ao escore total de depressão e quanto aos escores de cada categoria de depressão, empregamos respectivamente os testes Wilcoxon-Mann-Whitney (WMW) e χ². Para as variáveis "estado de saúde" em geral do SF-36 e classificação da depressão, calculou-se a Odds Ratio bruta e ajustada por meio de modelagem de regressão logística. O nível de significância foi estabelecido em 5%. Os resultados mostraram que houve diferenças entre os grupos nos oito domínios do SF-36, indicando queindivíduos com AR apresentam menores índices de QV e autoavaliação em saúde (ORajustada=14,38) e que 63,33% dos participantes com AR apresentam algum grau de depressão. Concluímos que a AR causa um impacto negativo na QV e que a depressão poder ser considerada um sintoma associado à diminuição da capacidade funcional decorrente da doença.
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Paul L, Rafferty D, Marshall-McKenna R, Gill JMR, McInnes I, Porter D, Woodburn J. Oxygen cost of walking, physical activity, and sedentary behaviours in rheumatoid arthritis. Scand J Rheumatol 2013; 43:28-34. [DOI: 10.3109/03009742.2013.802009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Horai N, Nagaoka T, Higuchi I, Kasai H, Yoshioka T, Umekita Y, Fukuzaki K, Nagata R, Miyata A, Abeyama K. Muscle wasting associated with pathologic change is a risk factor for the exacerbation of joint swelling in collagen-induced arthritis in cynomolgus monkeys. BMC Musculoskelet Disord 2013; 14:205. [PMID: 23834772 PMCID: PMC3710207 DOI: 10.1186/1471-2474-14-205] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 07/05/2013] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Not only joint destruction but also muscle wasting due to rheumatoid cachexia has been problem in terms of quality of life of patients with rheumatoid arthritis (RA). In the present study, we performed histopathological examination and assessed relationships between characteristic parameters relating to muscle and joint swelling in a collagen-induced arthritis (CIA) model using cynomolgus monkeys (CMs). METHODS Female CMs were used and CIA was induced by twice immunizations using bovine type II collagen with Freund's complete adjuvant. Arthritis level was evaluated from the degree of swelling at the peripheral joints of the fore and hind limbs. Food consumption, body weight, and serum biochemical parameters were measured sequentially. Five or 6 animals per time point were sacrificed at 2, 3, 5 and 9 weeks after the first immunization to obtain quadriceps femoris specimens for histopathology. Pimonidazole hydrochloride was intravenously administered to determine tissue hypoxia in skeletal muscle. RESULTS Gradual joint swelling was observed and the maximum arthritis score was noted at Week 5. In histopathology, necrosis of muscle fiber in the quadriceps femoris was observed only at Week 2 and the most significant findings such as degeneration, atrophy, and regeneration of muscle fiber were mainly observed at Week 5. Food consumption was decreased up to Week 4 but recovered thereafter. Body weight decreased up to Week 5 and did not completely recover thereafter. A biphasic increase in serum cortisol was also observed at Weeks 2 and 5. Histopathology showed that muscle lesions were mainly composed of degeneration and atrophy of the muscle fibers, and ATPase staining revealed that the changes were more pronounced in type II muscle fiber than type I muscle fiber. In the pimonidazole experiment, mosaic pattern in skeletal muscle was demonstrated in the intact animal, but not the CIA animal. Increased arthritis score was accompanied by a decrease in serum creatinine, a marker that reflects muscle mass. CONCLUSIONS Muscle wasting might exacerbate joint swelling in a collagen-induced arthritis model of cynomolgus monkeys.
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Cramp F, Berry J, Gardiner M, Smith F, Stephens D. Health behaviour change interventions for the promotion of physical activity in rheumatoid arthritis: a systematic review. Musculoskeletal Care 2013; 11:238-47. [PMID: 23653309 DOI: 10.1002/msc.1049] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is a chronic, inflammatory, autoimmune disease with typical onset between the ages of 40 and 50 years. Increasing levels of physical activity (PA) have been shown to decrease inflammation, reduce pain, increase functional ability and improve self-esteem in people with RA. Health behaviour change (HBC) interventions have recently shown promise in facilitating the promotion of PA within a range of long-term conditions. There is currently no evidence synthesis relating to HBC interventions to increase PA in the RA population. OBJECTIVES The aim of the present study was to determine whether HBC interventions can increase PA in people with RA and identify optimal interventions or promising constituent components of the HBC interventions. METHODS A systematic literature search was conducted to identify randomized, controlled trials investigating the effect of HBC interventions on PA level in adults with RA. Four review authors independently assessed the methodological quality of studies and extracted data based upon predefined criteria. RESULTS Following the application of inclusion/exclusion criteria, three studies remained for inclusion. Two studies reported significant short-term (<9 months) beneficial effects of HBC upon PA (p < 0.05). Individualized interventions were significantly more effective (p < 0.05). CONCLUSIONS Due to methodological flaws and a lack of comparison with usual care, it is not possible to conclude whether HBC interventions can increase PA in the RA population. Although it is possible to highlight promising elements of HBC interventions, such as goal setting and feedback on performance, further research on all specific components, including information provision, behaviour contracts and problem solving, is required to establish conclusive clinical guidelines.
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Affiliation(s)
- Fiona Cramp
- Faculty of Health and Life Sciences, University of the West of England, Bristol, UK
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Munsterman T, Takken T, Wittink H. Are persons with rheumatoid arthritis deconditioned? A review of physical activity and aerobic capacity. BMC Musculoskelet Disord 2012; 13:202. [PMID: 23078261 PMCID: PMC3575246 DOI: 10.1186/1471-2474-13-202] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 10/10/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although the general assumption is that patients with rheumatoid arthritis (RA) have decreased levels of physical activity, no review has addressed whether this assumption is correct. METHODS Our objective was to systematically review the literature for physical activity levels and aerobic capacity (VO2max). in patients with (RA), compared to healthy controls and a reference population. Studies investigating physical activity, energy expenditure or aerobic capacity in patients with RA were included. Twelve studies met our inclusion criteria. RESULTS In one study that used doubly labeled water, the gold standard measure, physical activity energy expenditure of patients with RA was significantly decreased. Five studies examined aerobic capacity. Contradictory evidence was found that patients with RA have lower VO2max than controls, but when compared to normative values, patients scored below the 10th percentile. In general, it appears that patients with RA spend more time in light and moderate activities and less in vigorous activities than controls. CONCLUSION Patients with RA appear to have significantly decreased energy expenditure, very low aerobic capacity compared to normative values and spend less time in vigorous activities than controls.
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Affiliation(s)
- Tjerk Munsterman
- Physical Therapy Center, Martini Hospital Groningen, P.O. Box 30033, 9700 RM Groningen, Netherlands
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de Jong HJI, Vandebriel RJ, Saldi SRF, van Dijk L, van Loveren H, Cohen Tervaert JW, Klungel OH. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers and the risk of developing rheumatoid arthritis in antihypertensive drug users. Pharmacoepidemiol Drug Saf 2012; 21:835-43. [PMID: 22674737 DOI: 10.1002/pds.3291] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 03/09/2012] [Accepted: 04/12/2012] [Indexed: 12/13/2022]
Abstract
PURPOSE Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are effective in the treatment of cardiovascular disease. Next to effects on hypertension and cardiac function, these drugs have anti-inflammatory and immunomodulating properties which may either facilitate or protect against the development of autoimmunity, potentially resulting in autoimmune diseases. Therefore, we determined in the current study the association between ACE inhibitor and ARB use and incident rheumatoid arthritis (RA). METHODS A matched case-control study was conducted among patients treated with antihypertensive drugs using the Netherlands Information Network of General Practice (LINH) database in 2001-2006. Cases were patients with a first-time diagnosis of RA. Each case was matched to five controls for age, sex, and index date, which was selected 1 year before the first diagnosis of RA. ACE inhibitor and ARB exposure was considered to be any prescription issued in the period before index date. Logistic regression analysis was used to estimate odds ratios (ORs) and their 95% confidence intervals (CI). RESULTS Our study included 211 cases and 667 matched controls. After controlling for potential confounders, ever use of ACE inhibitors or ARBs was not associated with incident RA (adjusted ORs [95%CI], 0.99 [0.55-1.79] and 1.02 [0.67-1.56], respectively). The adjusted ORs (95%CI) for current and past use of ACE inhibitors were 1.18 (0.75-1.85) and 0.61 (0.28-1.35). For current and past use of ARBs, these adjusted ORs (95%CI) were 1.40 (0.80-2.45) and 0.29 (0.05-1.67), respectively. No duration and dose-effect relationship was observed. CONCLUSIONS ACE inhibitor or ARB use is not associated with incident RA.
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Affiliation(s)
- Hilda J I de Jong
- Laboratory for Health Protection Research, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Heine P, Williams M, Williamson E, Bridle C, Adams J, O’Brien A, Evans D, Lamb S. Development and delivery of an exercise intervention for rheumatoid arthritis: Strengthening and stretching for rheumatoid arthritis of the hand (SARAH) trial. Physiotherapy 2012; 98:121-30. [DOI: 10.1016/j.physio.2011.03.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 03/28/2011] [Indexed: 10/18/2022]
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