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Xu T, Zhang B, Fang D. The effect of resistance training on patients with knee osteoarthritis: a systematic review and meta-analysis. Res Sports Med 2024:1-19. [PMID: 38980284 DOI: 10.1080/15438627.2024.2377087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 07/02/2024] [Indexed: 07/10/2024]
Abstract
The objective of this study is to investigate the beneficial effects of resistance training (RT) on individuals suffering from knee osteoarthritis (KOA). In order to gather relevant studies from the beginning of various databases until January 2023, a comprehensive search was conducted on PubMed, Embase, Scopus, Web of Science, and The Cochrane Library. Additionally, manual searches were performed on the reference lists. The association between RT and KOA was analysed using a random-effects model. The results indicated that patients with KOA who underwent RT experienced a significant reduction in the WOMAC (Western Ontario and McMaster Universities Osteoarthritis) Pain index (WMD = -2.441; 95% CI = -3.610 to -1.273; p < 0.01), the WOMAC Stiffness index (WMD = -1.018; 95% CI = -1.744 to -0.293; p < 0.01), the WOMAC Function index (WMD = -7.208; 95% CI = -10.412 to -4.004; p < 0.01), and the VAS (Visual Analogue Scale) index (WMD = -5.721; 95% CI = -9.320 to -2.121; p < 0.01). These improvements were observed when compared to the control group. However, no significant difference was found in the 6-MWT (6-Minute Walk Test) index between the two groups (WMD = 2.659; 95% CI= -16.741 to 22.058; p = 0.788). Consequently, RT has the potential to positively enhance pain, stiffness, and function in patients with KOA, while the 6-MWT index may not exhibit significant improvement.
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Affiliation(s)
- Tingrui Xu
- College of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Borui Zhang
- College of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Dongmei Fang
- College of Physical Education, Jiangsu Normal University, Xuzhou, China
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Ringsten M, Ivanic B, Iwarsson S, Lexell EM. Interventions to improve outdoor mobility among people living with disabilities: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1407. [PMID: 38882933 PMCID: PMC11177337 DOI: 10.1002/cl2.1407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 06/18/2024]
Abstract
Background Around 15% of the global population live with some form of disabilities and experience worse health outcomes, less participation in the community and are part of fewer activities outside the home. Outdoor mobility interventions aim to improve the ability to move, travel and orient outside the home and could influence the number of activities outside the home, participation and quality of life. However, outdoor mobility interventions may also lead to harm like falls or injuries or have unforeseen effects which could lead to mortality or hospitalization. Objectives To assess the efficacy of interventions aiming to improve outdoor mobility for adults living with disabilities and to explore if the efficacy varies between different conditions and different intervention components. Search Methods Standard, extensive Campbell search methods were used, including a total of 12 databases searched during January 2023, including trial registries. Selection Criteria Only randomized controlled trials were included, focusing on people living with disabilities, comparing interventions to improve outdoor mobility to control interventions as well as comparing different types of interventions to improve outdoor mobility. Data Collection and Analysis Standard methodological procedures expected by Campbell were used. The following important outcomes were 1. Activity outside the home; 2. Engagement in everyday life activities; 3. Participation; 4. Health-related Quality of Life; 5. Major harms; 6. Minor harms. The impact of the interventions was evaluated in the shorter (≤6 months) and longer term (≥7 months) after starting the intervention. Results are presented using risk ratios (RR), risk difference (RD), and standardized mean differences (SMD), with the associated confidence intervals (CI). The risk of bias 2-tool and the GRADE-framework were used to assess the certainty of the evidence. Main Results The screening comprised of 12.894 studies and included 22 studies involving 2.675 people living with disabilities and identified 12 ongoing studies. All reported outcomes except one (reported in one study, some concerns of bias) had overall high risk of bias. Thirteen studies were conducted in participants with disabilities due to stroke, five studies with older adults living with disabilities, two studies with wheelchair users, one study in participants with disabilities after a hip fracture, and one study in participants with cognitive impairments. Skill training interventions versus control interventions (16 studies) The evidence is very uncertain about the benefits and harms of skill training interventions versus control interventions not aimed to improve outdoor mobility among all people living with disabilities both in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Skill training interventions may improve engagement in everyday life activities among people with disabilities in the shorter term (RR: 1.46; 95% CI: 1.16 to 1.84; I 2 = 7%; RD: 0.15; 95% CI: -0.02 to 0.32; I 2 = 71%; 692 participants; three studies; low certainty evidence), but the evidence is very uncertain in the longer term, based on very low certainty evidence. Subgroup analysis of skill training interventions among people living with disabilities due to cognitive impairments suggests that such interventions may improve activity outside the home in the shorter term (SMD: 0.44; 95% CI: 0.07 to 0.81; I 2 = NA; 118 participants; one study; low certainty evidence). Subgroup analysis of skill training interventions among people living with cognitive impairments suggests that such interventions may improve health-related quality of life in the shorter term (SMD: 0.49; 95% CI: 0.12 to 0.88; I 2 = NA; 118 participants; one study; low certainty evidence). Physical training interventions versus control interventions (five studies) The evidence is very uncertain about the benefits and harms of physical training interventions versus control interventions not aimed to improve outdoor mobility in the shorter term (≤6 months) and longer term (≥7 months) for: Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. Physical training interventions may improve activity outside the home in the shorter (SMD: 0.35; 95% CI: 0.08 to 0.61; I 2 = NA; 228 participants; one study; low certainty evidence) and longer term (≥7 months) (SMD: 0.27; 95% CI: 0.00 to 0.54; I 2 = NA; 216 participants; one study; low certainty evidence). Comparison of different outdoor mobility interventions (one study) The evidence is very uncertain about the benefits and harms of outdoor mobility interventions of different lengths in the shorter term (≤6 months) and longer term (≥7 months) for Activity outside the home; Engagement in everyday life activities; Participation; Health-related Quality of Life; Major harms; and Minor harms, based on very low certainty evidence. No studies explored the efficacy of other types of interventions. Authors’ Conclusions Twenty-two studies of interventions to improve outdoor mobility for people living with disabilities were identified, but the evidence still remains uncertain about most benefits and harms of these interventions, both in the short- and long term. This is primarily related to risk of bias, small underpowered studies and limited reporting of important outcomes for people living with disabilities. For people with disabilities, skill training interventions may improve engagement in everyday life in the short term, and improve activity outside the home and health-related quality of life for people with cognitive impairments in the short term. Still, this is based on low certainty evidence from few studies and should be interpreted with caution. One study with low certainty evidence suggests that physical training interventions may improve activity outside the home in the short term. In addition, the effect sizes across all outcomes were considered small or trivial, and could be of limited relevance to people living with disabilities. The evidence is currently uncertain if there are interventions that can improve outdoor mobility for people with disabilities, and can improve other important outcomes, while avoiding harms. To guide decisions about the use of interventions to improve outdoor mobility, future studies should use more rigorous design and report important outcomes for people with disabilities to reduce the current uncertainty.
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Affiliation(s)
- Martin Ringsten
- Cochrane Sweden, Research and Development Skåne University Hospital Lund Sweden
- Department of Health Sciences Lund University Lund Sweden
| | | | | | - Eva Månsson Lexell
- Department of Health Sciences Lund University Lund Sweden
- Department of Neurology, Rehabilitation Medicine, Cognitive Medicine and Geriatrics Skåne University Hospital Lund-Malmö Sweden
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Du X, Fan R, Kong J. What improvements do general exercise training and traditional Chinese exercises have on knee osteoarthritis? A narrative review based on biological mechanisms and clinical efficacy. Front Med (Lausanne) 2024; 11:1395375. [PMID: 38841568 PMCID: PMC11150680 DOI: 10.3389/fmed.2024.1395375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Background Knee osteoarthritis (KOA) is a disease that significantly affects the quality of life of patients, with a complex pathophysiology that includes degeneration of cartilage and subchondral bone, synovitis, and associations with mechanical load, inflammation, metabolic factors, hormonal changes, and aging. Objective This article aims to comprehensively review the biological mechanisms and clinical effects of general exercise training and traditional Chinese exercises (such as Tai Chi and Qigong) on the treatment of KOA, providing references for the development of clinical exercise prescriptions. Methods A systematic search of databases including PubMed, Web of Science, Google Scholar, and China National Knowledge Infrastructure (CNKI) was conducted, reviewing studies including randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses. Keywords included "knee osteoarthritis," "exercise therapy," "physical activity," and "traditional Chinese exercise." Results and conclusion General exercise training positively affects KOA by mechanisms such as promoting blood circulation, improving the metabolism of inflammatory factors, enhancing the expression of anti-inflammatory cytokines, and reducing cartilage cell aging. Traditional Chinese exercises, like Tai Chi and Qigong, benefit the improvement of KOA symptoms and tissue repair by regulating immune function and alleviating joint inflammation. Clinical studies have shown that both types of exercise can improve physical function, quality of life, and pain relief in patients with KOA. Both general exercise training and traditional Chinese exercises are non-pharmacological treatment options for KOA that can effectively improve patients' physiological function and quality of life. Future research should further explore the long-term effects and biological mechanisms of these exercise interventions and develop personalized exercise programs based on the specific needs of patients.
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Affiliation(s)
- Xingbin Du
- Shandong Huayu University of Technology, Dezhou, China
- Faculty of Education, Qufu Normal University, Qufu, China
| | - Rao Fan
- College of Sports Science, Qufu Normal University, Qufu, China
| | - Jianda Kong
- College of Sports Science, Qufu Normal University, Qufu, China
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De la Corte-Rodriguez H, Roman-Belmonte JM, Resino-Luis C, Madrid-Gonzalez J, Rodriguez-Merchan EC. The Role of Physical Exercise in Chronic Musculoskeletal Pain: Best Medicine-A Narrative Review. Healthcare (Basel) 2024; 12:242. [PMID: 38255129 PMCID: PMC10815384 DOI: 10.3390/healthcare12020242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia.
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Affiliation(s)
- Hortensia De la Corte-Rodriguez
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital, 28046 Madrid, Spain;
- IdiPAZ Institute for Health Research, 28046 Madrid, Spain
| | - Juan M. Roman-Belmonte
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.); (C.R.-L.)
- Medical School, Universidad Alfonso X El Sabio (UAX), 28691 Madrid, Spain
| | - Cristina Resino-Luis
- Department of Physical Medicine and Rehabilitation, Cruz Roja San José y Santa Adela University Hospital, 28003 Madrid, Spain; (J.M.R.-B.); (C.R.-L.)
| | - Jorge Madrid-Gonzalez
- Department of Physical Medicine and Rehabilitation, La Paz University Hospital, 28046 Madrid, Spain;
| | - Emerito Carlos Rodriguez-Merchan
- Department of Orthopedic Surgery, La Paz University Hospital, 28046 Madrid, Spain;
- Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research—IdiPAZ (La Paz University Hospital—Autonomous University of Madrid), 28046 Madrid, Spain
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Pakosz P, Konieczny M, Domaszewski P, Dybek T, Gnoiński M, Skorupska E. Comparison of concentric and eccentric resistance training in terms of changes in the muscle contractile properties. J Electromyogr Kinesiol 2023; 73:102824. [PMID: 37696055 DOI: 10.1016/j.jelekin.2023.102824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/29/2023] [Accepted: 09/06/2023] [Indexed: 09/13/2023] Open
Abstract
The habitual use of resistance exercises involving concentric and eccentric contractions can increase muscle strength, speed and endurance. However, current knowledge has limited potential to fully understand the application of such resistance training and the muscle changes that occur to differentiate these two types of training. The aim of this study was to compare the effects of concentric contraction (CON) and eccentric contraction (ECC) during an acute bout of resistance training on the hamstring contractile properties. A group of 20 female recreational athletes were divided into two equal groups, CON training and ECC training. The contractile properties of the muscles on both sides of the body were assessed using tensiomyography (TMG): biceps femoris (BF) and semitendinosus (ST). The muscles were assessed twice, before and after 10 maximal repetitions of either concentric or eccentric isotonic contractions. The results indicate a greater change in TMG parameters with ECC training, with p < 0.001 (Td and Tc). An acute bout of resistance training induces changes in the muscle hamstrings contractile properties in both CON and ECC training. Eccentric training causes greater changes than concentric training, shortening contraction time (Td, Tc), increase radial displacement velocity (Vrd) and affecting changes in muscle belly displacement (Dm), so may be more effective in training.
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Affiliation(s)
- Paweł Pakosz
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland.
| | - Mariusz Konieczny
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | - Przemysław Domaszewski
- Department of Health Sciences, Institute of Health Sciences, University of Opole, Opole, Poland
| | - Tomasz Dybek
- Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
| | | | - Elżbieta Skorupska
- Department of Physiotherapy, Poznan University of Medical Sciences, Poznań, Poland
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Thomas DT, Prabhakar AJ, Eapen C, Patel VD, Palaniswamy V, Dsouza MC, R S, Kamat YD. Comparison of Single and Combined Treatment with Exercise Therapy and Collagen Supplementation on Early Knee Arthritis among Athletes-A Quasi-Randomized Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7088. [PMID: 38063519 PMCID: PMC10706409 DOI: 10.3390/ijerph20237088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 12/18/2023]
Abstract
Athletic injuries are commonly implicated in the development of early osteoarthritic (EOA) changes in the knee. These changes have a significant impact on athletic performance, and therefore the early detection of EOA is paramount. The objective of the study is to assess the impact of different interventions on individuals with EOA, particularly focusing on recreational athletes. The study aims to evaluate the effectiveness of three treatment groups in improving various aspects related to knee EOA, including pain, range of motion, strength, and function. A study was undertaken with 48 recreational athletes with EOA who were assigned to one of three groups by the referring orthopedic surgeon: collagen (Col), exercise (Ex), or collagen and exercise (ColEx) groups. All the participants received their respective group-based intervention for 12 weeks. Visual analog scale (VAS), knee flexion range of motion (ROM) knee flexors and extensors strength, and KOOS were assessed at baseline, and after 4 weeks, 8 weeks, and 12 weeks of intervention. VAS for activity improved in all treatment groups, with no difference between groups. The between-group analysis for knee ROM revealed a significant difference (p = 0.022) in the Col vs. Ex group at 12 weeks. The knee flexor and extensor strength and the KOOS scores improved considerably in the Ex and the ColEx group (p < 0.05) at 12 weeks. Exercise therapy improved pain, strength and function in subjects with EOA, whereas the association of collagen seems to have accentuated the effects of exercise in bringing about clinical improvements.
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Affiliation(s)
- Dias Tina Thomas
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Ashish John Prabhakar
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Charu Eapen
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Vivek D. Patel
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Vijayakumar Palaniswamy
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Molly Cynthia Dsouza
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Shruthi R
- Department of Physiotherapy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India; (D.T.T.); (C.E.); (V.D.P.); (V.P.); (M.C.D.); (S.R.)
| | - Yogeesh Dattakumar Kamat
- Adjunct Faculty, Department of Orthopaedics, Kasturba Medical College Hospital, Ambedkar Circle, Mangalore, India;
- Consultant Hip and Knee Surgeon, KMC Hospital, Ambedkar Circle, Mangalore, India
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Vincent HK, Sharififar S, McLaren C, May J, Vincent KR. Acute and chronic cardiovascular responses to concentric and eccentric exercise in older adults with knee osteoarthritis. BMC Sports Sci Med Rehabil 2023; 15:95. [PMID: 37528468 PMCID: PMC10394881 DOI: 10.1186/s13102-023-00708-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/25/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE Muscle contraction type in resistance exercise training may confer benefits besides strength in individuals with osteoarthritis and cardiovascular disease (CVD) risks. The purpose of the study was to explore whether Eccentric-resistance training (RT) improved hemodynamic responses to acute walking exercise stress compared to Concentric-RT among individuals with knee OA over four months. METHODS This was a secondary analysis from a randomized, controlled, single-blinded study. Participants (N = 88; 68.3 ± 6.4 yrs; 67.4% female) were randomized to one of two work-matched resistance training (RT) programs against a non-RT control group. Pre-training and month four, participants completed a self-paced Six-Minute Walk Test (6MWT) and progressive treadmill exercise test. Heart rates, blood pressures and mean arterial pressures (MAP) were captured during each test. Antihypertensive medications use was documented at each time point. RESULTS Leg strength improved in both training groups by month four (p < .05). Changes in 6MWT distance and progressive treadmill test time were not different across groups over four months. Neither Concentric or Eccentric RT produced different hemodyamic responses during the 6MWT compared to the control group post-training. However, Concentric RT was associated with 6.0%-7.4% reductions in systolic blood pressure during the graded treadmill walking test at 50%, 75% and 100% of the test time compared to Eccentric RT and the controls (p = .045). MAP values were lower at 75% and 100% of the treadmill test after Concentric RT (5.7%-6.0% reductions) compared to Eccentric RT (1.0%-2.4% reductions) and controls (1.5% and 4.0% elevations) post-training (p = .024). Antihypertensive medication use did not change in any group. CONCLUSIONS The repeated, progressive exposures of Concentric RT-induced blunted the hypertensive responses to acute exercise compared to Eccentric-RT. Among people with knee OA, Concentric-RT may confer strength benefits to manage OA and possibly reduce cardiovascular stress during exercise.
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Affiliation(s)
- Heather K Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA.
| | - Sharareh Sharififar
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Christian McLaren
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - James May
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
| | - Kevin R Vincent
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Florida, UF Orthopaedics and Sports Medicine Institute, PO Box 112730, Gainesville, FL, 32611, USA
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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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Sasaki R, Honda Y, Oga S, Fukushima T, Tanaka N, Kajiwara Y, Nakagawa K, Takahashi A, Sakamoto Y, Morita H, Kondo Y, Okita S, Kondo Y, Goto K, Kataoka H, Sakamoto J, Okita M. Effect of exercise and/or educational interventions on physical activity and pain in patients with hip/knee osteoarthritis: A systematic review with meta-analysis. PLoS One 2022; 17:e0275591. [PMID: 36409668 PMCID: PMC9678259 DOI: 10.1371/journal.pone.0275591] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 09/20/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To investigate the effectiveness of exercise and/or educational intervention on physical activity and pain in patients with hip/knee osteoarthritis (OA) using systematic review and meta-analysis. METHODS We searched randomized controlled trials that investigated physical activity and pain and compared exercise and/or educational intervention with usual care in patients with hip/knee OA in MEDLINE (PubMed), ProQuest, Scopus, and the Physiotherapy Evidence Database (PEDro), including all those published by April 30, 2022 and written in English. Studies that newly applied analgesics after onset of the intervention were excluded. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological qualities. The random-effects model was used for meta-analysis with standard mean differences using RevMan version 5.4. The body of evidence for each study was synthesized using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Twenty studies including 2,350 patients were included (7 exercise studies, 8 educational intervention studies and 5 combination studies). The meta-analysis demonstrated that there is very low evidence that combination therapy of exercise and educational intervention improve the physical activity level at the endpoint (4 articles; SMD 0.33, 95% CI 0.04 to 0.51, P = 0.03). Low evidence was observed for combination therapy reducing pain (4 articles; SMD -0.15, 95% CI -0.29 to -0.02, P = 0.03). DISCUSSION The current evidence indicated that combination therapy of exercise and educational intervention leads to improved physical activity and pain reduction in hip/knee OA patients, but the risk of bias in each study, especially in allocation concealment, downgraded the evidence level. These findings support the use of a combination therapy of exercise and educational intervention to promote physical activity levels in patients with hip/knee OA. TRAIL REGISTRATION There was no financial support for this research. The protocol was registered at the International Prospective Register of Systematic Reviews (registration code: CRD42020205804).
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Affiliation(s)
- Ryo Sasaki
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Juzenkai Hospital, Nagasaki, Japan
| | - Yuichiro Honda
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
| | - Satoshi Oga
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, Hyogo, Japan
| | - Takuya Fukushima
- Department of Physical Medicine and Rehabilitation, Kansai Medical University, Osaka, Japan
| | - Natsumi Tanaka
- Department of Physical Therapy, School of Rehabilitation Sciences, Seirei Christopher University, Shizuoka, Japan
| | - Yasuhiro Kajiwara
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Nakagawa
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Ayumi Takahashi
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Yukinori Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Hinako Morita
- Department of Rehabilitation, Nagasaki University Hospital, Nagasaki, Japan
| | - Yutaro Kondo
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Seima Okita
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Yasutaka Kondo
- Department of Rehabilitation, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan
| | - Kyo Goto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Hideki Kataoka
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nagasaki Memorial Hospital, Nagasaki, Japan
| | - Junya Sakamoto
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
| | - Minoru Okita
- Department of Physical Therapy Science, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Institute of Biomedical Sciences (Health Sciences), Nagasaki University, Nagasaki, Japan
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10
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Aras D, Tang A, Ahmad H. Analysis of the Covid-19 pandemic impact on osteoarthritis patient visits at physiotherapy clinics in Indonesia – A retrospective cohort study. Ann Med Surg (Lond) 2022; 84:104826. [PMID: 36373107 PMCID: PMC9636604 DOI: 10.1016/j.amsu.2022.104826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/21/2022] [Accepted: 10/30/2022] [Indexed: 11/07/2022] Open
Abstract
Objectives This study aimed to determine the impact of visits by knee OA patients to physiotherapy clinics in Indonesia during the Covid-19 pandemic. Method This retrospective cohort study collected data from knee OA patients seeking treatment at a physiotherapy clinic in Makassar, Indonesia, from January to December 2021. The number of patient visits per month was compared using descriptive statistics. The treatment outcomes were measured in Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and analyzed using inferential statistics. Result During the Covid-19 pandemic, there was a decrease in knee OA patient visits to physiotherapy clinics. Knee OA patient visits increased after the vaccination program was implemented, especially for patients who had been vaccinated with the full dose. Conclusion The frequency of knee OA patient visits to physiotherapy clinics decreased during the Covid-19 pandemic. It impacted the outcome of treatment received by the patients. However, patient visits increased after the vaccination program was implemented.
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Trojani MC, Chorin F, Gerus P, Breuil V, Michel C, Guis S, Bendahan D, Roux C. Concentric or eccentric physical activity for patients with symptomatic osteoarthritis of the knee: a randomized prospective study. Ther Adv Musculoskelet Dis 2022; 14:1759720X221102805. [PMID: 35832351 PMCID: PMC9272179 DOI: 10.1177/1759720x221102805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 05/06/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Knee osteoarthritis–related pain limits physical function and leads to functional disability. Physical activity is one of the central recommendations for the management of knee osteoarthritis. Although concentric muscle activities are often preferred to eccentric ones, the corresponding rationale remains controversial. Objective: To explore the effect of a 6-week exercise program on function, pain, and performance in patients with symptomatic knee osteoarthritis. Methods: Patients with symptomatic knee osteoarthritis were included in the prospective EX-ART project (Walking performance in osteoARThritic subjects: effect of an ECCentric muscle strengthening program) and randomized in a 6-week rehabilitation program including either eccentric or concentric activities. Metrics of interest chosen as end points measured before and after the rehabilitation were WOMAC score, pain, and muscular performance (quadriceps power PMAX and contraction strength MMAX). MRI was also used to assess muscle volume and fat infiltration changes. Results: 30 patients were included in each group; mean age was 74 (±7.6); 69% were women. At week 6, both groups showed a significant improvement in the WOMAC without difference between the two groups (p = 0.7). No difference between the two groups was identified for the pain reduction (p = 0.7). A significant improvement in the change in PMAX and MMAX at high velocity (p = 0.001 and p = 0.002) was observed in the eccentric group only. A vastus medialis hypertrophy was quantified in the eccentric group only (p = 0.002), whereas fat infiltration in the quadriceps muscles was unchanged. Conclusion: Physical activity, whether eccentric or concentric, has a benefit on function and pain in patients with symptomatic knee osteoarthritis. A few differences have been identified between the two types of rehabilitation. More particularly, a gain in muscle performance and vastus medialis volume was found with eccentric rehabilitation only. Registration: www.ClinicalTrials.gov, registration number NCT03167502.
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Affiliation(s)
| | - Fréderic Chorin
- LAMHESS Laboratory, HEALTHY Graduate School, Université Côte d'Azur, Nice, France
| | - Pauline Gerus
- LAMHESS Laboratory, HEALTHY Graduate School, Université Côte d'Azur, Nice, France
| | - Véronique Breuil
- Department of Rheumatology, Nice University Hospital, Université Côte d'Azur, Nice, France
| | - Constance Michel
- Center for Biological and Medical Magnetic Resonance, Faculty of Medicine of La Timone, Aix Marseille University, CNRS (UMR 7339), Marseille, France
| | - Sandrine Guis
- Department of Rheumatology, Conception Hospital, Marseille, France
| | - David Bendahan
- Center for Biological and Medical Magnetic Resonance, Faculty of Medicine of La Timone, Aix Marseille University, CNRS (UMR 7339), Marseille, France
| | - Christian Roux
- Department of Rheumatology, Nice University Hospital, Université Côte d'Azur, Nice, France
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12
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Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci 2022; 14:854026. [PMID: 35592699 PMCID: PMC9110817 DOI: 10.3389/fnagi.2022.854026] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/11/2022] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) has a very high incidence worldwide and has become a very common joint disease in the elderly. Currently, the treatment methods for OA include surgery, drug therapy, and exercise therapy. In recent years, the treatment of certain diseases by exercise has received increasing research and attention. Proper exercise can improve the physiological function of various organs of the body. At present, the treatment of OA is usually symptomatic. Limited methods are available for the treatment of OA according to its pathogenesis, and effective intervention has not been developed to slow down the progress of OA from the molecular level. Only by clarifying the mechanism of exercise treatment of OA and the influence of different exercise intensities on OA patients can we choose the appropriate exercise prescription to prevent and treat OA. This review mainly expounds the mechanism that exercise alleviates the pathological changes of OA by affecting the degradation of the ECM, apoptosis, inflammatory response, autophagy, and changes of ncRNA, and summarizes the effects of different exercise types on OA patients. Finally, it is found that different exercise types, exercise intensity, exercise time and exercise frequency have different effects on OA patients. At the same time, suitable exercise prescriptions are recommended for OA patients.
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Affiliation(s)
- Hui Kong
- College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedic Hospital, Shanghai, China
- *Correspondence: Xin-An Zhang,
| | - Xin-An Zhang
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Xue-Qiang Wang,
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13
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Xie L, Li M. Analysis of Clinical Efficacy of Clearing Heat and Dispelling Paralysis Soup in the Treatment of Osteoarthritis of the Knee Joint and Its Effect on Patients' Motor Function. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:5104121. [PMID: 35237340 PMCID: PMC8885200 DOI: 10.1155/2022/5104121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/14/2022] [Accepted: 01/20/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To investigate the effects of clearing heat and dispelling paralysis soup for osteoarthritis of the knee joint on the motor function of the knee joint and the level of inflammation of the organism in patients. METHODS One hundred and sixteen patients with knee osteoarthritis admitted from January 2020 to May 2021 were selected and randomly divided into 2 groups, 58 cases in the control group were treated with loxoprofen sodium dispersible tablets, and 58 cases in the experimental group were treated with Qinghe dispel paralysis soup on the basis of the control group and the patients' balance ability analysis, gait parameter change analysis, VAS, JOA, AIMS2-SF scale assessment, and serum index. The treatment effects of the two treatment regimens were analyzed by testing. RESULTS The anterior-posterior axis, left-right axis, A2-A6, A4-A8, and circumferential axis of the experimental group were lower than those of the control group after treatment (P < 0.05); the step length of the experimental group was higher than that of the control group after treatment (P < 0.05), and there were no significant differences in step speed, double-support phase, and step width (P > 0.05), but both groups improved significantly compared with those before treatment (P < 0.05); the VAS score of the experimental group was lower than that of the control group after treatment. The VAS scores of the experimental group were lower than those of the control group, and the scores of JOA and AIMS2-SF were higher than those of the control group (P < 0.05); the levels of TIMP-1 in the experimental group were higher than those in the control group, and the levels of TNF-α, TLR4, MMP-3, and IL-1 were lower than those in the control group after treatment (P < 0.05); there was no significant difference in the incidence of adverse reactions between the two groups during treatment (P > 0.05), and the efficiency of the experimental group was higher than that of the control group (P < 0.05). CONCLUSION Combined treatment with Qinghe dispel paralysis soup can better promote the recovery of balance, improve motor ability, and reduce the development of inflammation in the organism, with high safety and effectiveness.
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Affiliation(s)
- Lihu Xie
- The First Affiliated Hospital, Department of Rheumatology and Immunology, Hengyang Medical College, University of South China, Hengyang Hunan 421001, China
| | - Mei Li
- The First Affiliated Hospital, Department of Rheumatology and Immunology, Hengyang Medical College, University of South China, Hengyang Hunan 421001, China
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14
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Guo G, Wu B, Xie S, Xu J, Zhou X, Wu G, Lu P. Effectiveness and safety of Tai Chi for chronic pain of knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28497. [PMID: 35029201 PMCID: PMC8758038 DOI: 10.1097/md.0000000000028497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 12/16/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Chronic pain (CP) has been a major area of interest in the field of knee osteoarthritis (KOA), further aggravating the dysthymia, stiffness, and dysfunction of KOA patients. As an important part of complementary and alternative medicine, Tai Chi has a positive effect on KOA patients. The systematic review is to evaluate the effectiveness and safety of Tai Chi for KOA patients with CP. METHODS A systematic search will be performed in the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of Tai Chi in treating chronic pain of knee osteoarthritis: the Cochrane Library, PubMed, EMBASE, OVID-MEDLINE, and four Chinese databases (Wan Fang, CNKI, CBMdisc and VIP). Each database will be searched from inception to Dec. 2021. The process will include study selection, data extraction, risk of bias assessment and meta-analysis. RESULTS This proposed study will evaluate the effectiveness and safety of Tai Chi for KOA patients with CP. Improvement in pain and adverse effects of KOA will be included in our measure. CONCLUSIONS This proposed systematic review and meta-analysis will evaluate the existing evidence on the effectiveness and safety of Tai Chi for KOA patients with CP. DISSEMINATION AND ETHICS The results of this review will be disseminated through peer-reviewed publication. This review does not require ethical approval because all of the data used in this systematic review and meta-analysis have already been published. Furthermore, all of these data will be analyzed anonymously during the review process. INPLASY REGISTRATION NUMBER INPLASY2021120020.
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Affiliation(s)
- Guangxin Guo
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Boyi Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shengji Xie
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianghan Xu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xu Zhou
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guanghui Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ping Lu
- School of Acupuncture-moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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15
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Germano Maciel D, Cerqueira MS, Brito Vieira WHD. Use of rating of perceived exertion during anterior cruciate ligament reconstruction and knee osteoarthritis rehabilitation: a scoping review protocol. BMJ Open 2021; 11:e055786. [PMID: 34907073 PMCID: PMC8672024 DOI: 10.1136/bmjopen-2021-055786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Anterior cruciate ligament (ACL) tear and knee osteoarthritis (KOA) are the most prevalent musculoskeletal disorders of the knee. Rehabilitation with progressive resistance training is recommended for both disorders. Rating of perceived exertion (RPE) is widely used to prescribe, monitor, and control exercise load. However, the lack of detailed methodological description and variability in the use of RPE may hinder its validity. This scoping review summarises methodological aspects of the use of RPE in resistance exercises during ACL reconstruction and KOA rehabilitation. We also aim to identify possible methodological issues related to the use of RPE and provide recommendations for future studies. METHODS AND ANALYSIS This scoping review protocol was developed following the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement extension for Scoping Reviews. The search will be conducted in Medline/PubMed, Embase, CINAHL, PEDro, Central and SPORTDiscus databases. The terms "anterior cruciate ligament rehabilitation", "knee osteoarthritis" and "resistance exercise" and their synonymous will be used isolated and combined (boolean operators AND/OR/NOT). Two reviewers will independently conduct title and abstract screening and evaluate full texts of potentially eligible articles. Data related to study design, sample, intervention characteristics and RPE outcomes will be extracted, summarised and qualitatively analysed. ETHICS AND DISSEMINATION The proposed scoping review does not require ethical approval since it will synthesise information from publicly available studies. Regarding dissemination activities, results will be submitted for publication in a scientific journal and presented at conferences in the field.
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Affiliation(s)
- Daniel Germano Maciel
- Neuromuscular Performance Laboratory, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Mikhail Santos Cerqueira
- Neuromuscular Performance Laboratory, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Wouber Hérickson de Brito Vieira
- Neuromuscular Performance Laboratory, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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16
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Cudejko T, Button K, Willott J, Al-Amri M. Applications of Wearable Technology in a Real-Life Setting in People with Knee Osteoarthritis: A Systematic Scoping Review. J Clin Med 2021; 10:5645. [PMID: 34884347 PMCID: PMC8658504 DOI: 10.3390/jcm10235645] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/12/2022] Open
Abstract
With the growing number of people affected by osteoarthritis, wearable technology may enable the provision of care outside a traditional clinical setting and thus transform how healthcare is delivered for this patient group. Here, we mapped the available empirical evidence on the utilization of wearable technology in a real-world setting in people with knee osteoarthritis. From an analysis of 68 studies, we found that the use of accelerometers for physical activity assessment is the most prevalent mode of use of wearable technology in this population. We identify low technical complexity and cost, ability to connect with a healthcare professional, and consistency in the analysis of the data as the most critical facilitators for the feasibility of using wearable technology in a real-world setting. To fully realize the clinical potential of wearable technology for people with knee osteoarthritis, this review highlights the need for more research employing wearables for information sharing and treatment, increased inter-study consistency through standardization and improved reporting, and increased representation of vulnerable populations.
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Affiliation(s)
- Tomasz Cudejko
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, College House, King George V Drive East, Heath Park, Cardiff CF14 4EP, UK; (K.B.); (J.W.); (M.A.-A.)
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17
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Harris-Love MO, Gollie JM, Keogh JWL. Eccentric Exercise: Adaptations and Applications for Health and Performance. J Funct Morphol Kinesiol 2021; 6:96. [PMID: 34842737 PMCID: PMC8628948 DOI: 10.3390/jfmk6040096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 11/19/2021] [Accepted: 11/19/2021] [Indexed: 12/12/2022] Open
Abstract
The goals of this narrative review are to provide a brief overview of the muscle and tendon adaptations to eccentric resistance exercise and address the applications of this form of training to aid rehabilitative interventions and enhance sports performance. This work is centered on the author contributions to the Special Issue entitled "Eccentric Exercise: Adaptations and Applications for Health and Performance". The major themes from the contributing authors include the need to place greater attention on eccentric exercise mode selection based on training goals and individual fitness level, optimal approaches to implementing eccentric resistance exercise for therapeutic purposes, factors that affect the use of eccentric exercise across the lifespan, and general recommendations to integrate eccentric exercise in athletic training regimens. The authors propose that movement velocity and the absorption or recovery of kinetic energy are critical components of eccentric exercise programming. Regarding the therapeutic use of eccentric resistance training, patient-level factors regarding condition severity, fitness level, and stage of rehabilitation should govern the plan of care. In athletic populations, use of eccentric exercise may improve movement competency and promote improved safety and performance of sport-specific tasks. Eccentric resistance training is a viable option for youth, young adults, and older adults when the exercise prescription appropriately addresses program goals, exercise tolerability, and compliance. Despite the benefits of eccentric exercise, several key questions remain unanswered regarding its application underscoring the need for further investigation.
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Affiliation(s)
- Michael O. Harris-Love
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
- Geriatric Research Education and Clinical Center, VA Eastern Colorado Healthcare System, Aurora, CO 80045, USA
- Muscle Morphology, Mechanics, and Performance Laboratory, Geriatrics Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
| | - Jared M. Gollie
- Muscle Morphology, Mechanics, and Performance Laboratory, Geriatrics Service, Veterans Affairs Medical Center, Washington, DC 20422, USA;
- Department of Health, Human Function, and Rehabilitation Sciences, School of Medicine & Health Sciences, George Washington University, Washington, DC 20052, USA
| | - Justin W. L. Keogh
- Faculty of Health Sciences and Medicine, Bond University, Robina, QLD 4226, Australia;
- Sports Performance Research Centre New Zealand, Auckland University of Technology, Auckland 1010, New Zealand
- Cluster for Health Improvement, Faculty of Science, Health, Education and Engineering, University of the Sunshine Coast, Sunshine Coast, QLD 4556, Australia
- Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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18
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Cleland TL, Gharib M, Williams R, Jain NB. What's New in Orthopaedic Rehabilitation. J Bone Joint Surg Am 2021; 103:2063-2069. [PMID: 34546999 DOI: 10.2106/jbjs.21.00868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Travis L Cleland
- Department of Physical Medicine and Rehabilitation, Crystal Clinic Orthopaedic Center, Akron, Ohio
| | - Mahmood Gharib
- Department of Physical Medicine and Rehabilitation, University of Minnesota Medical Center, Minneapolis, Minnesota
| | - Reed Williams
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Nitin B Jain
- Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, Texas
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19
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Wang Y, Wu Z, Chen Z, Ye X, Chen G, Yang J, Zhang P, Xie F, Guan Y, Wu J, Chen W, Ye Z, Xu X. Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Med (Lausanne) 2021; 8:699921. [PMID: 34778281 PMCID: PMC8581183 DOI: 10.3389/fmed.2021.699921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 10/04/2021] [Indexed: 12/04/2022] Open
Abstract
Background: There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention. Objective: This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA. Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses. Results: A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P < 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = -1.28, 95%CI: [-1.64, -0.92], I 2 = 0%, P < 0.00001) and mobility (timed walk over spongy surface) (SMD = -0.76, 95%CI: [-1.33, -0.18], I 2 = 64%, P = 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = -1.54, 95%CI: [-2.74, -0.34], I 2 = 79%, P = 0.01), physical function (SMD = -0.34, 95%CI: [-0.56, -0.12], I 2 = 0%, P = 0.003), and knee ROM (P < 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = -0.95, 95%CI: [-1.73, -0.18], I 2 = 78%, P = 0.02) in the proprioceptive training plus conventional physiotherapy group. Conclusions: Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.
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Affiliation(s)
- Yi Wang
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zugui Wu
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Guoqian Chen
- Department of Orthopaedic Surgery, Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China
| | - Jiaman Yang
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Peiming Zhang
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Fang Xie
- Affiliated Changde Hospital, Hunan University of Traditional Chinese Medicine, Changde, China
| | - Yingxin Guan
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiatao Wu
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Weijian Chen
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuemeng Xu
- The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
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