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Hamada K, Tamura H, Hirohama K, Mitsutake T, Imura T, Tanaka S, Tanaka R. The effectiveness of group education in people over 50 years old with knee pain: A systematic review and meta-analysis of randomized control trials. Musculoskelet Sci Pract 2022; 62:102627. [PMID: 35926473 DOI: 10.1016/j.msksp.2022.102627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND International guidelines recommend educational intervention to treat knee osteoarthritis. However, they do not specify the type of intervention and the effectiveness of group educational intervention for knee pain is unclear. OBJECTIVES We aimed to examine the effectiveness of group educational interventions for people over 50 years old with knee pain compared with a control group. DESIGN A systematic review and meta-analysis of randomized controlled trials (RCTs). METHOD We searched Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database, and Cumulative Index to Nursing and Allied Health Literature and screened for RCTs involving participants over 50 years old that reported the effects of group education on knee pain. We performed meta-analyses and evaluated the methodological quality and evidence quality using the Physiotherapy Evidence Database scale and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system, respectively. RESULTS The search retrieved 1,177 studies. Seven RCTs were ultimately included, four of which were subjected to meta-analysis, showing standardized mean differences of -0.22 (95% confidence interval [CI]: -0.42 to -0.02, n = 423; I2 = 0% GRADE: low). All studies included in the meta-analysis involved exercise without individualized instruction in addition to group educational intervention. CONCLUSIONS Group education, when delivered in addition to exercises, significantly reduces knee pain in people over 50 years old.
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Affiliation(s)
- Kazuaki Hamada
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; Wako Orthopedic Clinic, Hiroshima, Japan.
| | - Hiroyuki Tamura
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; NEC Livex,Ltd., Karada Care Business Promotion Office, Tokyo, Japan
| | - Kenta Hirohama
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; Sakamidorii Hospital, Hiroshima, Japan
| | - Tsubasa Mitsutake
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; Department of Physical Therapy, Fukuoka International University of Health and Welfare, Japan
| | - Takeshi Imura
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Shigeharu Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan; Division of Physical Therapy, School of Rehabilitation, Faculty of Health and Social Services, Kanagawa University of Human Services, Japan
| | - Ryo Tanaka
- Graduate School of Humanities and Social Sciences, Hiroshima University, Japan.
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Wu H, Yao R, Wu J, Wen G, Wang Y. Does kinesio taping plus exercise improve pain and function in patients with knee osteoarthritis?: A systematic review and meta-analysis of randomized controlled trials. Front Physiol 2022; 13:961264. [PMID: 36160871 PMCID: PMC9500481 DOI: 10.3389/fphys.2022.961264] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Kinesio taping (KT) and exercise are described for improving pain and function of knee osteoarthritis (KOA) patients in most studies. However, the question remains if KT plus exercise is better than only exercise treatment.Objective: To perform a systematic review and meta-analysis of randomized controlled trials (RCTs) to assess the effects of KT plus exercise in improving pain and knee function of KOA patients.Methods: The databases PubMed, Cochrane Library, EMBASE, Springer, web of science and China National Knowledge Internet (CNKI) were searched till July 2022. People diagnosed with KOA were included. The intervention was KT plus exercise, but the comparison group was intervened only with exercise. Outcome measures were the Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Timed Up and Go (TUG). Only RCTs were included. The Review Manager software (Version 5.3.5) was used to assess risk of bias, statistical heterogeneity and meta-analysis.Results: The inclusion criteria were satisfied by 642 individuals from sixteen RCTs. There was a significant difference between KT plus exercise group and only exercise group in terms of VAS score after intervention (mean difference (MD) = −0.86; 95% CI = −1.32 to −0.40; p = 0.0003). In terms of VAS at follow-up period (MD = −0.58; 95% CI = −1.41 to 0.25; p = 0.17), WOMAC score (MD = 0.28; 95% CI = −9.16 to 9.71; p = 0.95) and TUG after intervention (MD = −0.74; 95% CI = −1.72 to 0.24; p = 0.14), no significant difference was found.Conclusion: Although KT plus exercise reduced pain better than exercise, it did not enhance knee function in patients with KOA. These conclusions may change when more high-quality research is conducted.
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Affiliation(s)
- Haiyang Wu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Huangpu Branch, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoyu Yao
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junhao Wu
- Huangpu Branch, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guowei Wen
- Huangpu Branch, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Yiru Wang,
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Zhong Y, Xu Y, Xue S, Zhu L, Lu H, Wang C, Chen H, Sang W, Ma J. Nangibotide attenuates osteoarthritis by inhibiting osteoblast apoptosis and TGF-β activity in subchondral bone. Inflammopharmacology 2022; 30:1107-1117. [PMID: 35391646 DOI: 10.1007/s10787-022-00984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
Osteoarthritis (OA) is a chronic joint disorder that causes cartilage degradation and subchondral bone abnormalities. Nangibotide, also known as LR12, is a dodecapeptide with considerable anti-inflammatory properties, but its significance in OA is uncertain. The aim of the study was to determine whether nangibotide could attenuate the progression of OA, and elucidate the underlying mechanism. In vitro experiments showed that nangibotide strongly inhibited TNF-α-induced osteogenic reduction, significantly enhanced osteoblast proliferation and prevented apoptosis in MC3T3-E1 cells. Male C57BL/6 J mice aged 2 months were randomly allocated to three groups: sham, ACLT, and ACLT with nangibotide therapy. Nangibotide suppressed ACLT-induced cartilage degradation and MMP-13 expression. MicroCT analysis revealed that nangibotide attenuated in vivo subchondral bone loss induced by ACLT. Histomorphometry results showed that nangibotide attenuated ACLT-induced osteoblast inhibition; TUNEL assays and immunohistochemical staining of cleaved-caspase3 further confirmed the in vivo anti-apoptotic effect of nangibotide on osteoblasts. Furthermore, we found that nangibotide exerted protective effects by suppressing TGF-β signaling mediated by Smad2/3 to restore coupled bone remodeling in the subchondral bone. In conclusion, the findings suggest that nangibotide might exert a protective effect on the bone-cartilage unit and maybe an alternative treatment option for OA.
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Affiliation(s)
- Yiming Zhong
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Yiming Xu
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Song Xue
- Department of Rheumatology and Immunology, Arthritis Research Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Libo Zhu
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Haiming Lu
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Cong Wang
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Hongjie Chen
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China
| | - Weilin Sang
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China.
| | - Jinzhong Ma
- Department of Orthopedics, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, No. 100, Haining Rd, Shanghai, 200080, China.
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Heddon S, Saulnier N, Mercado J, Shalmiyev M, Berteau JP. Systematic review shows no strong evidence regarding the use of elastic taping for pain improvement in patients with primary knee osteoarthritis. Medicine (Baltimore) 2021; 100:e25382. [PMID: 33787644 PMCID: PMC8021313 DOI: 10.1097/md.0000000000025382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/11/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A recent trend in the field of primary knee osteoarthritis suggests that elastic tape (e.g., K-tape) relieves pressure on the joint by increasing tension on fascia. Elastic tape (ET) is expected to decrease pain and help patients to recover faster. OBJECTIVE This systematic review aims to analyze the efficacy of this method on pain in patients with knee osteoarthritis by using The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. DATA SOURCES Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard for reporting systematic reviews of qualitative and quantitative evidence, we used 3 electronic databases, PubMed, Cochrane, and EBSCO, and grey literature was included. STUDY ELIGIBILITY CRITERIA Articles were screened for duplicates, screened for inclusion and exclusion criteria, and critically appraised. PARTICIPANTS AND INTERVENTION People older than 45 years old with primary osteoarthritis (OA) and application of ET. STUDY APPRAISAL AND SYNTHESIS METHODS 2005 Oxford standard. RESULTS Amongst all the papers found, 6 Randomized Control Trials (RCT) for a total of 392 participants met the criteria and were included in our review. Three papers out of the 6 RCT had low risks of bias. When the ET was compared to sham taping, the results show no to moderate decreases of WOMAC scores in patients with primary knee osteoarthritis. LIMITATIONS We focused on a single index test (WOMAC) and could not perform meta-analyses. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS Although ET does not provide strong adverse outcomes, our data do not support the use of ET as a treatment alone because of too slight reductions of the WOMAC score for reaching clinical efficiency. Thus, our systematic review shows no strong evidence regarding the use of elastic taping for pain improvement in patients with primary knee osteoarthritis.
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Affiliation(s)
- Stephan Heddon
- Department of Physical Therapy, City University of New York – College of Staten Island
| | - Nicole Saulnier
- Department of Physical Therapy, City University of New York – College of Staten Island
| | - Jorge Mercado
- Department of Physical Therapy, City University of New York – College of Staten Island
| | - Michelle Shalmiyev
- Department of Physical Therapy, City University of New York – College of Staten Island
| | - Jean-Philippe Berteau
- Department of Physical Therapy, City University of New York – College of Staten Island
- New York Centre for Biomedical Engineering, City University of New York – City College of New York
- Nanosciences Initiative, City University of New York – Advanced Science Research Center, New York
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Sun Q, Zhen G, Li TP, Guo Q, Li Y, Su W, Xue P, Wang X, Wan M, Guan Y, Dong X, Li S, Cai M, Cao X. Parathyroid hormone attenuates osteoarthritis pain by remodeling subchondral bone in mice. eLife 2021; 10:e66532. [PMID: 33646122 PMCID: PMC8012060 DOI: 10.7554/elife.66532] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/26/2021] [Indexed: 12/20/2022] Open
Abstract
Osteoarthritis, a highly prevalent degenerative joint disorder, is characterized by joint pain and disability. Available treatments fail to modify osteoarthritis progression and decrease joint pain effectively. Here, we show that intermittent parathyroid hormone (iPTH) attenuates osteoarthritis pain by inhibiting subchondral sensory innervation, subchondral bone deterioration, and articular cartilage degeneration in a destabilized medial meniscus (DMM) mouse model. We found that subchondral sensory innervation for osteoarthritis pain was significantly decreased in PTH-treated DMM mice compared with vehicle-treated DMM mice. In parallel, deterioration of subchondral bone microarchitecture in DMM mice was attenuated by iPTH treatment. Increased level of prostaglandin E2 in subchondral bone of DMM mice was reduced by iPTH treatment. Furthermore, uncoupled subchondral bone remodeling caused by increased transforming growth factor β signaling was regulated by PTH-induced endocytosis of the PTH type 1 receptor-transforming growth factor β type 2 receptor complex. Notably, iPTH improved subchondral bone microarchitecture and decreased level of prostaglandin E2 and sensory innervation of subchondral bone in DMM mice by acting specifically through PTH type 1 receptor in Nestin+ mesenchymal stromal cells. Thus, iPTH could be a potential disease-modifying therapy for osteoarthritis.
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Affiliation(s)
- Qi Sun
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji UniversityShanghaiChina
| | - Gehua Zhen
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Tuo Peter Li
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Qiaoyue Guo
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Yusheng Li
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Weiping Su
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Peng Xue
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Xiao Wang
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Mei Wan
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Yun Guan
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of MedicineBaltimoreUnited States
| | - Xinzhong Dong
- Department of Neuroscience, The Johns Hopkins University School of Medicine, Howard Hughes Medical InstituteBaltimoreUnited States
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Howard Hughes Medical InstituteBaltimoreUnited States
- Department of Dermatology, The Johns Hopkins University School of Medicine, Howard Hughes Medical InstituteBaltimoreUnited States
- Center of Sensory Biology, The Johns Hopkins University School of Medicine, Howard Hughes Medical InstituteBaltimoreUnited States
| | - Shaohua Li
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji UniversityShanghaiChina
| | - Ming Cai
- Department of Orthopaedics, Shanghai Tenth People's Hospital, School of Medicine, Tongji UniversityShanghaiChina
| | - Xu Cao
- Department of Orthopaedic Surgery, Institute of Cell Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
- Department of Biomedical Engineering, The Johns Hopkins University School of MedicineBaltimoreUnited States
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6
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Usman Z, Maharaj SS, Kaka B. Effects of combination therapy and infrared radiation on pain, physical function, and quality of life in subjects with knee osteoarthritis: A randomized controlled study. Hong Kong Physiother J 2019; 39:133-142. [PMID: 31889764 PMCID: PMC6900333 DOI: 10.1142/s1013702519500124] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/30/2017] [Indexed: 11/29/2022] Open
Abstract
Background: Knee osteoarthritis (KOA) is a common degenerative articular disease that causes disability and poor quality of life (QoL) of the individuals. Electrotherapeutic agents such as therapeutic ultrasound (US), interferential current (IFC), and infrared radiation are used in the treatment. It is not clear which of these agents is the best in improving these variables. Objective: The study aimed to compare the effects of the combined application of US and IFC therapies and infrared radiation on pain, functional activities, and QoL in people with KOA. Methods: In a randomized controlled study, 60 participants were randomized into two groups, the combination therapy group (CTG) and the infrared radiation group (IRG). Each group received 15-min treatment three times per week for 12 weeks. The visual analog scale (VAS) was used to assess the pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functional activities and the Short Form Health Survey questionnaire for QoL. Results: Participants in the CTG had a significant (p<0.05) reduction in pain and significant (p<0.05) improvement in functional activities and QoL compared to the IRG. Conclusion: The results of this study support the use of the combination of IFC and US therapies to reduce pain and improve function and QoL for KOA patients.
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Affiliation(s)
- Zubair Usman
- Department of Physiotherapy, Rasheed Shakoni Teaching Hospital, P.M.B. 7200, Dutse Jigawa State, Nigeria
| | - Sonill Sooknunan Maharaj
- Department of Physiotherapy, University of KwaZulu-Natal, Private Bag X 54001, Durban 4000, South Africa
| | - Bashir Kaka
- Department of Physiotherapy, University of KwaZulu-Natal, Private Bag X 54001, Durban 4000, South Africa.,Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano State, Nigeria
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Mazloum V, Rabiei P, Rahnama N, Sabzehparvar E. The comparison of the effectiveness of conventional therapeutic exercises and Pilates on pain and function in patients with knee osteoarthritis. Complement Ther Clin Pract 2018; 31:343-348. [DOI: 10.1016/j.ctcp.2017.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 09/15/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
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Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M. Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. J Physiother 2016; 62:153-8. [PMID: 27320828 DOI: 10.1016/j.jphys.2016.05.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 02/17/2016] [Accepted: 05/20/2016] [Indexed: 11/16/2022] Open
Abstract
QUESTION Does Kinesio Taping reduce pain and swelling, and increase muscle strength, function and knee-related health status in older people with knee osteoarthritis? DESIGN Randomised, controlled trial with concealed allocation, intention-to-treat analysis and blinded assessment. PARTICIPANTS Seventy-six older people with knee osteoarthritis. INTERVENTION The experimental group received three simultaneous Kinesio Taping techniques to treat pain, strength and swelling. The control group received sham taping. All participants kept the taping on for 4 days. OUTCOME MEASURES The outcomes were: concentric muscle strength of knee extensors and flexors, measured by isokinetic dynamometry with an angular velocity of 60 deg/second normalised for body mass [(Nm/kg) x 100 (%)]; pressure pain threshold via digital pressure algometry (kgf/cm(2)); lower-limb swelling via volumetry (l) and perimetry (cm); physical function via the Lysholm Knee Scoring Scale (0 = worst to 100=best); and knee-related health status via the Western Ontario and McMaster (WOMAC) osteoarthritis index (0=best to 96=worst). Outcomes were measured at Day 4 (end of the taping period) and Day 19 (follow-up) after the start of the treatment. RESULTS At Day 4, there were no significant between-group differences for knee extensor muscle strength (MD -1%, 95% CI -7 to 5), knee flexor muscle strength (MD 2%, 95% CI -3 to 7), the pressure pain threshold at any measured point, volumetry (MD 0.05 L, 95% CI -0.01 to 0.11), perimetry at any measured point, Lysholm score (MD -4 points, 95% CI -9 to 2), or WOMAC score (MD -2 points, 95% CI -8 to 4). The lack of significant between-group difference was also seen at the follow-up assessment on Day 19. CONCLUSION The Kinesio Taping techniques investigated in this study provided no beneficial effects for older people with knee osteoarthritis on any of the assessed outcomes. TRIAL REGISTRATION Brazilian Registry of Clinical Trials, RBR-36r3t5. [Wageck B, Nunes GS, Bohlen NB, Santos GM, de Noronha M (2016) Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial.Journal of Physiotherapy62: 153-158].
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Affiliation(s)
- Bruna Wageck
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil; Department of Rehabilitation, Nutrition and Sport, La Trobe University, Melbourne, Australia
| | - Guilherme S Nunes
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Nicolas Bernardon Bohlen
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Gilmar Moraes Santos
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil
| | - Marcos de Noronha
- Department of Physiotherapy, Center of Health and Sport Sciences, Santa Catarina State University, Florianópolis, Brazil; Department of Community and Allied Health, La Trobe University, Bendigo, Australia
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Abstract
With the aging of the world's population, the prevalence of age-related diseases is continually increasing, especially osteoarthritis, the most common form of joint disease. In addition to its high prevalence, osteoarthritis has been correlated with high medical and social costs. Among the treatment methods, viscosupplementation (intra-articular injection of hyaluronic acid derivatives) has been gaining more prominence. The substances used are high molecular weight polysaccharides that, in addition to mechanical functions of weight distribution and joint lubrication, have anti-inflammatory properties and physical-chemical action on a variety of joint characteristics. These effects are directly proportional to the molecular weight and concentration of the drug used and any cross-links that may be present in the drug. Viscosupplementation is a simple procedure and can be performed in outpatient clinics. It provides benefits regarding pain and function, and also favorably alters the course of the disease, through quantitatively and qualitatively improving the joint cartilage. It has a good safety profile and favorable cost-effectiveness relationship, and is indicated both for osteoarthritis cases and after an arthroscopic procedure.
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Garver MJ, Focht BC, Taylor SJ. Integrating lifestyle approaches into osteoarthritis care. J Multidiscip Healthc 2015; 8:409-18. [PMID: 26396527 PMCID: PMC4576887 DOI: 10.2147/jmdh.s71273] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
As the lifetime risk, societal cost, and overall functional impact of osteoarthritis (OA) is imposing, it is imperative that clinicians provide an individualized care model for patients. Patients must be offered a multiplicity of care strategies and encouraged to embrace lifestyle approaches for self-managing the effects and symptoms of OA. Certainly, the attitude of the clinician and patient will directly influence receptivity and implementation of lifestyle approaches. This work proposes how the use of structured and routine assessments and cognitive therapy ideologies may complement a comprehensive treatment plan. Assessments described herein include objective and/or self-report measures of physical function, pain, attitude about social support, and sleep quality. Baseline assessments followed by systematic monitoring of the results may give patients and clinicians valuable insight into the effectiveness of the care plan. Empirical evidence from randomized trials with OA patients highlights the effectiveness of cognitive behavioral change strategies for addressing salient concerns for OA (pain control, mobility performance, and sleep quality). Cognitive restructuring can provide patients with renewed power in managing their disease. Cognitive therapy topics discussed presently include: 1) what is OA?, 2) effectiveness of exercise and FITT (frequency, intensity, time, and type) principles for OA patients, 3) goal-setting and barriers, and 4) translating to independent care. Woven within the discussion about cognitive therapy are ideas about how the results from baseline assessments and group-mediated dynamics might assist more favorable outcomes. There are a plethora of assessments and cognitive therapy topics that could be utilized in the care strategy that we are promoting, but the present topics were selected for their low clinician and patient burden and promising results in trials with OA patients. Clinicians who are comfortable and knowledgeable about a wider range of management tools may serve more effectively in the critical, central management process and help patients embrace personal care more successfully.
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Affiliation(s)
- Matthew J Garver
- Department of Kinesiology and Nutrition, Abilene Christian University, Abilene, TX, USA
| | - Brian C Focht
- Department of Human Sciences, Ohio State University, Columbus, OH, USA
| | - Sarah J Taylor
- School of Occupational Therapy, Texas Woman's University, Dallas, TX, USA
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11
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Knee Manual Therapy for Aging and Older Adults. TOPICS IN GERIATRIC REHABILITATION 2015. [DOI: 10.1097/tgr.0000000000000072] [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]
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12
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Chen WL, Hsu WC, Lin YJ, Hsieh LF. Comparison of Intra-articular Hyaluronic Acid Injections With Transcutaneous Electric Nerve Stimulation for the Management of Knee Osteoarthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil 2013; 94:1482-9. [DOI: 10.1016/j.apmr.2013.04.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/29/2013] [Accepted: 04/02/2013] [Indexed: 01/17/2023]
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13
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Therapeutic effects of short-term monochromatic infrared energy therapy on patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. J Orthop Sports Phys Ther 2012; 42:947-56. [PMID: 22960644 DOI: 10.2519/jospt.2012.3881] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Randomized, double-blind, placebo-controlled study. OBJECTIVES To examine the short-term therapeutic effects of monochromatic infrared energy (MIRE) on participants with knee osteoarthritis (OA). Patients were assessed according to the International Classification of Functioning, Disability and Health. BACKGROUND MIRE is commonly used in therapy for patients with peripheral neuropathies. However, research has not focused intensively on the therapeutic effects of MIRE in patients with knee OA. METHODS This study enrolled 73 participants with knee OA. Participants received six 40-minute sessions of active or placebo MIRE treatment (890-nm wavelength; power, 6.24 W; energy density, 2.08 J/cm2/min; total energy, 83.2 J/cm2) over the knee joints for 2 weeks. International Classification of Functioning, Disability and Health-related outcomes were collected weekly over 4 weeks using the Knee injury and Osteoarthritis Outcome Score, Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire. Data were analyzed by repeated-measures analysis of variance. RESULTS No statistically significant differences were found for the interaction of group by time for Knee injury and Osteoarthritis Outcome Score scores, including pain, other symptoms, function in daily living, function in sport and recreation, and knee-related quality of life. Scores on the Lysholm Knee Scale, Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Chronic Pain Grade questionnaire, World Health Organization Quality of Life-brief version, and OA Quality of Life Questionnaire also showed no significant differences between the 2 groups at any of the 4 follow-up assessments. CONCLUSION Short-term MIRE therapy provided no beneficial effects to body functions, activities, participation, and quality of life in patients with knee OA.
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Thieme H, Borgetto B. Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups. PSYCHO-SOCIAL MEDICINE 2012; 9:Doc08. [PMID: 23133502 PMCID: PMC3488804 DOI: 10.3205/psm000086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG.
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Affiliation(s)
- Holm Thieme
- University of Applied Sciences and Arts Hildesheim, Faculty of Social Work and Health, Research Group on Occupational, Speech and Physical Therapies, Hildesheim, Germany
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Local and systemic cardiovascular effects from monochromatic infrared therapy in patients with knee osteoarthritis: a double-blind, randomized, placebo-controlled study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2012; 2012:583016. [PMID: 22792125 PMCID: PMC3391934 DOI: 10.1155/2012/583016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 04/27/2012] [Accepted: 04/27/2012] [Indexed: 11/24/2022]
Abstract
Infrared (IR) therapy is used for pain relief in patients with knee osteoarthritis (OA). However, IR's effects on the cardiovascular system remain uncertain. Therefore, we investigated the local and systemic cardiovascular effects of monochromatic IR therapy on patients with knee OA in a double-blind, randomized, placebo-controlled study. Seventy-one subjects with knee OA received one session of 40 min of active or placebo monochromatic IR treatment (with power output of 6.24 W, wavelength of 890 nm, power density of 34.7 mW/cm2 for 40 min, total energy of 41.6 J/cm2 per knee per session) over the knee joints. Heart rate, blood pressure, and knee arterial blood flow velocity were periodically assessed at the baseline, during, and after treatment. Data were analyzed by repeated-measure analysis of covariance. Compared to baseline, there were no statistically significant group x time interaction effects between the 2 groups for heart rate (P = 0.160), blood pressure (systolic blood pressure: P = 0.861; diastolic blood pressure: P = 0.757), or mean arterial blood flow velocity (P = 0.769) in follow-up assessments. The present study revealed that although there was no increase of knee arterial blood flow velocity, monochromatic IR therapy produced no detrimental systemic cardiovascular effects.
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Hsieh RL, Lo MT, Liao WC, Lee WC. Short-Term Effects of 890-Nanometer Radiation on Pain, Physical Activity, and Postural Stability in Patients With Knee Osteoarthritis: A Double-Blind, Randomized, Placebo-Controlled Study. Arch Phys Med Rehabil 2012; 93:757-64. [DOI: 10.1016/j.apmr.2012.01.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Revised: 01/06/2012] [Accepted: 01/06/2012] [Indexed: 10/28/2022]
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Sampson ER, Hilton MJ, Tian Y, Chen D, Schwarz EM, Mooney RA, Bukata SV, O'Keefe RJ, Awad H, Puzas JE, Rosier RN, Zuscik MJ. Teriparatide as a chondroregenerative therapy for injury-induced osteoarthritis. Sci Transl Med 2012; 3:101ra93. [PMID: 21937758 DOI: 10.1126/scitranslmed.3002214] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
There is no disease-modifying therapy for osteoarthritis, a degenerative joint disease that is projected to afflict more than 67 million individuals in the United States alone by 2030. Because disease pathogenesis is associated with inappropriate articular chondrocyte maturation resembling that seen during normal endochondral ossification, pathways that govern the maturation of articular chondrocytes are candidate therapeutic targets. It is well established that parathyroid hormone (PTH) acting via the type 1 PTH receptor induces matrix synthesis and suppresses maturation of chondrocytes. We report that the PTH receptor is up-regulated in articular chondrocytes after meniscal injury and in osteoarthritis in humans and in a mouse model of injury-induced knee osteoarthritis. To test whether recombinant human PTH(1-34) (teriparatide) would inhibit aberrant chondrocyte maturation and associated articular cartilage degeneration, we administered systemic teriparatide (Forteo), a Food and Drug Administration-approved treatment for osteoporosis, either immediately after or 8 weeks after meniscal/ligamentous injury in mice. Knee joints were harvested at 4, 8, or 12 weeks after injury to examine the effects of teriparatide on cartilage degeneration and articular chondrocyte maturation. Microcomputed tomography revealed increased bone volume within joints from teriparatide-treated mice compared to saline-treated control animals. Immediate systemic administration of teriparatide increased proteoglycan content and inhibited articular cartilage degeneration, whereas delayed treatment beginning 8 weeks after injury induced a regenerative effect. The chondroprotective and chondroregenerative effects of teriparatide correlated with decreased expression of type X collagen, RUNX2 (runt-related transcription factor 2), matrix metalloproteinase 13, and the carboxyl-terminal aggrecan cleavage product NITEGE. These preclinical findings provide proof of concept that Forteo may be useful for decelerating cartilage degeneration and inducing matrix regeneration in patients with osteoarthritis.
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Affiliation(s)
- Erik R Sampson
- Department of Orthopaedics and Rehabilitation, Center for Musculoskeletal Research, University of Rochester Medical Center, 601 Elmwood Avenue, Box 665, Rochester, NY 14642, USA.
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Batterham SI, Heywood S, Keating JL. Systematic review and meta-analysis comparing land and aquatic exercise for people with hip or knee arthritis on function, mobility and other health outcomes. BMC Musculoskelet Disord 2011; 12:123. [PMID: 21635746 PMCID: PMC3141607 DOI: 10.1186/1471-2474-12-123] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2010] [Accepted: 06/02/2011] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Aquatic and land based exercise are frequently prescribed to maintain function for people with arthritis. The relative efficacy of these rehabilitation strategies for this population has not been established.This review investigated the effects of aquatic compared to land based exercise on function, mobility or participants' perception of programs for people with arthritis. METHODS Medline, CINAHL, AMED and the Cochrane Central Register of Controlled Clinical Trials were searched up to July 2010. Ten randomised, controlled clinical trials that compared land to aquatic exercise for adults with arthritis were included. Study quality was assessed with the PEDro scale. Data relevant to the review question were systematically extracted by two independent reviewers. Standardised mean differences between groups for key outcomes were calculated. Meta-analyses were performed for function, mobility and indices that pooled health outcomes across multiple domains. RESULTS No differences in outcomes were observed for the two rehabilitation strategies in meta-analysis. There was considerable variability between trials in key program characteristics including prescribed exercises and design quality. Components of exercise programs were poorly reported by the majority of trials. No research was found that examined participant preferences for aquatic compared to land based exercise, identifying this as an area for further research. CONCLUSION Outcomes following aquatic exercise for adults with arthritis appear comparable to land based exercise. When people are unable to exercise on land, or find land based exercise difficult, aquatic programs provide an enabling alternative strategy.
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Affiliation(s)
- Stephanie I Batterham
- Department of Physiotherapy, Monash University Peninsula campus, McMahons Rd, Frankston, Australia
| | - Sophie Heywood
- The Melbourne Sports Medicine Centre, 4/250 Collins St, Melbourne, Australia
| | - Jennifer L Keating
- Department of Physiotherapy, Monash University Peninsula campus, McMahons Rd, Frankston, Australia
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Hawker GA, Mian S, Bednis K, Stanaitis I. Osteoarthritis year 2010 in review: non-pharmacologic therapy. Osteoarthritis Cartilage 2011; 19:366-74. [PMID: 21324369 DOI: 10.1016/j.joca.2011.01.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To highlight seminal publications in the past year on the topic of non-pharmacologic management of osteoarthritis (OA). DESIGN A systematic search of the PUBMED and Cochrane databases from September 2009 to September 2010 was conducted to identify articles reporting on studies examining the safety or efficacy of non-pharmacologic therapies in the management of OA. Non-pharmacologic therapies were those considered in the 2008 OARSI OA guidelines. Identified articles were reviewed for quality; those of highest quality and deemed to have greatest potential impact on the management of OA were summarized. RESULTS The search identified 117 unique articles. Of these, four studies were chosen to highlight. A nested two-stage trial found that traditional Chinese acupuncture (TCA) was not superior to sham acupuncture, but that the providers' style affected both pain reduction and satisfaction with treatment, suggesting that the analgesic benefits of acupuncture may be partially mediated by the acupuncturists' behavior. A systematic review found little evidence of a significant effect for electrostimulation vs sham or no intervention on pain in knee OA. A single-blinded trial of Tai Chi vs attention controls found that 12 weeks of Tai Chi was associated with improvements in symptoms and disability in patients with knee OA. A randomized trial of early ACL reconstructive surgery and rehabilitation vs structured rehabilitation alone in subjects with acute anterior cruciate ligament tears found that, at 24 months following randomization, all study participants had improved, suggesting that a strategy of structured rehabilitation followed acute ACL injury may preclude the need for surgical reconstruction. CONCLUSIONS High quality studies of the safety and efficacy of non-pharmacologic agents in the management of OA remain challenging due to difficulties with adequate blinding and appropriate selection of attention controls. High quality studies suggest modest, if any, benefit of many non-pharmacologic therapies over attention control or placebo, but a significant impact of both over no intervention at all.
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Affiliation(s)
- G A Hawker
- Canadian Osteoarthritis Research Program, Women's College Research Institute, Women's College Hospital, University of Toronto, Toronto, ON M5S 1B2, Canada.
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Rahmann AE. Exercise for people with hip or knee osteoarthritis: a comparison of land-based and aquatic interventions. Open Access J Sports Med 2010; 1:123-35. [PMID: 24198550 PMCID: PMC3781862 DOI: 10.2147/oajsm.s6941] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Expert opinion considers the referral of people with osteoarthritis (OA) for physiotherapy to be a core component of managing the functional disability and pain of the disease. Clinical guidelines for the physiotherapy management of people with OA focus on three main areas: exercise, pain relief, and specific manual therapy techniques. Land-based group and individual physiotherapy exercise programs, as well as manual therapy, have demonstrated a distinct benefit in favor of physiotherapy intervention. Similarly, both general and specific aquatic physiotherapy exercise programs have shown positive outcomes for people with OA. This review will focus primarily on therapeutic exercise to improve strength and fitness and reduce pain in people with hip or knee OA. An overview of the principles of hydrodynamics relevant to aquatic exercise is also included to facilitate an understanding of effective aquatic exercise programs. The issue of compliance with exercise programs will also be discussed. Clinicians will, therefore, gain an understanding of the benefits of land-based and aquatic exercise for people with OA.
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Affiliation(s)
- Ann E Rahmann
- Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Australia
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