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Beischl S, Banke IJ, von Eisenhart-Rothe R, Twardy V. [Isolated Patellofemoral Osteoarthritis]. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2024; 162:93-107. [PMID: 38350459 DOI: 10.1055/a-2012-2473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Isolated patellofemoral osteoarthritis is a complex pathology. It occurs frequently in women over 40 years and leads to a high degree of suffering. The causes of femoropatellar degeneration are manifold and require stage-specific therapy. This is very challenging for the treating physician. This article is intended to provide a structured overview of the symptoms, diagnostics and stage-specific therapy of patellofemoral osteoarthritis.
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Zmerly H, Milanese C, El Ghoch M, Itani L, Tannir H, Kreidieh D, Yumuk V, Pellegrini M. Personalized Physical Activity Programs for the Management of Knee Osteoarthritis in Individuals with Obesity: A Patient-Centered Approach. Diseases 2023; 11:182. [PMID: 38131988 PMCID: PMC10742871 DOI: 10.3390/diseases11040182] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/03/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
Physical activity (PA) plays a vital role in knee osteoarthritis (KOA) management. However, engaging individuals with KOA in regular exercise is challenging, especially when they are affected by obesity. The aim of the current review is to elucidate how to increase adherence to exercise in this population. When implementing a PA program with patients with KOA and obesity, a specific multi-step approach can be adopted. In phase I (the baseline assessment), the patients' eligibility for exercise is ascertained and a physical fitness assessment, sarcopenic obesity screening and quantification of the pain experienced are undertaken. Phase II adopts a patient-centered approach in implementing a PA program that combines an active lifestyle (>6000 steps/day) with land- or water-based exercise programs performed over eight to twelve weeks, with a frequency of three to five sessions per week, each lasting 60 min. In phase III, several strategies can be used to increase the patients' adherence to higher levels of PA, including the following: (i) personalizing PA goal-setting and real-time monitoring; (ii) enhancing physical fitness and the management of sarcopenic obesity; (iii) building a sustainable environment and a supportive social network for an active lifestyle; and (iv) reducing pain, which can ameliorate the clinical severity of KOA and help with weight management in this population.
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Affiliation(s)
- Hassan Zmerly
- Orthopaedics and Traumatology Unit, Villa Erbosa Hospital, 40129 Bologna, Italy;
- Ludes Campus, 6912 Lugano, Switzerland
| | - Chiara Milanese
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37131 Verona, Italy;
| | - Marwan El Ghoch
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Hana Tannir
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Dima Kreidieh
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut P.O. Box 11-5020, Lebanon; (L.I.); (H.T.); (D.K.)
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, 34363 Istanbul, Türkiye;
| | - Massimo Pellegrini
- Center for the Study of Metabolism, Body Composition and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
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Wang T, Wang J, Chen Y, Ruan Y, Dai S. Efficacy of aquatic exercise in chronic musculoskeletal disorders: a systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 2023; 18:942. [PMID: 38066577 PMCID: PMC10704680 DOI: 10.1186/s13018-023-04417-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Aquatic exercise (AE) is becoming ever more popular as a physical therapy, while it is unclear what precise improvements it will produce and how effective it will be in comparison with other non-surgical therapies. The study aimed to assess whether AE positively impacts chronic musculoskeletal disorder patients in terms of pain, physical function, and quality of life. METHODS PRISMA guidelines were followed, and our study protocol was published online at PROSPERO under registration number CRD42023417411. We searched PubMed, Embase, Web of Science, and Cochrane library databases for English-language articles published before April 11, 2023, including studies from all relevant randomized controlled trials (RCTs). After screening, we ultimately included 32 RCTs with a total of 2,200 participants. We also performed subgroup analyses for all included studies. This meta-analysis calculated standardized mean difference (SMD) with 95% confidence interval (CI), and the variance was estimated using a random-effects model. The quality of the included studies was assessed by using the Cochrane collaborative "risk of bias" assessment tool (version 2.0). Thus ensuring that the literature included is of high quality. RESULTS This meta-analysis included 32 trials with 2,200 participants; these patients were all between the ages of 38-80. The study showed that compared to the no exercise (NE) group, patients in the AE group experienced a remarkable reduction in pain (SMD: -0.64, P < 0.001), a significant increase in physical function (SMD: 0.62, P < 0.001), and a statistically significant improvement in quality of life (SMD: -0.64, P < 0.001). When compared to land-based exercise (LE), AE significantly relieves patients' pain (SMD: -0.35, P = 0.03). CONCLUSIONS This is the first systematic review and meta-analysis to study whether AE could improve chronic musculoskeletal disorders. The evidence suggests that AE benefits pain, physical function, and quality of life in adults with chronic musculoskeletal conditions compared to NE. Furthermore, when compared to LE, AE continues to provide a better improvement in patient pain. More long-term clinical trials are needed to confirm AE's positive effects and improvement mechanisms and the more existential advantages compared to LE.
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Affiliation(s)
- Tianyue Wang
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
| | - Jiamin Wang
- The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yuheng Chen
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Yanmin Ruan
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Senjie Dai
- The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, 310053, China
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Wang J, Chen Z, Chen X, Yang Y, Gan W, Wang F. Impact of Bad Ragaz ring in hot spring water on knee osteoarthritis: A prospective observational study. Medicine (Baltimore) 2023; 102:e34457. [PMID: 37565912 PMCID: PMC10419570 DOI: 10.1097/md.0000000000034457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/03/2023] [Indexed: 08/12/2023] Open
Abstract
To evaluate the impact of the Bad Ragaz ring method (BRRM) in hot spring water for knee osteoarthritis (KOA), this prospective study enrolled KOA patients treated at the hospital between March 2020 and December 2020. The primary outcome was the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index score. A total of 60 patients were included, with 30 participants in the BRRM group and 30 patients in the non-BRRM group, respectively. The mean age was 56.4 ± 10.2 years (13 females), and the duration of disease was 5.0 ± 2.2 years in the BRRM group. The mean age was 56.0 ± 11.3 years (14 females), and the disease duration was 4.7 ± 2.1 years in the non-BRRM group. There were no differences between the 2 groups in the pain, stiffness, and function scores of the WOMAC (all P > .05) before treatment. The pre post difference in total WOMAC scores (56.57 ± 12.45 vs 36.81 ± 13.51, Cohen d = 1.52, P < .01) between the 2 groups was statistically significant. Compared with the non-BRRM group, the BRRM group showed lower scores for pain (6.5 ± 1.5 vs 8.1 ± 2.9, Cohen d = -0.69, P = .01), stiffness (2.7 ± 1.0 vs 5.0 ± 1.2, Cohen d = -1.93, P < .01), and function (14.8 ± 6.6 vs 26.7 ± 7.5, Cohen d = -1.68, P < .01) after treatment. In conclusion, the BRRM might improve the pain and function of patients with KOA.
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Affiliation(s)
- Jianqiang Wang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Zeng Chen
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Xiaoqing Chen
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Yang Yang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Wei Gan
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
| | - Fachao Wang
- Cadre Sanatorium of Hainan & Geriatric Hospital of Hainan (CSH), Hainan, Haikou, China
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Zhou WS, Mao SJ, Zhang SK, Xu H, Li WL. Effects of aquatic exercises on physical fitness and quality of life in postmenopausal women: an updated systematic review and meta-analysis. Front Public Health 2023; 11:1126126. [PMID: 37361170 PMCID: PMC10285069 DOI: 10.3389/fpubh.2023.1126126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
Objective In the present systematic review and meta-analysis, we aimed to evaluate and update the effects of aquatic exercise on physical fitness and quality of life (QoL) in postmenopausal women. Methods The databases Cochrane Library, PubMed, Web of Science, and MEDLINE were searched for randomized controlled trials (RCTs) on the topic from inception to July 2022. The GetData software was used to extract data from the published images. RevMan5.4 software was used for statistical analysis. Data are expressed as standardized mean difference (SMD) with 95% confidence intervals (CI). I2 index was employed for heterogeneity. Egger's test was used to assess publication bias. We evaluated the methodological quality of included studies using the Physiotherapy Evidence Database scale. Results We included 594 participants in 16 RCTs (19 comparison groups). The results indicated that aquatic exercise can significantly improve lower limb strength (LLS), upper limb strength (ULS), agility, flexibility, and overall QoL. No significant effects were found on aerobic capacity. Subgroup-analysis results indicated that aquatic exercise only significantly improved LLS, ULS, agility, and flexibility in postmenopausal women < 65 years of age. However, aquatic exercise improves the overall QoL both in postmenopausal women < 65 years and ≥ 65 years. Aquatic resistance exercise significantly improves LLS, ULS, agility and flexibility. In addition, aquatic aerobic exercise can effectively increase LLS, and combined aquatic aerobic and resistance exercise can enhance the overall QoL. Conclusions Aquatic exercise can effectively improve physical fitness and overall QoL in postmenopausal women, but has limited effects on aerobic capacity; thus, it is highly recommended in postmenopausal women.
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Affiliation(s)
- Wen-Sheng Zhou
- College of Physical Education, Jiangsu Second Normal University, Nanjing, China
| | | | - Shi-Kun Zhang
- Department of Police Physical Education, Jiangsu Police Institute, Nanjing, China
| | - Hong Xu
- Department of Sport and Health Science, College of Natural Science, Sangmyung University, Seoul, South Korea
| | - Wei-Lu Li
- Nanjing Zhong-Yang Road Primary School, Nanjing, China
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Mo L, Jiang B, Mei T, Zhou D. Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Orthop J Sports Med 2023; 11:23259671231172773. [PMID: 37346776 PMCID: PMC10280533 DOI: 10.1177/23259671231172773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 06/23/2023] Open
Abstract
Background Exercise is an effective nonpharmaceutical therapy for knee osteoarthritis (KOA). Purpose To identify the most effective type of exercise therapy for KOA with regard to pain, stiffness, joint function, and quality of life. Study Design Systematic review; Level of evidence, 3. Methods The PubMed, Web of Science, Embase, and Cochrane Library databases were searched, from inception to April 4, 2022. Included were randomized controlled trials that assessed the efficacy on KOA among 5 different exercise therapy groups (aquatic exercise [AE], stationary cycling [CY], resistance training [RT], traditional exercise [TC], and yoga [YG]) and compared with the control group. Outcomes among the groups were assessed with the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 6-minute walk test (6-MWT), visual analog scale (VAS) for pain, and Knee injury and Osteoarthritis Outcome Score (KOOS); weighted mean differences (WMDs) and 95% confidence intervals were calculated. Network meta-analyses comparing outcomes between all groups and with controls were performed, and group rankings were calculated using the surface under the cumulative ranking curve (SUCRA). Results A total of 39 studies (N = 2646 participants) were included. Most of the studies failed to blind participants and researchers, resulting in a high risk of performance bias. Significantly worse WOMAC-Pain scores were seen in controls compared with all exercise interventions except AE (WMD [95% CI]: CY, -4.45 [-5.69 to -3.20]; RT, -4.28 [-5.48 to -3.07]; TC, -4.20 [-5.37 to -3.04]; and YG, -0.57 [-1.04 to -1.04]), and worse scores were seen in controls compared with YG regarding WOMAC-Stiffness (WMD, -1.40 [95% CI, -2.45 to -0.34]) and WOMAC-Function (WMD, -0.49 [95% CI, -0.95 to -0.02]). According to the SUCRA, CY was the most effective for improving WOMAC-Pain (80.8%) and 6-MWT (76.1%); YG was most effective for improving WOMAC-Stiffness (90.6%), WOMAC-Function (77.4%), KOOS-Activities of Daily Living (72.0%), and KOOS-Quality of Life (79.1%); AE was the most effective regarding VAS pain (77.2%) and KOOS-Pain (64.0%); and RT was the most effective regarding KOOS-Symptoms (84.5%). Conclusion All 5 types of exercise were able to ameliorate KOA. AE (for pain relief) and YG (for joint stiffness, limited knee function, and quality of life) were the most effective approaches, followed by RT, CY, and TC.
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Affiliation(s)
- Ling Mo
- Teaching and Research Office of China
Academy of Sports and Health, Beijing Sport University, Beijing, China
| | - Banghua Jiang
- Teaching and Research Office of China
Academy of Sports and Health, Beijing Sport University, Beijing, China
| | - Tao Mei
- Teaching and Research Office of China
Academy of Sports and Health, Beijing Sport University, Beijing, China
| | - Daihua Zhou
- School of Education, Chongqing Normal
University, Chongqing, China
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Yesil M, Ozcan O, Dundar U, Toktas H, Yesil H. Aquatic vs. land-based exercise after arthroscopic partial meniscectomy in middle-aged active patients with a degenerative meniscal tear: A randomized, controlled study. J Orthop Sci 2023; 28:391-397. [PMID: 34924251 DOI: 10.1016/j.jos.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/12/2021] [Accepted: 11/21/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Awareness of the value of aquatic exercise (AE) in the postoperative rehabilitation has increased, and several inherent advantages of AE, such as adjustment of both resistance and muscle strengthening parameters makes good rationale for its inclusion in postoperative rehabilitation. This study aimed to determine and compare the benefits of AE and land-based exercise (LBE) on pain, functionality, and quality of life after arthroscopic partial meniscectomy (APM). METHODS This randomized controlled study included 30 middle-aged (35-50), physically active patients who were randomized into LBE (n = 15) and AE (n = 15) groups after APM for a degenerative meniscal tear. Visual analogue scale (VAS), Short Form-36 (SF-36), single-leg hop test and Lysholm questionnaire scores in addition to isokinetic muscle strength values were evaluated at baseline, at fourth week immediately after cessation of exercise program and at eighth week follow-up visits. The exercise sessions were conducted in 1-h sessions per day, three days a week for a total of four weeks. RESULTS Significant improvement was observed in the VAS, single-leg hop test, Lysholm questionnaire, and most of SF-36 subscale scores in both groups at both fourth and eighth follow-ups. Isokinetic dynamometer revealed significant improvement in the peak torque values for extension at angular velocities of 60° and 180° at both follow-ups in the AE group. LBE group showed significant improvement in the peak torque value for extension only at an angular velocity of 60° only at fourth week follow-up. There was no significant difference between groups for any of these parameters at any of the follow-ups. CONCLUSION Both AE and LBE programs had significantly improved pain, function, isokinetic muscle strength, and quality of life in patients after APM. Either type of exercise is essential as part of the rehabilitation protocol for good clinical outcomes after APM and should not be neglected (level II). CLINICALTRIALS REGISTRATION NUMBER NCT04925726.
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Affiliation(s)
- Murat Yesil
- Department of Orthopaedics and Traumatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey.
| | - Ozal Ozcan
- Department of Orthopaedics and Traumatology, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Umit Dundar
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hasan Toktas
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Hilal Yesil
- Department of Physical Medicine and Rehabilitation, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Xu Z, Wang Y, Zhang Y, Lu Y, Wen Y. Efficacy and safety of aquatic exercise in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2023; 37:330-347. [PMID: 36320162 DOI: 10.1177/02692155221134240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To examine the efficacy and safety of aquatic exercise for people with knee osteoarthritis. DATA SOURCES PubMed, Web of Science, Embase, CENTRAL, CNKI and WanFang databases were searched from 1966 to September 2022. REVIEW METHODS Randomized controlled trials evaluating aquatic exercise for people with knee osteoarthritis compared with no exercise and land-based exercise were included. The Grading of Recommendations Assessment, Development and Evaluation system was used to evaluate the certainty of evidence. RESULTS Twenty-two studies with 1394 participants were included. Compared with no exercise (13 trials with 746 participants), low-to high-certainty evidence revealed that aquatic exercise yielded significant improvements in patient-reported pain (SMD -0.58, 95% CI -0.82 to -0.33), stiffness (SMD -0.57, 95% CI -1.03 to -0.11) and physical function (SMD -0.35, 95% CI -0.52 to -0.18) immediately postintervention. A sustained effect was observed only for pain at three months postintervention (SMD -0.48, 95% CI -0.91 to -0.06). The confidence intervals demonstrated that the pooled results do not exclude the minimal clinically important differences. There were no significant differences between the effects of aquatic exercise and land-based exercise (13 trials with 648 participants) on pain (SMD -0.12, 95% CI -0.29 to 0.04), stiffness (SMD -0.17, 95% CI -0.49 to 0.16) or physical function (SMD -0.13, 95% CI -0.28 to 0.02). No study reported a serious adverse event in relation to aquatic exercise. CONCLUSION Aquatic exercise provides a short-term clinical benefit that is sustained for at least three months postintervention in terms of pain in people with knee osteoarthritis.
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Affiliation(s)
- Zhen Xu
- Department of Physical Education, 12538Nankai University, Tianjin, China
| | - Yidi Wang
- China Swimming College, 47838Beijing Sport University, Beijing, China
| | - Yue Zhang
- Department of Physical Education, 12474Shanghai Jiao Tong University, Shanghai, China
| | - Yifan Lu
- School of Sports Medicine and Rehabilitation, 47838Beijing Sport University, Beijing, China.,Key Laboratory of Physical Fitness and Exercise, Ministry of Education, 47838Beijing Sport University, Beijing, China
| | - Yuhong Wen
- Key Laboratory of Physical Fitness and Exercise, Ministry of Education, 47838Beijing Sport University, Beijing, China.,School of Recreational Sports and Tourism, 47838Beijing Sport University, Beijing, China
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Maccarone MC, Magro G, Albertin C, Barbetta G, Barone S, Castaldelli C, Manica P, Marcoli S, Mediati M, Minuto D, Poli P, Sigurtà C, Raffaetà G, Masiero S. Short-time effects of spa rehabilitation on pain, mood and quality of life among patients with degenerative or post-surgery musculoskeletal disorders. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2023; 67:29-36. [PMID: 36207541 PMCID: PMC9546417 DOI: 10.1007/s00484-022-02381-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
Clinical trials have demonstrated traditional spa therapy effects in musculoskeletal disorders (MSDs). This is the first observational study in Italy aimed at evaluating in real-life the short-time effects of spa rehabilitation on pain, mood and quality of life (QoL) among degenerative or post-surgery MSDs patients. Through the involvement of six Italian spa facilities, 160 patients were enrolled; data from 123 patients were finally analysed. Seventy-nine patients (64.3%) accessed the spa for degenerative MSDs, while 44 (35.8%) had a post-surgical condition. All the patients included in the study underwent 12 sessions of water-based exercise (joint exercises, muscle strengthening, gait training, proprioceptive and balance techniques) conducted in thermal or in warm water pools, six sessions per week, for a period of 2 weeks from March 2019 up to October 2019. A group of 45 patients (36.6%) also received traditional thermal therapies, including 12 mud therapy sessions and 12 thermal baths, six times each week, for 2 weeks. Evaluation before and after the treatment included the Numerical Rating Scale (NRS), the Short Form Health Survey (SF-12) and the EuroQol-5D (EQ-5D). The analysis of the scores reported in the questionnaires after the treatment showed a significant improvement in all the scores evaluated. Comparison between patients that performed water-based exercise protocols alone (group A) and patients that in addition to water exercise performed traditional thermal interventions (group B) showed no statistically significant differences in NRSp, NRSa, NRSm, SF-12 PCS, SF-12 MCS and EQ-5D variations; only NRSa value reduction was lower in group B. Sulphate water was found to be associated with a lower reduction of all the scores considered, when compared to the other water types. Patients with degenerative or post-surgery MSDs showed favourable effects on pain, mood and QoL after water exercise training alone or in combination with traditional thermal therapy. Our research provides the first proof that spa rehabilitation can be in real-life conditions an appropriate alternative strategy for post-orthopaedic surgical outcomes recovery. In the future, these results will need to be further investigated.
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Affiliation(s)
| | - Giacomo Magro
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy
| | | | | | | | | | | | | | | | | | | | | | - Gloria Raffaetà
- Second Orthopaedic and Traumatologic Clinic of Pisa, University of Pisa, Pisa, Italy
| | - Stefano Masiero
- Physical Medicine and Rehabilitation School, University of Padova, Padua, Italy
- Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua, Italy
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10
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Pedersen JR, Sari DM, Juhl CB, Thorlund JB, Skou ST, Roos EM, Bricca A. Variability in effect sizes of exercise therapy for knee osteoarthritis depending on comparator interventions. Ann Phys Rehabil Med 2022; 66:101708. [PMID: 36191859 DOI: 10.1016/j.rehab.2022.101708] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 08/01/2022] [Accepted: 09/24/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Systematic reviews of exercise therapy for knee osteoarthritis (OA) have largely ignored the variability in comparator interventions. OBJECTIVE To assess how effect estimates of exercise therapy for knee OA as reported in randomized controlled trials vary depending on the comparator interventions. METHODS We followed the Cochrane Handbook and PRISMA guidance to conduct and report this meta-epidemiological study. Randomised controlled trials (RCTs) were identified from systematic reviews published in 2015 or later and reference lists of included studies. Exercise therapy RCTs testing interventions that adhered to the American College of Sports Medicine (ACSM) guidelines compared to any comparator intervention in people with knee OA and reporting outcomes of knee pain, physical function and/or quadriceps strength at the end of intervention were included. RESULTS Thirty-five RCTs with 2412 participants were included. Comparator interventions included no intervention, non-ACSM compliant exercise therapy, education/self-management, and passive modalities. For pain, standardized mean difference (SMD) for ACSM compliant exercise therapy compared to passive modalities was 1.76 (95% CI 0.49, 3.04), no intervention 0.93 (95% CI 0.50; 1.36), education/self-management 0.27 (95% CI 0.07, 0.47), and non-ACSM compliant exercise therapy 0.09 (95% CI -0.06, 0.23). For physical function, SMD for ACSM compliant exercise therapy compared to passive modalities was 1.29 (95% CI 0.41, 2.17), no intervention 0.76 (95% CI 0.15, 1.36), non-ACSM compliant exercise therapy 0.25 (95% CI -0.00, 0.51) and education/self-management 0.21 (95% CI -0.14, 0.55). For quadriceps strength, SMD for ACSM compliant exercise therapy compared to no intervention was 0.69 (95% CI 0.42, 0.96), non-ACSM compliant exercise therapy 0.23 (95% CI -0.01, 0.46), education/self-management -0.02 (95% CI -0.45, 0.42) and passive modalities 0.80 (95% CI -0.10, 1.71). CONCLUSION The effect of exercise therapy for knee OA varies significantly depending on the comparator intervention. This variability should be assessed routinely in systematic reviews.
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Affiliation(s)
- Julie Rønne Pedersen
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark.
| | - Dilara Merve Sari
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark; Department of Physiotherapy and Rehabilitation, Institute of Health Sciences, Marmara University, Turkey
| | - Carsten Bogh Juhl
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark; Department of Physiotherapy and Occupational Therapy, Copenhagen University Hospital Herlev and Gentofte, Denmark
| | - Jonas Bloch Thorlund
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark; Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark
| | - Ewa M Roos
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark
| | - Alessio Bricca
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campus 55, Odense 5230, Denmark; The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Denmark
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11
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Caiado VS, Santos ACG, Moreira-Marconi E, Moura-Fernandes MC, Seixas A, Taiar R, Lacerda ACR, Sonza A, Mendonça VA, Sá-Caputo DC, Bernardo-Filho M. Effects of Physical Exercises Alone on the Functional Capacity of Individuals with Obesity and Knee Osteoarthritis: A Systematic Review. BIOLOGY 2022; 11:biology11101391. [PMID: 36290296 PMCID: PMC9598071 DOI: 10.3390/biology11101391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/16/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary Osteoarthritis is a degenerative joint disease that affects millions of people around the world. Knee osteoarthritis is one of the causes of more significant functional disability among people with it. Currently, obesity is identified as one of the main risk factors for the onset of the disease due to excess load on the joints of the lower limbs, especially the knees. The association of measures, such as weight reduction through diets and exercise, can alleviate symptoms and increase the physical condition of people affected by these clinical conditions. However, many individuals with obesity have difficulty adhering to diet programs and need to improve in order to perform their functional activities. The aim of this systematic review was to evaluate the results of several physical exercise programs conducted without the association of diet, demonstrating the improvement of the functional capacity of individuals with these concomitant clinical conditions, presenting another proposal to reduce the symptoms of the disease in this population. Abstract The association between obesity and knee osteoarthritis (KOA) is reported in the literature. The inflammatory factors described in obesity associated with mechanical overload on the knee joint lead to KOA development and reduced functional capacity in these individuals. Most physical exercise (PE) protocols associate a diet program to improve the functional capacity of individuals with concomitant KOA and obesity. There is a lack of published protocols performing PE alone, which would be without an associated diet program in individuals with both clinical conditions. In this systematic review, the authors summarize the effects of the application of PE alone, describing each protocol and reporting the improvement in the function of people with these clinical conditions. This investigation was conducted according to the PRISMA guidelines and registered in PROSPERO. Five databases (MEDLINE/PubMed, PEDro, Scopus, CINAHL and Web of Science) were used up to July 2022 and ten studies, including 534 participants, met the inclusion criteria. The PEDro scale, Cochrane collaborations and ROBINS-I tools were used to evaluate the methodological quality and risk of bias. It was concluded that PE performed alone seems to provide an improvement in the functional capacity of these individuals even without an associated diet plan in the condition of obesity.
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Affiliation(s)
- Vanessa Silva Caiado
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas-LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil
| | - Aline Cristina Gomes Santos
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas-LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil
| | - Eloá Moreira-Marconi
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas-LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil
| | - Marcia Cristina Moura-Fernandes
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
| | - Adérito Seixas
- Escola Superior de Saúde, Universidade Fernando Pessoa, 4249-004 Porto, Portugal
| | - Redha Taiar
- MATériaux et Ingénierie Mécanique (MATIM), Université de Reims Champagne-Ardenne, 51100 Reims, France
- Correspondence:
| | - Ana Cristina Rodrigues Lacerda
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, Brazil
| | - Anelise Sonza
- Programa de Pós-Graduação em Fisioterapia, Programa de Pós-Graduação em Ciências do Movimento Humano, Residência Multiprofissional em Saúde da Família e Comunidade, Universidade do Estado de Santa Catarina, Florianópolis 88035-901, Brazil
| | - Vanessa Amaral Mendonça
- Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina 39100-000, Brazil
| | - Danúbia Cunha Sá-Caputo
- Laboratório de Vibrações Mecânicas e Práticas Integrativas-LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil
- Programa de Pós-Graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil
- Departamento de Fisioterapia, Faculdade Bezerra de Araújo, Rio de Janeiro 23052-180, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas-LAVIMPI, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcântara Gomes, Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20950-003, Brazil
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12
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Jurado-Castro JM, Muñoz-López M, Ledesma AST, Ranchal-Sanchez A. Effectiveness of Exercise in Patients with Overweight or Obesity Suffering from Knee Osteoarthritis: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10510. [PMID: 36078226 PMCID: PMC9518463 DOI: 10.3390/ijerph191710510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/19/2022] [Accepted: 08/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES The main purpose of this study was to review the evidence about the effectiveness of exercise in patients with overweight or obesity suffering from knee osteoarthritis. METHODS Randomized clinical trials (RCTs) published between January 2002 and May 2022 were included. RESULTS A total of 64 articles were identified, of which six met the criteria for meta-analysis. The pain scale score was higher in the control group (mean difference 0.95; confidence interval 0.42-1.47; p < 0.001; I2 = 44%). The physical function scale (lower scores indicate lower levels of symptoms or physical disability) presented a higher score in the control group (mean difference 3.74; confidence interval 0.85-6.53; p < 0.05; I2 = 56%). Moreover, the intervention group achieved a greater distance (meters) walking in a 6 min interval (mean difference 38.18; confidence interval 20.01-56.35; p < 0.001; I2 = 0%). CONCLUSIONS Exercise interventions seem effective in improving quality of life in people with overweight or obesity suffering from knee osteoarthritis, reducing pain and improving physical function.
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Affiliation(s)
- Jose Manuel Jurado-Castro
- Metabolism and Investigation Unit, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
| | - Mariano Muñoz-López
- Ciencias De La Actividad Física y El Deporte, Escuela Universitaria de Osuna (Centro Adscrito a la Universidad de Sevilla), 41640 Osuna, Spain
| | - Agustín Sánchez-Toledo Ledesma
- Instituto de Seguridad y Bienestar Laboral, 14001 Cordoba, Spain
- Higher School of Engineering and Technology, International University of La Rioja (UNIR), 26004 Logroño, Spain
| | - Antonio Ranchal-Sanchez
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Cordoba, 14071 Cordoba, Spain
- Grupo De Investigación Clínico Epidemiológica De Atención Primaria, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, 14004 Cordoba, Spain
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13
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Webb EJ, Osmotherly PG, Baines SK. Effect of Dietary Weight Loss and Macronutrient Intake on Body Composition and Physical Function in Adults with Knee Osteoarthritis: A Systematic Review. J Nutr Gerontol Geriatr 2022; 41:103-125. [PMID: 35642456 DOI: 10.1080/21551197.2022.2063219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Overweight and obesity increase the risk of development and progression of knee osteoarthritis (OA), with higher levels of fat mass and lower levels of lean mass associated with poorer functional status. The aim was to assess changes in weight, body composition and physical function following weight loss or weight maintenance interventions in knee OA. A comprehensive search of four databases was conducted. The risk of bias was assessed using the Quality Criteria Checklist for primary research. Primary outcomes included weight, body composition and physical function; secondary outcomes were lipids, inflammatory biomarkers and muscle strength. Eleven studies were included utilizing diet and exercise (n = 4) or diet-only (n = 7) interventions, two of which were weight maintenance studies. Most studies (n = 10) reported improvements in physical function with significant weight loss, while the change in strength reported in three studies was variable. The diet and exercise studies reported an average reduction in weight of 6.7% and lean mass of 1.6 kg, with greater improvements in physical function. The diet-only studies, including weight maintenance interventions, reported greater average weight loss (7.8%) and reduction in LM (2.0 kg). Overall, better retention of lean mass and muscle strength was observed in participants with higher protein intake (≥37% of energy) and subsequently improved physical function.
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Affiliation(s)
- Emily J Webb
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Peter G Osmotherly
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Surinder K Baines
- School of Health Sciences, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
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14
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Duan X, Wei W, Zhou P, Liu X, Yu J, Xu Y, Huang L, Yang S. Effectiveness of aquatic exercise in lower limb osteoarthritis: a meta-analysis of randomized controlled trials. Int J Rehabil Res 2022; 45:126-136. [PMID: 35437296 DOI: 10.1097/mrr.0000000000000527] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to evaluate the short-term and follow-up effectiveness of aquatic training on the health status of lower limb osteoarthritis. Randomized controlled trials (RCTs) on related topics were systematically searched in PubMed, Embase, Web of Science, the Cochrane Library, Physiotherapy Evidence Database (PEDro), the China National Knowledge Infrastructure and Wanfang databases from inception to January 2021. RevMan 5.3 was used for statistical analysis, and the standardized mean difference (SMD) was used to present pooled effect sizes. As a result, 19 RCTs (1592 patients) were included. Compared with unsupervised home exercise or usual care (land-based training excluded), aquatic training showed short-term pain relief (SMD, -0.54; 95% CI, -0.81 to -0.28), physical function improvement (SMD, -0.64; 95% CI, -1.00 to -0.28), stiffness reduction (SMD, -0.40; 95% CI, -0.79 to -0.01) and improved function in sport and recreation (SMD, -0.30; 95% CI, -0.59 to -0.02). Analyses restricted to patients with knee osteoarthritis only also confirmed the positive effects of aquatic training on most dimensions excluding physical function. At medium-term follow-ups, improvements in physical function and function in sport and recreation were observed. No significant difference was observed between arms in the above four outcomes at long-term follow-ups. All studies reported no major adverse event with relation to aquatic training, and the minor adverse events were not common. It is concluded that aquatic training likely has short-term benefits on pain, physical function, stiffness and sport ability in lower limb osteoarthritis patients, but these positive effects may not last long.
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Affiliation(s)
| | - Wei Wei
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
| | | | - Xi Liu
- Department of Rehabilitation
| | | | - Yang Xu
- Department of Rehabilitation
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15
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Ma J, Chen X, Xin J, Niu X, Liu Z, Zhao Q. Overall treatment effects of aquatic physical therapy in knee osteoarthritis: a systematic review and meta-analysis. J Orthop Surg Res 2022; 17:190. [PMID: 35346294 PMCID: PMC8961922 DOI: 10.1186/s13018-022-03069-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Objective To determine the benefits of aquatic physical therapy as a rehabilitation strategy for knee osteoarthritis patients. Methods Electronic databases systematically searched up to July 2021. Results 580 RCTs were selected. A total of thirteen studies comprising 883 participants were included in the study. For pain, meta-analyses showed that aquatic physical therapy is associated with a significant change in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain (SMD = − 1.09, 95%CI − 1.97, − 0.21, p = 0.02) and visual analog scale (VAS) (SMD = − 0.55, 95%CI − 0.98, − 0.12, p = 0.01). In addition, for physical function, meta-analyses showed that aquatic physical therapy effectively improved WOMAC physical function (SMD = − 0.57, 95%CI − 1.14, − 0.01, p = 0.05). However, our findings showed no significant improvements in symptoms of joints, quality of life (QOL), flexibility, and body composition with knee osteoarthritis. For muscle strength, we found that aquatic physical therapy can only improve knee extension muscle strength (MD = 2.11, 95%CI 0.02, 4.20, p = 0.05). Additionally, for walking ability, we observed that aquatic physical therapy effectively reduced Timed-Up-and-Go Test (TUGT) in a large degree (MD = − 0.89, 95%CI − 1.25, − 0.53, p < 0.05). Conclusions According to the findings reported in the studies analyzed in the review, aquatic physical therapy had a positive effect on the pain, physical function, knee extension muscle strength, and walking ability among people with knee osteoarthritis.
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16
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Zeng CY, Zhang ZR, Tang ZM, Hua FZ. Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Front Physiol 2022; 12:794062. [PMID: 34975542 PMCID: PMC8716769 DOI: 10.3389/fphys.2021.794062] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/19/2021] [Indexed: 01/09/2023] Open
Abstract
Knee osteoarthritis is a chronic degenerative disease. Cartilage and subchondral bone degeneration, as well as synovitis, are the main pathological changes associated with knee osteoarthritis. Mechanical overload, inflammation, metabolic factors, hormonal changes, and aging play a vital role in aggravating the progression of knee osteoarthritis. The main treatments for knee osteoarthritis include pharmacotherapy, physiotherapy, and surgery. However, pharmacotherapy has many side effects, and surgery is only suitable for patients with end-stage knee osteoarthritis. Exercise training, as a complementary and adjunctive physiotherapy, can prevent cartilage degeneration, inhibit inflammation, and prevent loss of the subchondral bone and metaphyseal bone trabeculae. Increasing evidence indicates that exercise training can improve pain, stiffness, joint dysfunction, and muscle weakness in patients with knee osteoarthritis. There are several exercise trainings options for the treatment of knee osteoarthritis, including aerobic exercise, strength training, neuromuscular exercise, balance training, proprioception training, aquatic exercise, and traditional exercise. For Knee osteoarthritis (KOA) experimental animals, those exercise trainings can reduce inflammation, delay cartilage and bone degeneration, change tendon, and muscle structure. In this review, we summarize the main symptoms of knee osteoarthritis, the mechanisms of exercise training, and the therapeutic effects of different exercise training methods on patients with knee osteoarthritis. We hope this review will allow patients in different situations to receive appropriate exercise therapy for knee osteoarthritis, and provide a reference for further research and clinical application of exercise training for knee osteoarthritis.
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Affiliation(s)
- Chu-Yang Zeng
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhen-Rong Zhang
- School of Rehabilitation, Capital Medical University, Beijing, China
| | - Zhi-Ming Tang
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
| | - Fu-Zhou Hua
- Department of Anesthesiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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17
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Zhou WS, Ren FF, Yang Y, Chien KY. Aquatic Exercise for Health Promotion: A 31-Year Bibliometric Analysis. Percept Mot Skills 2021; 128:2166-2185. [PMID: 34256626 DOI: 10.1177/00315125211032159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present study aimed to review the research literature on aquatic exercise for health promotion using bibliometric methods and CiteSpace software. The number of studies related to this topic are constantly expanding, with the USA, Brazil, and Australia the centers of this research. Most published papers fall within Sports Science, but the disciplines of Physiology, Psychology, and Rehabilitation were also found to be dominant domains for this literature. The seven most prolific authors were from Brazil or Spain. The most frequently cited references focused on sub-topics of physiology, biochemistry, physical fitness, psychological health, cardiovascular disease, and joint disease. New research trends have shifted to the promotion of cardiovascular health in clinical populations (stroke, overweight, hypertension, endothelium dysfunctional, obese, inflammation, antioxidant, heart failure). Overall, this review found that research hot spots and trends in this realm have focused on improving cardiovascular health with aquatic exercise.
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Affiliation(s)
- Wen-Sheng Zhou
- Department of Physical Education, Nanjing Xiao-Zhuang University, Nanjing, China.,Graduate Institute of Sports Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
| | - Fei-Fei Ren
- Department of Physical Education, 12490Beijing Language and Culture University, 12490Beijing Language and Culture University, Beijing, China.,Graduate Institute of Athletics and Coaching Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
| | - Yong Yang
- Graduate Institute of Athletics and Coaching Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan.,Institute of Physical Education, Henan University, Kaifeng, China
| | - Kuei-Yu Chien
- Graduate Institute of Sports Science, 63369National Taiwan Sport University, National Taiwan Sport University, Taoyuan, Taiwan
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18
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Carraça EV, Encantado J, Battista F, Beaulieu K, Blundell JE, Busetto L, van Baak M, Dicker D, Ermolao A, Farpour-Lambert N, Pramono A, Woodward E, Bellicha A, Oppert JM. Effect of exercise training on psychological outcomes in adults with overweight or obesity: A systematic review and meta-analysis. Obes Rev 2021; 22 Suppl 4:e13261. [PMID: 33960106 PMCID: PMC8365728 DOI: 10.1111/obr.13261] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
This study systematically identified the effects of exercise on multiple psychological outcomes among adults with overweight/obesity, also assessing whether these effects differed across exercise types, genders, age, and body mass index (BMI) categories. Pubmed, Web of Science, PsychInfo, and SportDiscus were searched up to October 2019 for peer-reviewed papers assessing exercise training effects on psychosocial outcomes in adults with overweight/obesity. Thirty-six articles, 32 randomized controlled trials (RCTs), were included in this review. Most interventions were supervised (65%), ranging between 6 and 76 weeks (median = 12). Sixteen psychological outcomes were studied. Exercise induced positive changes in quality of life but did not reduce depression. Large effect sizes were observed on quality of life's physical component, but exercise was also able to improve vitality and mental health. Most psychological outcomes (e.g., body image, anxiety, and perceived stress) are poorly studied, evidencing either conflicting or null exercise effects. Exercise self-efficacy and autonomous motivations were also consistently improved. Exercise types and gender seem to moderate exercise psychological effects. Exercise training programs might lead to positive changes in some psychological outcomes, especially in quality of life, in adults with overweight and obesity, but more studies, with greater systematization in program characteristics, and longer follow-ups are still required to allow more solid conclusions.
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Affiliation(s)
- Eliana V Carraça
- CIDEFES, Universidade Lusófona de Humanidades e Tecnologias, Faculdade de Educação Física e Desporto, Lisbon, Portugal
| | - Jorge Encantado
- APPsyCI-Applied Psychology Research Center Capabilities and Inclusion, ISPA-University Institute, Lisbon, Portugal
| | - Francesca Battista
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John E Blundell
- Appetite Control and Energy Balance Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luca Busetto
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Medicine, University of Padova, Padua, Italy
| | - Marleen van Baak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Dror Dicker
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Internal Medicine D, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Nathalie Farpour-Lambert
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Obesity Prevention and Care Program Contrepoids; Service of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Adryan Pramono
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University Medical Centre+, Maastricht, Netherlands
| | - Euan Woodward
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO)
| | - Alice Bellicha
- INSERM, Nutrition and obesities: systemic approaches, NutriOmics, Sorbonne University, Paris, France.,UFR SESS-STAPS, University Paris-Est Créteil, Créteil, France
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
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19
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Chu SF, Liou TH, Chen HC, Huang SW, Liao CD. Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients 2021; 13:1992. [PMID: 34200533 PMCID: PMC8230320 DOI: 10.3390/nu13061992] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/03/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022] Open
Abstract
Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4-8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.
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Affiliation(s)
- Shu-Fen Chu
- College of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China;
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (T.-H.L.); (H.-C.C.); (S.-W.H.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (T.-H.L.); (H.-C.C.); (S.-W.H.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (T.-H.L.); (H.-C.C.); (S.-W.H.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (T.-H.L.); (H.-C.C.); (S.-W.H.)
- Master Program in Long-Term Care, Taipei Medical University, College of Nursing, Taipei 110301, Taiwan
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20
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Khruakhorn S, Chiwarakranon S. Effects of hydrotherapy and land-based exercise on mobility and quality of life in patients with knee osteoarthritis: a randomized control trial. J Phys Ther Sci 2021; 33:375-383. [PMID: 33935364 PMCID: PMC8079887 DOI: 10.1589/jpts.33.375] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/30/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] To determine the effects of hydrotherapy and land-based exercises on functional mobility and quality of life among patients with knee osteoarthritis. [Participants and Methods] We conducted a randomized controlled trial with knee osteoarthritis patients randomly allocated into land-based (n=17) and hydrotherapy groups (n=17). The Time-Up and Go (TUG), Five Times Sit-to-Stand (5STS), Stair Climbing Test (SCT), and Quality of Life by questionnaires including the Modified Western Ontario and McMaster Universities Osteoarthritis Index questionnaire Thai version (Thai WOMAC) were assessed at baseline and 6 weeks. The World Health Organization Quality of Life BREF Thai version (WHOQOL-BREF-THAI) questionnaire were assessed at baseline and six weeks and 6 months. [Results] There was no significant difference in outcomes between the groups after 6-weeks and 6-months of follow-up. After 6 weeks, Thai WOMAC score improved in both groups. Only 5STS was improved in the land-based group, while the hydrotherapy group showed significant TUG, 5STS, and SCT improvement. Furthermore, only hydrotherapy showed significant improvement in WHOQOL-BREF-THAI scores in the mental, social, quality of health, and total domains after six months. [Conclusion] Both exercises equally improved functional mobility and quality of life. Hydrotherapy and land-based exercise could improve functional mobility and quality of life in patients with knee osteoarthritis.
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Affiliation(s)
- Santhanee Khruakhorn
- Department of Physical Therapy, Faculty of Allied Health
Sciences, Thammasat University Rangsit Campus: 99 Moo.18 Phahonyothin Road, Khlong Nueng,
Khlong Luang, Pathum Thani 12120, Thailand
| | - Sanon Chiwarakranon
- Department of Physical Therapy, Faculty of Allied Health
Sciences, Thammasat University Rangsit Campus: 99 Moo.18 Phahonyothin Road, Khlong Nueng,
Khlong Luang, Pathum Thani 12120, Thailand
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21
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de Mattos F, Pereira G, Bento PCB. Water-Based Exercises Performed with High-Speed Movement Improves Strength and Physical Function in Older Women with Knee Osteoarthritis. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2021. [DOI: 10.1080/02703181.2020.1788690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Fernanda de Mattos
- Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
| | - Gleber Pereira
- Department of Physical Education, Federal University of Paraná, Curitiba, Brazil
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22
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Liao CD, Chen HC, Kuo YC, Tsauo JY, Huang SW, Liou TH. Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2020; 72:1703-1718. [PMID: 31628720 DOI: 10.1002/acr.24097] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate the effect of muscle strength exercise training (MSET) on lean mass (LM) gain and muscle hypertrophy in older patients with lower extremity osteoarthritis (OA). METHODS A comprehensive search of online databases was performed on April 20, 2019. Randomized controlled trials (RCTs) that reported the effects of MSET on LM, muscle thickness, and cross-sectional area (CSA) in older patients with OA were identified. A risk of bias assessment and meta-analysis were performed for the included RCTs. RESULTS We included 19 RCTs with a median Physiotherapy Evidence Database score of 6 of 10 (range 3-7). In total, data from 1,195 patients (65% women, 85% with knee OA) with a mean age of 62.1 years (range 40-86 years) were analyzed. MSET resulted in significantly higher LM gain (standardized mean difference [SMD] 0.49 [95% confidence interval (95% CI) 0.28, 0.71], P < 0.00001) than did the nonexercise controls. Meta-analysis results revealed significantly positive effects of MSET on muscle thickness (SMD 0.82 [95% CI 0.20, 1.43], P = 0.009) and CSA (SMD 0.80 [95% CI 0.25, 1.35], P = 0.004) compared with nonexercise controls. No significant effects in favor of MSET were observed for any muscle outcome compared with exercise controls. Five RCTs reported nonsevere adverse events in response to MSET, whereas no RCTs reported severe events. CONCLUSION MSET is effective in increasing LM and muscle size in older adults with OA. Clinicians should incorporate MSET into their management of patients at risk of low muscle mass to maximize health status, particularly for older individuals with OA.
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Affiliation(s)
- Chun-De Liao
- National Taiwan University and Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hung-Chou Chen
- Shuang Ho Hospital and Taipei Medical University, Taipei, Taiwan
| | - Yu-Chi Kuo
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | | | - Shih-Wei Huang
- Shuang Ho Hospital and Taipei Medical University, Taipei, Taiwan, and National Taiwan Sport University, Taoyuan, Taiwan
| | - Tsan-Hon Liou
- Shuang Ho Hospital and Taipei Medical University, Taipei, Taiwan
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23
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Al Mahrouqi MM, MacDonald DA, Vicenzino B, Smith MD. Quality of life, function and disability in individuals with chronic ankle symptoms: a cross-sectional online survey. J Foot Ankle Res 2020; 13:67. [PMID: 33198773 PMCID: PMC7667748 DOI: 10.1186/s13047-020-00432-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/18/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Chronic ankle conditions affect approximately 20% of Australian adults. Although there is a plethora of research on chronic hip and knee conditions, there is limited understanding of the impact of ankle problems. Thus, the significance of chronic ankle conditions is not clear. The aim of this study was to compare self-reported function, disability, instability, physical activity and quality of life (QoL) between adults with and without ankle symptoms. A secondary aim was to explore factors associated with QoL. METHOD Individuals with symptoms of ankle pain and stiffness (symptomatic individuals) and controls with no ankle pain or stiffness (asymptomatic individuals) completed a cross-sectional online survey. The survey included the Ankle Osteoarthritis Scale (AOS), Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), International Physical Activity Questionnaire (IPAQ), Assessment of QoL (AQoL-6D), and questions about ankle injury history. RESULTS A total of 394 individuals (270 symptomatic and 124 asymptomatic) with mean age of 48.8 (standard deviation (SD): 12.1) years and body mass index of 28.7 (7.7) kgm- 2 completed the survey. Standardized mean differences (SMD) were large to very large (1.45 to 3.20) for greater disability (AOS) and instability (CAIT), and poorer function (FAAM) in symptomatic compared to asymptomatic individuals. Individuals with ankle symptoms had higher body mass index and lower QoL (medium effect: SMD > 1). There were no differences in self-report physical activity between groups. Lower activities of daily living (ADL) function (FAAM-ADL) best explained QoL in a multiple regression model (R2 = 0.66, p = 0.001). CONCLUSION Individuals with ankle symptoms reported ankle instability, greater disability, compromised function and worse QoL compared to asymptomatic individuals. There was a strong relationship between ankle function and QoL. Ankle-specific ability during ADL best explained the reduced QoL in individuals with ankle symptoms. Clinicians and researchers should consider ankle function as an antecedent to poorer QoL in patients who have ankle symptoms.
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Affiliation(s)
- M. M. Al Mahrouqi
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
- Division of Physiotherapy, Oman College of Health Sciences, Ministry of Health, Muscat, P.O. Box 3720, PC 112 Sultanate of Oman
| | - D. A. MacDonald
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
- Physiotherapy, School of Allied Health Sciences, Griffith University, Gold Coast, QLD 4222 Australia
| | - B. Vicenzino
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
| | - M. D. Smith
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD 4072 Australia
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24
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Stokes AC, Xie W, Lundberg DJ, Hempstead K, Zajacova A, Zimmer Z, Glei DA, Meara E, Preston SH. Increases in BMI and chronic pain for US adults in midlife, 1992 to 2016. SSM Popul Health 2020; 12:100644. [PMID: 33134473 PMCID: PMC7585155 DOI: 10.1016/j.ssmph.2020.100644] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 07/29/2020] [Accepted: 08/06/2020] [Indexed: 01/30/2023] Open
Abstract
Recent unprecedented increases in mortality and morbidity during midlife are often ascribed to rising despair in the US population. An alternative and less often examined explanation is that these trends reflect, at least in part, the lagged effects of the obesity epidemic. Adults in midlife today are more likely to live with obesity and have a greater cumulative exposure to excess adiposity during their lifetime than any previous generation. Prior work has demonstrated a link between obesity and mortality risk at midlife, but the mechanisms remain unclear. Pain may represent one important pathway linking obesity to mortality trends. Pain is a debilitating condition that has increased significantly over recent decades and is associated with both morbidity and mortality, including suicide and opioid-related mortality. Evidence suggests obesity and pain may be linked, but there is little evidence of an association at the population level. In this paper, we examine to what extent increases in overweight and obesity explain the rising trends in chronic pain observed among middle-aged adults in the US from 1992 to 2016. We assess trends in both mild/moderate nonlimiting pain and severe and/or limiting pain. In doing so, we draw attention to one mechanism through which overweight/obesity may have contributed to recent population health trends. Our analysis found that increases in BMI from 1992 to 2016 may account for up to 20% of the upward trend in mild/moderate nonlimiting pain and 32% of the trend in severe and/or limiting pain for women, and 10% and 19% of the trends respectively for men. We study the contribution of overweight and obesity to recent trends in pain among middle-aged adults. Overweight and obesity accounted for 32.1% of increases in severe or limiting pain among women and 19.0% among men. Overweight and obesity explained a larger share of the increase in severe than mild/moderate pain. The study highlights the importance of obesity prevention to decrease the prevalence of pain.
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Affiliation(s)
- Andrew C Stokes
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Wubin Xie
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | - Dielle J Lundberg
- Department of Global Health, Boston University School of Public Health, Boston, MA, USA
| | | | - Anna Zajacova
- Social Science Centre, The University of Western Ontario, London, Ontario, Canada
| | - Zachary Zimmer
- Department of Family Studies and Gerontology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Dana A Glei
- Center for Population and Health, Georgetown University, Washington, DC, USA
| | - Ellen Meara
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel H Preston
- Population Studies Center, University of Pennsylvania, Philadelphia, PA, USA
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25
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Myers BJ. Isokinetic testing of muscle strength in older adults with knee osteoarthritis: An integrative review. ISOKINET EXERC SCI 2020. [DOI: 10.3233/ies-201150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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26
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Liao CD, Chiu YS, Ku JW, Huang SW, Liou TH. Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial. J Clin Med 2020; 9:jcm9072194. [PMID: 32664548 PMCID: PMC7408891 DOI: 10.3390/jcm9072194] [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: 06/11/2020] [Revised: 07/01/2020] [Accepted: 07/08/2020] [Indexed: 12/27/2022] Open
Abstract
(1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T0) and postoperative at 1 month (T1; before RET) and 4 months (T2; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T1 and T2 from T0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T2, the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.
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Affiliation(s)
- Chun-De Liao
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (C.-D.L.); (S.-W.H.)
| | - Yen-Shuo Chiu
- Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan;
| | - Jan-Wen Ku
- Department of Radiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan;
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (C.-D.L.); (S.-W.H.)
- Graduate Institute of Sports Science, National Taiwan Sport University, Taoyuan 33301, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan; (C.-D.L.); (S.-W.H.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2249-0088
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27
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Effectiveness of Weight-Loss Interventions for Reducing Pain and Disability in People With Common Musculoskeletal Disorders: A Systematic Review With Meta-Analysis. J Orthop Sports Phys Ther 2020; 50:319-333. [PMID: 32272032 DOI: 10.2519/jospt.2020.9041] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To assess the effectiveness of weight-loss interventions on pain and disability in people with knee and hip osteoarthritis (OA) and spinal pain. DESIGN Intervention systematic review. LITERATURE SEARCH Twelve online databases and clinical trial registries. STUDY SELECTION CRITERIA Randomized controlled trials of any weight-loss intervention (eg, diet, physical activity, surgical, pharmaceutical) that reported pain or disability outcomes in people with knee or hip OA or spinal pain. DATA SYNTHESIS We calculated mean differences or standardized mean differences (SMDs) and 95% confidence intervals (CIs). We used the Cochrane risk of bias tool to assess risk of bias and the Grading of Recommendations Assessment, Development, and Evaluation tool to judge credibility of evidence. RESULTS Twenty-two trials with 3602 participants were included. There was very low- to very low-credibility evidence for a moderate effect of weight-loss interventions on pain intensity (10 trials, n = 1806; SMD, -0.54; 95% CI: -0.86, -0.22; I2 = 87%, P<.001) and a small effect on disability (11 trials, n = 1821; SMD, -0.32; 95% CI: -0.49, -0.14; I2 = 58%, P<.001) compared to minimal care for people with OA. For knee OA, there was low- to moderate-credibility evidence that weight-loss interventions were not more effective than exercise only for pain intensity and disability, respectively (4 trials, n = 673; SMD, -0.13; 95% CI: -0.40, 0.14; I2 = 55%; 5 trials, n = 737; SMD, -0.20; 95% CI: -0.41, 0.00; I2 = 32%). CONCLUSION Weight-loss interventions may provide small to moderate improvements in pain and disability for OA compared to minimal care. There was limited and inconclusive evidence for weight-loss interventions targeting spinal pain. J Orthop Sports Phys Ther 2020;50(6):319-333. Epub 9 Apr 2020. doi:10.2519/jospt.2020.9041.
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28
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Effects of Elastic Resistance Exercise After Total Knee Replacement on Muscle Mass and Physical Function in Elderly Women With Osteoarthritis: A Randomized Controlled Trial. Am J Phys Med Rehabil 2020; 99:381-389. [PMID: 31687984 DOI: 10.1097/phm.0000000000001344] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Knee osteoarthritis and age are associated with high sarcopenia risk, especially in patients who have received total knee replacement. The aim of this study was to identify the effects of elastic resistance exercise training after total knee replacement on muscle mass and physical outcomes in older women with knee osteoarthritis. DESIGN Sixty older women who received unilateral primary total knee replacement surgery were randomized to an experimental group, which received 12 wks of postoperative elastic resistance exercise training, or a control group, which received standard care. The outcome measures included physical function performance (ie, Timed Up & Go, gait speed, forward reach, single-leg stance, timed chair rise), appendicular lean mass, and the Western Ontario and McMaster Universities Osteoarthritis Index. The assessment time points were 2 wks before surgery (T0), 1 mo after surgery (T1, before resistance exercise training), and 4 mos after surgery (T2, upon completion of resistance exercise training). RESULTS After 12 wks of postoperative elastic resistance exercise training, the experimental group exhibited a significantly greater change in appendicular lean mass (mean difference = 0.81 kg, P = 0.004) than the control group. Elastic resistance exercise training also exerted significant effects on Timed Up & Go and gait speed with mean differences of 0.28 m/sec (P < 0.001) and -2.66 secs (P < 0.001), respectively. CONCLUSIONS A 12-wk elastic resistance exercise training program after total knee replacement exerted benefits on muscle mass, mobility, and Western Ontario and McMaster Universities Osteoarthritis Index functional outcomes in older women with knee osteoarthritis.
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Munukka M, Waller B, Häkkinen A, Nieminen MT, Lammentausta E, Kujala UM, Paloneva J, Kautiainen H, Kiviranta I, Heinonen A. Effects of progressive aquatic resistance training on symptoms and quality of life in women with knee osteoarthritis: A secondary analysis. Scand J Med Sci Sports 2020; 30:1064-1072. [PMID: 31999876 DOI: 10.1111/sms.13630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 01/27/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a secondary analysis to study the effects, those 4 months of aquatic resistance training have on self-assessed symptoms and quality of life in post-menopausal women with mild knee osteoarthritis (OA), after the intervention and after a 12-month follow-up period. METHODS A total of 87 post-menopausal volunteer women, aged 60-68 years, with mild knee OA were recruited in a randomized, controlled, 4-month aquatic training trial (RCT) and randomly assigned to an intervention (n = 43) and a control (n = 44) group. The intervention group participated in 48 supervised aquatic resistance training sessions over 4 months while the control group maintained their usual level of physical activity. Additionally, 77 participants completed the 12-month post-intervention follow-up period. Self-assessed symptoms were estimated using the OA-specific Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and Health-related Quality of life (HRQoL) using the generic Short-form Health Survey (SF-36). RESULTS After 4 months of aquatic resistance training, there was a significant decrease in the stiffness dimension of WOMAC -8.5 mm (95% CI = -14.9 to -2.0, P = .006) in the training group compared to the controls. After the cessation of the training, this benefit was no longer observed during the 12-month follow-up. No between-group differences were observed in any of the SF-36 dimensions. CONCLUSIONS The results of this study show that participation in an intensive aquatic resistance training program did not have any short- or long-term impact on pain and physical function or quality of life in women with mild knee OA. However, a small short-term decrease in knee stiffness was observed.
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Affiliation(s)
- Matti Munukka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Benjamin Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Physical Activity, Physical Education, Sport and Health Research Centre (PAPESH), Sports Science Department, School of Science and Engineering, Reykjavik University, Reykjavik, Iceland
| | - Arja Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Finland Central Hospital, Jyväskylä, Finland
| | - Miika T Nieminen
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland.,Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | | | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juha Paloneva
- Department of Surgery, Central Finland Central Hospital, Jyväskylä, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Ilkka Kiviranta
- Department of Orthopaedics and Traumatology, University of Helsinki, and Helsinki University Hospital, Helsinki, Finland
| | - Ari Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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30
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Barrow DR, Abbate LM, Paquette MR, Driban JB, Vincent HK, Newman C, Messier SP, Ambrose KR, Shultz SP. Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review. BMC Musculoskelet Disord 2019; 20:610. [PMID: 31861990 PMCID: PMC6925458 DOI: 10.1186/s12891-019-3004-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/12/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis. METHODS A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) "obes*" AND "exercise" AND "interven*" AND "musculoskeletal pain OR knee pain OR hip pain". Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18-50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain. RESULTS Seven studies were included. Similarities in exercise intensity (40-80% VO2max), frequency (three times per week), duration (30-60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups. CONCLUSION Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30-60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.
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Affiliation(s)
- Dylan R Barrow
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand
| | - Lauren M Abbate
- Geriatric Research, Education, and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, CO, USA.,Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Max R Paquette
- School of Health Studies, University of Memphis, Memphis, TN, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Heather K Vincent
- UF Health Sports Performance Center, Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL, USA
| | - Connie Newman
- Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, New York University School of Medicine, New York, NY, USA
| | - Stephen P Messier
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Kirsten R Ambrose
- Osteoarthritis Action Alliance, Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah P Shultz
- School of Sport, Exercise and Nutrition, Massey University, Wellington, New Zealand. .,Department of Kinesiology, Seattle University, 901 12th Avenue, Seattle, WA, 98122, USA.
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31
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Schulz JM, Birmingham TB, Atkinson HF, Woehrle E, Primeau CA, Lukacs MJ, Al-Khazraji BK, Khan MCM, Zomar BO, Petrella RJ, Beier F, Appleton CT, Shoemaker JK, Bryant DM. Are we missing the target? Are we aiming too low? What are the aerobic exercise prescriptions and their effects on markers of cardiovascular health and systemic inflammation in patients with knee osteoarthritis? A systematic review and meta-analysis. Br J Sports Med 2019; 54:771-775. [DOI: 10.1136/bjsports-2018-100231] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2019] [Indexed: 11/04/2022]
Abstract
ObjectivesWe systemically reviewed published studies that evaluated aerobic exercise interventions in patients with knee osteoarthritis (OA) to: (1) report the frequency, intensity, type and time (FITT) of exercise prescriptions and (2) quantify the changes in markers of cardiovascular health and systemic inflammation.Data sourcesPubMed, CINAHL, Scopus; inception to January 2019.Eligibility criteriaRandomised clinical trials (RCT), cohort studies, case series.DesignWe summarised exercise prescriptions for all studies and calculated effect sizes with 95% CIs for between-group (RCTs that compared exercise and control groups) and within-group (pre-post exercise) differences in aerobic capacity (VO2), heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and inflammatory markers (interleukin-6 (IL-6), tumour necrosis factor-alpha). We pooled results where possible using random effects models.ResultsInterventions from 49 studies were summarised; 8% (4/49) met all FITT guidelines; 16% (8/49) met all or most FITT guidelines. Fourteen studies (10 RCTs) reported at least one marker of cardiovascular health or systemic inflammation. Mean differences (95% CI) indicated a small to moderate increase in VO2 (0.84 mL/min/kg; 95% CI 0.37 to 1.31), decrease in HR (−3.56 beats per minute; 95% CI −5.60 to −1.52) and DBP (−4.10 mm Hg; 95% CI −4.82 to −3.38) and no change in SBP (−0.36 mm Hg; 95% CI −3.88 to 3.16) and IL-6 (0.37 pg/mL; 95% CI −0.11 to 0.85). Within-group differences were also small to moderate.ConclusionsIn studies of aerobic exercise in patients with knee OA, very few interventions met guideline-recommended dose; there were small to moderate changes in markers of cardiovascular health and no decrease in markers of systemic inflammation. These findings question whether aerobic exercise is being used to its full potential in patients with knee OA.PROSPERO registration numberCRD42018087859.
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The impact of cardiorespiratory fitness on classical cardiovascular disease risk factors in rheumatoid arthritis: a cross-sectional and longitudinal study. Rheumatol Int 2019; 39:1759-1766. [PMID: 31482199 DOI: 10.1007/s00296-019-04431-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 08/20/2019] [Indexed: 01/22/2023]
Abstract
Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease (CVD). Advanced measures of cardiorespiratory fitness (CRF) are associated with CVD risk factors. The present study aimed to examine whether CVD risk factors can predict clinic-based measures of CRF, using the Siconolfi step test and to determine if exercise can improve RA patients' cardiovascular health. Sixty-five RA patients (46 females, age 58 ± 11 years) completed assessments of CRF, CVD risk factors, body composition and RA characteristics. Ten patients participated in a follow-up 8-week exercise intervention. CRF was low (22 ml kg-1 min-1) and associated with higher diastolic blood pressure (r = - 0.37, p = 0.002), higher global CVD risk (r = - 0.267, p = 0.031) and worse body composition profile (body fat, r = - 0.48, p < 0.001; waist, r = - 0.65, p < 0.001; hip, r = - 0.58, p < 0.001). Regular exercise significantly improved CRF (p = 0.021), lower body strength (p < 0.001), agility (p < 0.001), systolic blood pressure (p = 0.021), body fat (p = 0.018), waist circumference (p = 0.035), hip circumference (p = 0.016), disease activity (p = 0.002), disability (p = 0.007) and QoL (p = 0.004). Elevated diastolic blood pressure and worse body composition profile are strong predictors of clinic-based measures of CRF. CRF is an important determinant of CVD risk and warrants inclusion in the routine assessment of RA patients. Regular exercise can improve CRF and CVD risk factors without any exacerbation of disease activity and should be offered as part of routine care.
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Luan X, Tian X, Zhang H, Huang R, Li N, Chen P, Wang R. Exercise as a prescription for patients with various diseases. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:422-441. [PMID: 31534817 PMCID: PMC6742679 DOI: 10.1016/j.jshs.2019.04.002] [Citation(s) in RCA: 212] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/12/2019] [Accepted: 03/01/2019] [Indexed: 05/18/2023]
Abstract
A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy. Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training, the effects and underlying mechanisms of exercise remain unclear. Thus, the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol. This review summarizes the latest exercise prescription treatments for 26 different diseases: musculoskeletal system diseases (low back pain, tendon injury, osteoporosis, osteoarthritis, and hip fracture), metabolic system diseases (obesity, type 2 diabetes, type 1 diabetes, and nonalcoholic fatty liver disease), cardio-cerebral vascular system diseases (coronary artery disease, stroke, and chronic heart failure), nervous system diseases (Parkinson's disease, Huntington's disease, Alzheimer's disease, depression, and anxiety disorders), respiratory system diseases (chronic obstructive pulmonary disease, interstitial lung disease, and after lung transplantation), urinary system diseases (chronic kidney disease and after kidney transplantation), and cancers (breast cancer, colon cancer, prostate cancer, and lung cancer). Each exercise prescription is displayed in a corresponding table. The recommended type, intensity, and frequency of exercise prescriptions are summarized, and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.
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Affiliation(s)
- Xin Luan
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Xiangyang Tian
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Haixin Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Department of Sport, Huainan Normal University, Huainan 232038, China
| | - Rui Huang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Na Li
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Peijie Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Corresponding authors.
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
- Corresponding authors.
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Teng M, Zhou HJ, Lin L, Lim PH, Yeo D, Goh S, Tjan SY, Lim BP. Cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders in Singapore. J Public Health (Oxf) 2019. [PMID: 29534234 DOI: 10.1093/pubmed/fdy044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The study evaluated the cost-effectiveness of hydrotherapy versus land-based therapy in patients with musculoskeletal disorders (MSDs) in Singapore. METHODS A decision-analytic model was constructed to compare the cost-effectiveness of hydrotherapy to land-based therapy over 3 months from societal perspective. Target population comprised patients with low back pain (LBP), osteoarthritis (OA), rheumatoid arthritis (RA), total hip replacement (THR) and total knee replacement (TKR). Subgroup analyses were carried out to determine the cost-effectiveness of hydrotherapy in individual MSDs. Relative treatment effects were obtained through a systematic review of published data. RESULTS Compared to land-based therapy, hydrotherapy was associated with an incremental cost-effectiveness ratio (ICER) of SGD 27 471 per quality-adjusted life-year (QALY) gained, which was below the willingness-to-pay threshold of SGD 70 000 per QALY (one gross domestic product per capita in Singapore in 2015). For the respective MSDs, hydrotherapy were dominant (more effective and less costly) in THR and TKR, cost-effective for LBP and RA, and not cost-effective for OA. Treatment adherence and cost of hydrotherapy were key drivers to the ICER values. CONCLUSIONS Hydrotherapy was a cost-effective rehabilitation compared to land-based therapy for a population with MSDs in Singapore. However, the benefit of hydrotherapy was not observed in patients with OA.
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Affiliation(s)
- Monica Teng
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Hui Jun Zhou
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Liang Lin
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
| | - Pang Hung Lim
- Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore
| | - Doreen Yeo
- Rehabilitation Centre Allied Health Services, Tan Tock Seng Hospital, Singapore
| | - Suzanne Goh
- Allied Health Services and Pharmacy Operations Division, Tan Tock Seng Hospital, Singapore
| | - Soon Yin Tjan
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore
| | - Boon Peng Lim
- Pharmacy and Therapeutics Office, Group Health Informatics, National Healthcare Group, 3 Fusionopolis Link, #03-08 Nexus@one-north, Singapore, Singapore
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Vassão PG, de Souza MC, Silva BA, Junqueira RG, de Camargo MR, Dourado VZ, Tucci HT, Renno AC. Photobiomodulation via a cluster device associated with a physical exercise program in the level of pain and muscle strength in middle-aged and older women with knee osteoarthritis: a randomized placebo-controlled trial. Lasers Med Sci 2019; 35:139-148. [PMID: 31144070 DOI: 10.1007/s10103-019-02807-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/10/2019] [Indexed: 12/28/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disease that leads to pain and functional incapacity. The aim of the study is to investigate the effects of the incorporation of photobiomodulation (PBM) (via cluster) into a physical exercise program on the level of pain, lower limb muscle strength, and physical capacity, in patients with knee OA. Sixty-two female volunteers with a diagnosis of knee OA were distributed in 4 groups: exercise associated with placebo PBM group, exercise associated with active PBM group, active PBM group, and placebo PBM group. Sixteen sessions of lower limb strength exercises and PBM via cluster (808 nm, 100 mW, 7 points each side, 56 J total) were performed. The level of pain, physical capacity, and lower limb muscle strength were evaluated with the use of the numeric pain rating scale (NPRS), 6-min walking test (6-MWT) and timed up and go (TUG), and maximal voluntary isometric torque (MVIT) before and after the interventions. Both groups presented a significant decrease in the level of pain when compared with the placebo-treated women. Furthermore, the 6-MWT showed that the trained groups (with or without PBM) demonstrated higher values in the distance walked comparing pre and post-treatment values. The same behavior was found for the MVIT load before and after intervention. TUG was higher for all the treated with exercise groups comparing the pre and post-treatment values. Physical exercise and PBM showed analgesic effects. However, PBM did not have any extra effect along with the effects of exercise in improving the distance walked, the TUG, and the muscle strength.Trial registration: RBR-7t6nzr.
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Affiliation(s)
- Patricia Gabrielli Vassão
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil.
| | - Mayra Cavenague de Souza
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Bruna Arcaim Silva
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Rheguel Grillo Junqueira
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Marcela Regina de Camargo
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Victor Zuniga Dourado
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Helga Tatiana Tucci
- Department of Human Movement Science, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
| | - Ana Claudia Renno
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Rua Silva Jardim, 136, Santos, SP, 11015-020, Brazil
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Heywood S, McClelland J, Geigle P, Rahmann A, Villalta E, Mentiplay B, Clark R. Force during functional exercises on land and in water in older adults with and without knee osteoarthritis: Implications for rehabilitation. Knee 2019; 26:61-72. [PMID: 30611642 DOI: 10.1016/j.knee.2018.11.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 10/31/2018] [Accepted: 11/03/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND Closed kinetic chain and plyometric exercises are commonly used in aquatic rehabilitation because they are believed to reduce joint loading whilst replicating functional tasks. However, the forces and relationship to land-based functional movement is unknown. This study aims to compare vertical ground reaction force during squats, calf raises and jumping in older adults with and without knee osteoarthritis on land and in water. METHODS Forty one participants (Healthy n = 21; Knee osteoarthritis n = 20; Age 68.5 (4.4) years) completed squats and calf raises at slow, medium and maximal speeds and jumping at maximal speed on land and in waist and chest depth water. Vertical ground reaction force and pain rating was measured in each environment. RESULTS Force in all exercises was significantly greater on land than in chest depth water (p < 0.005). Peak force was significantly greater at maximal speed compared to slow speed (p < 0.001). The pattern of force in squats at slow speed in water was different to on land, with force highest at the start and end of the exercise and decreasing in the central phase. Pain ratings were significantly lower (p < 0.001) in water compared to on land in squats. CONCLUSIONS Closed kinetic chain exercises offer inherently different loading in an aquatic environment. Body weight squats and calf raises in water could be defined as either neuromotor or low load, high velocity training. Maximal speed exercise in water produces higher relative load compared to slow speed and minimal pain providing an opportunity for clinicians to use greater speed to address power deficits.
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Affiliation(s)
- Sophie Heywood
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia; University of the Sunshine Coast, Sippy Downs, Queensland, Australia.
| | | | - Paula Geigle
- School of Medicine, University of Maryland, Baltimore, MD, United States
| | - Ann Rahmann
- School of Physiotherapy, Australian Catholic University, Brisbane, Queensland, Australia
| | - Elizabeth Villalta
- Physiotherapy Department, St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Benjamin Mentiplay
- Latrobe University, Melbourne, Victoria, Australia; Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Ross Clark
- University of the Sunshine Coast, Sippy Downs, Queensland, Australia
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Tamin TZ, Loekito N. Aquatic versus land-based exercise for cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis: a randomized controlled trial. MEDICAL JOURNAL OF INDONESIA 2018. [DOI: 10.13181/mji.v27i4.2107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Background: Obesity with knee osteoarthritis (OA) is related to chronic pain causing physical inactivity that leads to decreased cardiorespiratory endurance and quality of life. Aquatic and land-based exercises are effective in improving physical activity. The aim of this study is to compare between aquatic and land-based exercise to improve cardiorespiratory endurance and quality of life in obese patients with knee osteoarthritis.Methods: A single-blind, randomized, controlled trial was conducted on thirty three obese patients with knee OA who visited Obesity Clinic of Medical Rehabilitation Cipto Mangunkusumo Hospital, from October 2016 to January 2017, subjects were divided into aquatic or land-based exercise group. Aerobic and knee-strengthening exercises were given. Cardiorespiratory endurance was assessed using the Borg Scale, whereas both the BORG CR-10 and SF-36 questionnaires were used to assess quality of life.Results: After intervention, there were significant improvements in the land-based exercise group in the rating of perceived exertion (p=0.02), role limitations due to physical health (p=0.024), role limitations due to emotional problems (p=0.041), energy/fatigue (p=0.016), and the decline in pain (p=0.049) parameters. While in the aquatic exercise, there were significant improvements in leg fatigue (p=0.016), energy/fatigue (p=0.025), emotional well-being (p<0.001), and general health (p=0.045) parameters. Despite this, there were no significant differences between two groups regarding cardiorespiratory endurance and quality of life.Conclusion: This study found that patients could start aquatic exercise to reduce leg fatigue and enhanced general health and energy. After that, exercise could be continued in land-based settings to improve cardiorespiratory endurance and quality of life.
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Rausch Osthoff AK, Juhl CB, Knittle K, Dagfinrud H, Hurkmans E, Braun J, Schoones J, Vliet Vlieland TPM, Niedermann K. Effects of exercise and physical activity promotion: meta-analysis informing the 2018 EULAR recommendations for physical activity in people with rheumatoid arthritis, spondyloarthritis and hip/knee osteoarthritis. RMD Open 2018; 4:e000713. [PMID: 30622734 PMCID: PMC6307596 DOI: 10.1136/rmdopen-2018-000713] [Citation(s) in RCA: 78] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/23/2018] [Accepted: 08/28/2018] [Indexed: 12/16/2022] Open
Abstract
Objective To evaluate the effectiveness of exercise and physical activity (PA) promotion on cardiovascular fitness, muscle strength, flexibility, neuromotor performance (eg, balance) and daily PA in people with rheumatoid arthritis (RA), spondyloarthritis (SpA) and hip/knee osteoarthritis (HOA/KOA). Methods systematic review (SR) and meta-analysis (MA) were performed searching the databases PubMed/Medline, CENTRAL, Embase, Web of Science, Emcare and PsycInfo until April 2017. We included randomised controlled trials (RCTs) in adults (≥18 years) with RA, SpA and HOA/KOA, investigating the effects of exercise or PA promotion according to the public health PA recommendations by the American College of Sports Medicine. The time point of interest was the first assessment after the intervention period. If suitable, data were pooled in a MA using a random-effects model presented as standardised mean difference (SMD). Results The SR included 63 RCTs, of which 49 (3909 people with RA/SpA/HOA/KOA) were included in the MA. Moderate effects were found of aerobic exercises and resistance training on cardiovascular fitness (SMD 0.56 (95% CI 0.38 to 0.75)) and muscle strength (SMD 0.54 (95% CI 0.35 to 0.72)), respectively, but no effect of combined strength/aerobic/flexibility exercises on flexibility (SMD 0.12 (95% CI -0.16 to 0.41)). PA promotion interventions produced a small increase in PA behaviour (SMD 0.21 (95% CI 0.03 to 0.38)). Conclusion Exercises and PA promotion according to public health recommendations for PA improved cardiovascular fitness, muscle strength and PA behaviour, with moderate effect sizes in people with SpA, RA and HOA/KOA. Trial registration number CRD42017082131.
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Affiliation(s)
- Anne-Kathrin Rausch Osthoff
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Carsten Bogh Juhl
- University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark.,University of Southern Denmark, Odense, Denmark
| | - Keegan Knittle
- Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Hanne Dagfinrud
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Emalie Hurkmans
- Department Social Affaire and Health, Ecorys, Rotterdam, The Netherlands
| | - Juergen Braun
- Rheumazentrum Ruhrgebiet, Herne, Germany.,Ruhr University, Bochum, Germany
| | - Jan Schoones
- Leiden University Medical Center, Leiden, The Netherlands
| | - Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Karin Niedermann
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
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Dong R, Wu Y, Xu S, Zhang L, Ying J, Jin H, Wang P, Xiao L, Tong P. Is aquatic exercise more effective than land-based exercise for knee osteoarthritis? Medicine (Baltimore) 2018; 97:e13823. [PMID: 30593178 PMCID: PMC6314737 DOI: 10.1097/md.0000000000013823] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND This study aimed to systemically review the effectiveness of aquatic exercise (AQE) compared to land-based exercise (LBE) in treating knee osteoarthritis (OA). METHODS The Medline, Embase, Web of Science, Cochrane Central Register of Controlled Clinical Trials, CINAHL, and psyclNFO databases were comprehensively searched for randomized controlled trials (RCTs) evaluating the effectiveness of AQE and LBE for knee OA from their inception date to September 24, 2018. The risk of bias was examined using the Cochrane Collaboration Tool, and Review Manager 5.3 was used for data collation and analysis. RESULTS Eight RCTs were included, involving a total of 579 patients. The meta-analysis showed that there was no significant difference between AQE and LBE for pain relief, physical function, and improvement in the quality of life, for both short- and long-term interventions, in patients with knee OA. However, the adherence and satisfaction level for AQE was higher than for LBE. Compared to no intervention, AQE showed a mild effect for elevating activities of daily living (standardized mean difference [SMD]: -0.55, 95% confidence interval [CI] [-0.94, -0.16], P = .005) and a high effect for improving sports and recreational activities (SMD: -1.03, 95% CI [-1.82, -0.25], P = .01). CONCLUSION AQE is comparable to LBE for treating knee OA.
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Affiliation(s)
- Rui Dong
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
| | - Yunyao Wu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi
| | | | - Lei Zhang
- Xiaoshan Traditional Chinese Medical Hospital
| | - Jun Ying
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
| | - Hongting Jin
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
| | - Pinger Wang
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
| | - Luwei Xiao
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
| | - Peijian Tong
- The First Clinical Medical College of Zhejiang Chinese Medical University
- Institute of Orthopaedic and Traumatology, Zhejiang Province, Hangzhou, Zhejiang
- Department of Orthopaedic Surgery, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Ha GC, Yoon JR, Yoo CG, Kang SJ, Ko KJ. Effects of 12-week aquatic exercise on cardiorespiratory fitness, knee isokinetic function, and Western Ontario and McMaster University osteoarthritis index in patients with knee osteoarthritis women. J Exerc Rehabil 2018; 14:870-876. [PMID: 30443535 PMCID: PMC6222165 DOI: 10.12965/jer.1836308.154] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/14/2018] [Indexed: 01/08/2023] Open
Abstract
The purpose of this study is to investigate the risk factors of metabolic syndrome, cardiorespiratory fitness, knee isokinetic function, and osteoarthritis index inpatients with knee osteoarthritis women. Subjects were divided into the exercise group (n=9, aged 60.89±5.06), and the control groups (n=8, aged 61.25±1.91). Aquatic exercise was performed for 12 weeks, 3 times a week, 60 min a day. The changes of metabolic syndrome risk factors, cardiorespiratory fitness, knee isokinetic function, and WOMAC index (Western Ontario and McMaster University osteoarthritis index) were measured and analyzed at pre- and postexercise program for verifying exercise effectiveness. As a result, fasting blood glucose (P<0.05), glycosylated hemoglobin (P<0.01), and triglyceride (P<0.05) were significantly decreased in the risk factors of metabolic syndrome. The maximum oxygen uptake in cardiorespiratory fitness was not significantly different. The left and right extensor muscles of knee isokinetic function increased significantly (P<0.01, P<0.01, respectively). There was no significant difference in flexor muscles. Osteoarthritis index was significantly improved in stiffness (P<0.01) and physical function (P<0.05). In conclusion, aquatic exercise can be regarded as an effective exercise program for managing metabolic syndrome risk factors, increasing muscle function, and improving osteoarthritis index in patients with osteoarthritis of the knee.
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Affiliation(s)
- Gi-Chul Ha
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Jae-Ryang Yoon
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Cheol-Gyu Yoo
- Department of Physical Education, Korea National Sport University, Seoul, Korea
| | - Seol-Jung Kang
- Department of Physical Education, Changwon National University, Changwon, Korea
| | - Kwang-Jun Ko
- Department of Sports Medicine, National Fitness Center, Seoul, Korea
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Rausch Osthoff AK, Niedermann K, Braun J, Adams J, Brodin N, Dagfinrud H, Duruoz T, Esbensen BA, Günther KP, Hurkmans E, Juhl CB, Kennedy N, Kiltz U, Knittle K, Nurmohamed M, Pais S, Severijns G, Swinnen TW, Pitsillidou IA, Warburton L, Yankov Z, Vliet Vlieland TPM. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis 2018; 77:1251-1260. [PMID: 29997112 DOI: 10.1136/annrheumdis-2018-213585] [Citation(s) in RCA: 395] [Impact Index Per Article: 65.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/05/2018] [Accepted: 06/16/2018] [Indexed: 12/11/2022]
Abstract
Regular physical activity (PA) is increasingly promoted for people with rheumatic and musculoskeletal diseases as well as the general population. We evaluated if the public health recommendations for PA are applicable for people with inflammatory arthritis (iA; Rheumatoid Arthritis and Spondyloarthritis) and osteoarthritis (hip/knee OA) in order to develop evidence-based recommendations for advice and guidance on PA in clinical practice. The EULAR standardised operating procedures for the development of recommendations were followed. A task force (TF) (including rheumatologists, other medical specialists and physicians, health professionals, patient-representatives, methodologists) from 16 countries met twice. In the first TF meeting, 13 research questions to support a systematic literature review (SLR) were identified and defined. In the second meeting, the SLR evidence was presented and discussed before the recommendations, research agenda and education agenda were formulated. The TF developed and agreed on four overarching principles and 10 recommendations for PA in people with iA and OA. The mean level of agreement between the TF members ranged between 9.8 and 8.8. Given the evidence for its effectiveness, feasibility and safety, PA is advocated as integral part of standard care throughout the course of these diseases. Finally, the TF agreed on related research and education agendas. Evidence and expert opinion inform these recommendations to provide guidance in the development, conduct and evaluation of PA-interventions and promotion in people with iA and OA. It is advised that these recommendations should be implemented considering individual needs and national health systems.
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Affiliation(s)
- Anne-Kathrin Rausch Osthoff
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland.,Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands
| | - Karin Niedermann
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet, Herne, Germany.,Ruhr University, Bochum, Germany
| | - Jo Adams
- Faculty of Health Sciences and Arthritis Research UK Centre of Excellence for Sport, Exercise and Osteoarthritis, University of Southampton, Southampton, UK
| | - Nina Brodin
- Department of Orthopaedics, Danderyd University Hospital Corp., Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
| | - Hanne Dagfinrud
- National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Tuncay Duruoz
- PMR Department, Rheumatology Division, Marmara University, School of Medicine, Istanbul, Turkey
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet., Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Klaus-Peter Günther
- University Center of Orthopaedics and Traumatology, University Medicine at Technische Universität Dresden, Dresden, Germany
| | - Emailie Hurkmans
- Department Social Affaire and Health, ECORYS Nederland BV, Rotterdam, Netherlands
| | - Carsten Bogh Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Departmentof Occupational and Physical Therapy, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark
| | - Norelee Kennedy
- School of Allied Health, Faculty of Education and Health Sciences and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Uta Kiltz
- Rheumazentrum Ruhrgebiet, Herne, Germany.,Ruhr University, Bochum, Germany
| | - Keegan Knittle
- Department of Social Psychology, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Michael Nurmohamed
- Department of Rheumatology, Amsterdam Rheumatology and immunology Center, VU University Medical Center, Amsterdam, The Netherlands
| | - Sandra Pais
- Centre for Biomedical Research, University of Algarve, Faro, Portugal
| | - Guy Severijns
- EULAR PARE Patient Research Partner, ReumaNet, Leuven, Belgium
| | - Thijs Willem Swinnen
- Department of Development and Regeneration, Skeletal Biology and Engineering Research Center, KU Leuven, Leuven, Belgium.,Division of Rheumatology, University Hospitals Leuven, Leuven, Belgium
| | - Irene A Pitsillidou
- EULAR Patient Research Partner, Cyprus League Against Rheumatism, Nicosia, Cyprus
| | | | - Zhivko Yankov
- PRP (Patient Research Partner EULAR), Bulgarian Ankylosing Spondylitis Patient Society, Sofia, Bulgaria and ASIF (Ankylosing Spondylitis International Federation), London, UK
| | - Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Leiden, Netherlands
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Cooper L, Ryan CG, Ells LJ, Hamilton S, Atkinson G, Cooper K, Johnson MI, Kirwan JP, Martin D. Weight loss interventions for adults with overweight/obesity and chronic musculoskeletal pain: a mixed methods systematic review. Obes Rev 2018; 19:989-1007. [PMID: 29781096 DOI: 10.1111/obr.12686] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 02/14/2018] [Indexed: 01/25/2023]
Abstract
Worldwide prevalence of adult overweight and obesity is a growing public health issue. Adults with overweight/obesity often have chronic musculoskeletal pain. Using a mixed-methods review, we aimed to quantify the effectiveness and explore the appropriateness of weight loss interventions for this population. Electronic databases were searched for studies published between 01/01/90 and 01/07/16. The review included 14 randomized controlled trials that reported weight and pain outcomes and three qualitative studies that explored perceptions of adults with co-existing overweight/obesity and chronic musculoskeletal pain. The random-effects pooled mean weight loss was 4.9 kg (95%CI:2.9,6.8) greater for intervention vs control. The pooled mean reduction in pain was 7.3/100 units (95%CI:4.1,10.5) greater for intervention vs control. Study heterogeneity was substantial for weight loss (I2 = 95%, tau = ±3.5 kg) and pain change (I2 = 67%, tau = ±4.1%). Meta-regression slopes for the predictors of study quality, mean age and baseline mean weight on mean study weight reduction were shallow and not statistically significant (P > 0.05). The meta-regression slope between mean pain reduction and mean weight lost was shallow, and not statistically significant, -0.09 kg per unit pain score change (95%CI:-0.21,0.40, P = 0.54). Meta-synthesis of qualitative findings resulted in two synthesized findings; the importance of healthcare professionals understanding the effects of pain on ability to control weight and developing management/education programmes that address comorbidity.
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Affiliation(s)
- L Cooper
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
| | - C G Ryan
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
| | - L J Ells
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
| | - S Hamilton
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
| | - G Atkinson
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
| | - K Cooper
- The Scottish Centre for Evidenced-Based, Multi-professional Practice: A Joanna Briggs Institute Centre of Excellence, School of Health Sciences, Robert Gordon University, UK
| | - M I Johnson
- Centre for Pain Research, School of Clinical and Applied Sciences, Leeds Beckett University, UK
| | - J P Kirwan
- Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
| | - D Martin
- School of Health and Social Care, Teesside University, UK.,Teesside Centre for Evidence Informed Practice: A Joanna Briggs Institute Centre of Excellence, UK
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Effects of a dance-based aquatic exercise program in obese postmenopausal women with knee osteoarthritis: a randomized controlled trial. Menopause 2018; 24:768-773. [PMID: 28141662 DOI: 10.1097/gme.0000000000000841] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effects of a dance-based aquatic exercise program on functionality, cardiorespiratory capacity, postexercise heart rate, and fatigue in obese postmenopausal women with knee osteoarthritis. METHODS A randomized controlled trial was performed. In all, 34 obese women diagnosed with knee osteoarthritis participated. Women were randomly allocated to an experimental group (n = 17) or a control group (n = 17). Participants in the experimental group were included in an 8-week dance-based aquatic exercise program conducted in community swimming pools. Those in the control group underwent a global aquatic exercise program. The primary outcome measure was functionality assessed with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were cardiorespiratory capacity evaluated with the 6-minute walk test, and postexercise heart rate and fatigue assessed using a visual analog scale. Variables were measured at baseline, after the intervention, and at 3-month follow-up. RESULTS A between-group analysis showed significant postintervention differences in functionality (aggregate postintervention WOMAC score of 37.30 ± 16.61 vs 41.83 ± 13.69; P = 0.048) in favor of the experimental group. In addition, significant between-group differences were found after the 8 weeks in cardiorespiratory capacity, postexercise heart rate, and fatigue. Follow-up continued to show significant differences between groups in function (aggregate WOMAC score of 38.60 ± 13.61 vs 42.60 ± 9.05; P = 0.038), postexercise heart rate, and fatigue. CONCLUSIONS An 8-week dance-based exercise program significantly improved function and cardiorespiratory capacity, and decreased postexercise heart rate and fatigue. Most of these improvements were maintained at 3-month follow-up in obese postmenopausal women.
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44
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Hurley M, Dickson K, Hallett R, Grant R, Hauari H, Walsh N, Stansfield C, Oliver S. Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. Cochrane Database Syst Rev 2018; 4:CD010842. [PMID: 29664187 PMCID: PMC6494515 DOI: 10.1002/14651858.cd010842.pub2] [Citation(s) in RCA: 104] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Chronic peripheral joint pain due to osteoarthritis (OA) is extremely prevalent and a major cause of physical dysfunction and psychosocial distress. Exercise is recommended to reduce joint pain and improve physical function, but the effect of exercise on psychosocial function (health beliefs, depression, anxiety and quality of life) in this population is unknown. OBJECTIVES To improve our understanding of the complex inter-relationship between pain, psychosocial effects, physical function and exercise. SEARCH METHODS Review authors searched 23 clinical, public health, psychology and social care databases and 25 other relevant resources including trials registers up to March 2016. We checked reference lists of included studies for relevant studies. We contacted key experts about unpublished studies. SELECTION CRITERIA To be included in the quantitative synthesis, studies had to be randomised controlled trials of land- or water-based exercise programmes compared with a control group consisting of no treatment or non-exercise intervention (such as medication, patient education) that measured either pain or function and at least one psychosocial outcome (self-efficacy, depression, anxiety, quality of life). Participants had to be aged 45 years or older, with a clinical diagnosis of OA (as defined by the study) or self-reported chronic hip or knee (or both) pain (defined as more than six months' duration).To be included in the qualitative synthesis, studies had to have reported people's opinions and experiences of exercise-based programmes (e.g. their views, understanding, experiences and beliefs about the utility of exercise in the management of chronic pain/OA). DATA COLLECTION AND ANALYSIS We used standard methodology recommended by Cochrane for the quantitative analysis. For the qualitative analysis, we extracted verbatim quotes from study participants and synthesised studies of patients' views using framework synthesis. We then conducted an integrative review, synthesising the quantitative and qualitative data together. MAIN RESULTS Twenty-one trials (2372 participants) met the inclusion criteria for quantitative synthesis. There were large variations in the exercise programme's content, mode of delivery, frequency and duration, participant's symptoms, duration of symptoms, outcomes measured, methodological quality and reporting. Comparator groups were varied and included normal care; education; and attention controls such as home visits, sham gel and wait list controls. Risk of bias was high in one and unclear risk in five studies regarding the randomisation process, high for 11 studies regarding allocation concealment, high for all 21 studies regarding blinding, and high for three studies and unclear for five studies regarding attrition. Studies did not provide information on adverse effects.There was moderate quality evidence that exercise reduced pain by an absolute percent reduction of 6% (95% confidence interval (CI) -9% to -4%, (9 studies, 1058 participants), equivalent to reducing (improving) pain by 1.25 points from 6.5 to 5.3 on a 0 to 20 scale and moderate quality evidence that exercise improved physical function by an absolute percent of 5.6% (95% CI -7.6% to 2.0%; standardised mean difference (SMD) -0.27, 95% CI -0.37 to -0.17, equivalent to reducing (improving) WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) function on a 0 to 100 scale from 49.9 to 44.3) (13 studies, 1599 participants)). Self-efficacy was increased by an absolute percent of 1.66% (95% CI 1.08% to 2.20%), although evidence was low quality (SMD 0.46, 95% CI 0.34 to 0.58, equivalent to improving the ExBeliefs score on a 17 to 85 scale from 64.3 to 65.4), with small benefits for depression from moderate quality evidence indicating an absolute percent reduction of 2.4% (95% CI -0.47% to 0.5%) (SMD -0.16, 95% CI -0.29 to -0.02, equivalent to improving depression measured using HADS (Hospital Anxiety and Depression Scale) on a 0 to 21 scale from 3.5 to 3.0) but no clinically or statistically significant effect on anxiety (SMD -0.11, 95% CI -0.26 to 0.05, 2% absolute improvement, 95% CI -5% to 1% equivalent to improving HADS anxiety on a 0 to 21 scale from 5.8 to 5.4; moderate quality evidence). Five studies measured the effect of exercise on health-related quality of life using the 36-item Short Form (SF-36) with statistically significant benefits for social function, increasing it by an absolute percent of 7.9% (95% CI 4.1% to 11.6%), equivalent to increasing SF-36 social function on a 0 to 100 scale from 73.6 to 81.5, although the evidence was low quality. Evidence was downgraded due to heterogeneity of measures, limitations with blinding and lack of detail regarding interventions. For 20/21 studies, there was a high risk of bias with blinding as participants self-reported and were not blinded to their participation in an exercise intervention.Twelve studies (with 6 to 29 participants) met inclusion criteria for qualitative synthesis. Their methodological rigour and quality was generally good. From the patients' perspectives, ways to improve the delivery of exercise interventions included: provide better information and advice about the safety and value of exercise; provide exercise tailored to individual's preferences, abilities and needs; challenge inappropriate health beliefs and provide better support.An integrative review, which compared the findings from quantitative trials with low risk of bias and the implications derived from the high-quality studies in the qualitative synthesis, confirmed the importance of these implications. AUTHORS' CONCLUSIONS Chronic hip and knee pain affects all domains of people's lives. People's beliefs about chronic pain shape their attitudes and behaviours about how to manage their pain. People are confused about the cause of their pain, and bewildered by its variability and randomness. Without adequate information and advice from healthcare professionals, people do not know what they should and should not do, and, as a consequence, avoid activity for fear of causing harm. Participation in exercise programmes may slightly improve physical function, depression and pain. It may slightly improve self-efficacy and social function, although there is probably little or no difference in anxiety. Providing reassurance and clear advice about the value of exercise in controlling symptoms, and opportunities to participate in exercise programmes that people regard as enjoyable and relevant, may encourage greater exercise participation, which brings a range of health benefits to a large population of people.
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Affiliation(s)
- Michael Hurley
- St George's, University of London and Kingston UniversitySchool of Rehabilitation Sciences, Faculty of Health, Social Care and Education2nd Floor Grosvenor WingCrammer Terrace, TootingLondonUKSW17 0RE
| | - Kelly Dickson
- UCL Institute of EducationSocial Science Research Unit18 Woburn SquareLondonUKWC1H 0NR
| | - Rachel Hallett
- St George's, University of London and Kingston UniversityCenter for Health and Social Care ResearchLondonUK
| | - Robert Grant
- St George's, University of London and Kingston UniversityCenter for Health and Social Care ResearchLondonUK
| | - Hanan Hauari
- University College LondonEPPI‐Centre, Social Science Research Unit, UCL Institute of Education20 Bedford WayLondonUKWC1H 0AL
| | - Nicola Walsh
- University of the West of EnglandGlenside CampusBristolUKBS16 1DD
| | - Claire Stansfield
- UCL Institute of Education, University College LondonEPPI‐Centre, Social Science Research Unit18 Woburn SquareLondonUKWC1H 0NR
| | - Sandy Oliver
- University College LondonEPPI‐Centre, Social Science Research Unit, UCL Institute of Education20 Bedford WayLondonUKWC1H 0AL
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The Influence of Exercise Dosing on Outcomes in Patients With Knee Disorders: A Systematic Review. J Orthop Sports Phys Ther 2018; 48:146-161. [PMID: 29320945 DOI: 10.2519/jospt.2018.7637] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Systematic review. Background Therapeutic exercise is commonly used to treat individuals with knee disorders, but dosing parameters for optimal outcomes are unclear. Large variations exist in exercise prescription, and research related to specific dosing variables for knee osteoarthritis, patellar tendinopathy, and patellofemoral pain is sparse. Objectives To identify specific doses of exercise related to improved outcomes of pain and function in individuals with common knee disorders, categorized by effect size. Methods Five electronic databases were searched for studies related to exercise and the 3 diagnoses. Means and standard deviations were used to calculate effect sizes for the exercise groups. The overall quality of evidence was assessed using the Physiotherapy Evidence Database scale. Results Five hundred eighty-three studies were found after the initial search, and 45 were included for analysis after screening. Physiotherapy Evidence Database scale scores were "fair" quality and ranged from 3 to 8. For knee osteoarthritis, 24 total therapeutic exercise sessions and 8- and 12-week durations of exercise were parameters most often associated with large effects. An exercise frequency of once per week was associated with no effect. No trends were seen with exercise dosing for patellar tendinopathy and patellofemoral pain. Conclusion This review suggests that there are clinically relevant exercise dosing variables that result in improved pain and function for patients with knee osteoarthritis, but optimal dosing is still unclear for patellar tendinopathy and patellofemoral pain. Prospective studies investigating dosing parameters are needed to confirm the results from this systematic review. Level of Evidence Therapy, level 1a. J Orthop Sports Phys Ther 2018;48(3):146-161. Epub 10 Jan 2018. doi:10.2519/jospt.2018.7637.
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46
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Masiero S, Vittadini F, Ferroni C, Bosco A, Serra R, Frigo AC, Frizziero A. The role of thermal balneotherapy in the treatment of obese patient with knee osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:243-252. [PMID: 28940031 DOI: 10.1007/s00484-017-1445-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/13/2017] [Accepted: 09/13/2017] [Indexed: 05/21/2023]
Abstract
Osteoarthritis (OA) is the most common form of arthritis clinically characterized by joint pain, functional limitation, and reduced quality of life. Several studies have shown a clear link between obesity and higher risk of knee OA. According to the multifactorial OA pathogenesis, the management of this condition requires a multidisciplinary approach. The objective of this study is to evaluate hydrokinesitherapy effects in thermal setting in obese patients with knee OA. Fifty-three patients were assessed for eligibility, of which 33 refused the treatment, while 10 patients dropped out after the enrollment for personal reasons or inability to adhere to the program. Ten patients (8 females, 2 males, mean age of 59.4 years) with obesity (range BMI 30-45 kg/m2) and knee OA (II-III grade of Kellgren-Lawrence scale) treated with hydrokinetic therapy in thermal water (two sessions per week for 8 consecutive weeks) completed the study. Primary outcome measure was pain (VAS). Secondary outcomes were clinical knee evaluation (range of motion-ROM, lower-limb muscle strength), WOMAC, and Lequesne Algofunctional Index. Patellar tendon and peri-articular soft tissue ultrasound evaluation and gait analysis at baseline (T0), at the end of treatment (T1), and at 6 months of follow-up (T2) were performed. Significant decrease on VAS pain during walking on a flat surface and going up/down stairs was reached from baseline at T1 (p = 0.0039; p = 0.0098) and was maintained at T2 (p = 0.00954) exclusively for VAS pain during walking on a flat surface. WOMAC score showed a significant reduction between T0 and T1 (p = 0.0137) and between T0 and T2 (p = 0.006438), as ROM evaluations. Kinematic path assessment did not show significant results in individual gait steps, except for the space-time variables of the average speed and the values of ground reaction force (GRF) obtained with force platforms. Hydrokinesitherapy in thermal environment in obese patients with knee OA may determine pain relief, joint function improvement, and walking speed increase until 6 months of follow-up.
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Affiliation(s)
| | | | | | - Anna Bosco
- Universita degli Studi di Padova, Padua, Italy
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47
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The influence of Aqua Power aerobics on body mass reduction in middle-aged, overweight women. Turk J Phys Med Rehabil 2017; 63:293-298. [PMID: 31453470 DOI: 10.5606/tftrd.2017.853] [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: 09/04/2016] [Accepted: 01/25/2017] [Indexed: 02/05/2023] Open
Abstract
Objectives This study aims to evaluate the effects of Aqua Power exercises on the body composition and cardiovascular response in middle- aged, overweight women after a six-month intervention. Patients and methods Between November 2013 and May 2014, a total of 37 middle-aged, overweight women (mean age 42.6 years, range 36 to 57 years) participated in the Aqua Power aerobic sessions twice per week for six months. The body composition was evaluated using the near-infrared method. The heart rate was self-controlled by the participant during the exercise. Results The majority of the body composition elements decreased after six months of the Aqua Power aerobic training. The heart rate values decreased in the females after the intervention period. Conclusion Aqua Power aerobics can be recommended for middle-aged females for the treatment of overweight and in the process of cardiopulmonary fitness improvement.
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48
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Waller B, Munukka M, Rantalainen T, Lammentausta E, Nieminen MT, Kiviranta I, Kautiainen H, Häkkinen A, Kujala UM, Heinonen A. Effects of high intensity resistance aquatic training on body composition and walking speed in women with mild knee osteoarthritis: a 4-month RCT with 12-month follow-up. Osteoarthritis Cartilage 2017; 25:1238-1246. [PMID: 28263901 DOI: 10.1016/j.joca.2017.02.800] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/31/2017] [Accepted: 02/21/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To investigate the effects of 4-months intensive aquatic resistance training on body composition and walking speed in post-menopausal women with mild knee osteoarthritis (OA), immediately after intervention and after 12-months follow-up. Additionally, influence of leisure time physical activity (LTPA) will be investigated. DESIGN This randomised clinical trial assigned eighty-seven volunteer postmenopausal women into two study arms. The intervention group (n = 43) participated in 48 supervised intensive aquatic resistance training sessions over 4-months while the control group (n = 44) maintained normal physical activity. Eighty four participants continued into the 12-months' follow-up period. Body composition was measured with dual-energy X-ray absorptiometry (DXA). Walking speed over 2 km and the knee injury and osteoarthritis outcome score (KOOS) were measured. LTPA was recorded with self-reported diaries. RESULTS After the 4-month intervention there was a significant decrease (P = 0.002) in fat mass (mean change: -1.17 kg; 95% CI: -2.00 to -0.43) and increase (P = 0.002) in walking speed (0.052 m/s; 95% CI: 0.018 to 0.086) in favour of the intervention group. Body composition returned to baseline after 12-months. In contrast, increased walking speed was maintained (0.046 m/s; 95% CI 0.006 to 0.086, P = 0.032). No change was seen in lean mass or KOOS. Daily LTPA over the 16-months had a significant effect (P = 0.007) on fat mass loss (f2 = 0.05) but no effect on walking speed. CONCLUSIONS Our findings show that high intensity aquatic resistance training decreases fat mass and improves walking speed in post-menopausal women with mild knee OA. Only improvements in walking speed were maintained at 12-months follow-up. Higher levels of LTPA were associated with fat mass loss. TRIAL REGISTRATION NUMBER ISRCTN65346593.
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Affiliation(s)
- B Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - M Munukka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - T Rantalainen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - E Lammentausta
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland.
| | - M T Nieminen
- Department of Diagnostic Radiology, Oulu University Hospital, Oulu, Finland; Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland; Medical Research Center, University of Oulu and Oulu University Hospital, Finland.
| | - I Kiviranta
- Department of Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | - H Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland; Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland.
| | - A Häkkinen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - U M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| | - A Heinonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Alcalde GE, Fonseca AC, Bôscoa TF, Gonçalves MR, Bernardo GC, Pianna B, Carnavale BF, Gimenes C, Barrile SR, Arca EA. Effect of aquatic physical therapy on pain perception, functional capacity and quality of life in older people with knee osteoarthritis: study protocol for a randomized controlled trial. Trials 2017; 18:317. [PMID: 28697785 PMCID: PMC5504767 DOI: 10.1186/s13063-017-2061-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 06/23/2017] [Indexed: 11/24/2022] Open
Abstract
Background Aquatic therapy promotes short-term benefits for patients with knee osteoarthritis (OA), and it may be the first therapeutic option for this pathological condition. The objective of this study was to investigate the effects of an aquatic therapy program on pain intensity, functional ability, and quality of life in older people with knee OA. Methods/design This is a parallel, two-arm, open, randomized controlled clinical trial with older people with knee OA. Volunteers will be allocated to an aquatic intervention group (WG), subjected to the intervention, or to a control group, not be subjected to any kind of intervention. Data collection pre- and postintervention will be composed of the evaluation of the perception of pain by visual analogue scale with application of nociceptive stimuli in four anatomical points of the knee, functional fitness tests, and application of the World Health Organization Quality of Life Scale abbreviated version and Western Ontario and McMaster Universities Osteoarthritis Index. The program will last 12 weeks, consisting of aerobic and functional exercises in the form of circuit training. Discussion The objective of this clinical trial is to evaluate the effect of aquatic therapy in elderly patients with knee OA. The study is guided by practice-based scientific evidence for the use of aquatic rehabilitation exercises. It is expected that the WG volunteers will show reduced pain intensity, increased flexibility, and improved functional capacity and quality of life. It is believed that the desired results can be attributed to physical and physiological effects of immersion in warm water associated with the exercise protocol proposed. The data will be published after completion of the study. Trial registration Brazilian Registry of Clinical Trials (ReBEC) registration number: RBR-78h48d. Registered on 19 August 2015. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2061-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Ana Carolina Fonseca
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
| | - Thais Fernanda Bôscoa
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
| | | | | | - Bruna Pianna
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
| | | | - Camila Gimenes
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
| | - Silvia Regina Barrile
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
| | - Eduardo Aguilar Arca
- Universidade do Sagrado Coração, Street Irmã Arminda, 10-50, Jardim Brasil, Bauru, SP, Brazil
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50
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Hydrotherapy improves pain and function in older women with knee osteoarthritis: a randomized controlled trial. Braz J Phys Ther 2017; 21:449-456. [PMID: 28733093 PMCID: PMC5693429 DOI: 10.1016/j.bjpt.2017.06.012] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 12/05/2016] [Accepted: 01/05/2017] [Indexed: 12/04/2022] Open
Abstract
Elderly women with knee osteoarthritis are at risk of developing limitations physical. Hidrotherapy improves pain, function, muscle power and strength in older women with knee osteoarthritis. Hydrotherapy is likely to be an effective treatment option for these patients.
Background Currently, there is poor evidence of the effect of hydrotherapy alone on patients with hip or knee osteoarthritis. Objectives The study aimed to assess the impact of hydrotherapy on pain, function, and muscle function in older women with knee osteoarthritis. Methods A randomized controlled trial was conducted to evaluate the efficacy of hydrotherapy in women with knee osteoarthritis. Seventy-three women aged 65 and older were randomized to hydrotherapy (n = 36) or a control group (n = 37). The hydrotherapy group received the intervention program in a heated pool (twice per week for six weeks) and an educational protocol while the control group received an educational protocol only. Primary outcomes (before and post-treatment) were pain intensity (0–100) and function (0–100), assessed with the WOMAC questionnaire. Secondary outcomes (before and post-treatment) were knee extensor and knee flexor muscle performance (strength, power, and endurance), assessed by an isokinetic dynamometer. The magnitude of change between the groups for the outcomes was calculated using linear regression models adjusted by baseline outcome values. Results The hydrotherapy group had better outcomes for pain (adjusted mean difference = 11 points, 95% CI: 3–18) and function (adjusted mean difference = 12 points, 95% CI: 5–18). Patients receiving hydrotherapy had better performance for knee flexor and extensor strength, knee flexor power, and knee extensor endurance. Conclusion Older women with knee osteoarthritis are likely to have benefits from a course of hydrotherapy exercises. Registry of clinical trials (Trial number RBR-8F57KR) – http://www.ensaiosclinicos.gov.br/rg/RBR-8f57kr/.
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