Promoting health and quality of life of patients with osteoarthritis of knee joint through non-pharmacological treatment strategies: A randomized controlled trial

Key characteristics of effective yoga interventions for managing osteoarthritis: a systematic review and meta-analysis

This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions for managing osteoarthritis symptoms, including joint pain and joint function. JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga's effectiveness on osteoarthritis symptoms. Meta-analyses and a narrative synthesis were conducted to address the objective. The systematic review and meta-analysis included 18 and 16 articles (representing 16 and 14 RCTs), respectively. Overall, the included studies had low methodological quality scores. 10 of 14 yoga interventions effectively reduced pain (standardised mean difference (SMD) - 0.70; 95% confidence interval (CI) - 1.08, - 0.32) and/or improved function (- 0.40; - 0.75, - 0.04). Notably, 8 effective interventions had centre-based (supervised, group) sessions, and 6 included additional home-based (unsupervised, individual) sessions. Effective interventions included 34 yogic poses (12 sitting, 10 standing, 8 supine, 4 prone), 8 breathing practices, and 3 meditation and relaxation practices. 8 interventions included yogic poses, and 7 also incorporated breathing practices and/or meditation and relaxation practices. 4 interventions included yogic pose modifications for osteoarthritis. The median duration of centre-based sessions was 8 weeks and each session was around 53 min, mostly delivered once a week. The median duration of home-based sessions was 10 weeks and each session was 30 min, usually instructed to practice 4 times a week. Given previous studies' limitations, a high-quality long-term RCT should be conducted using synthesised findings of previous effective yoga interventions.

The impact of Yoga on patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

The objective of this review is to conduct a comprehensive and systematic assessment of the efficacy of Yoga as an intervention for knee osteoarthritis (KOA).

METHODS

We searched PubMed, Cochrane Library, Embase, Web of Science, and PEDro as of January 3, 2024. Retrieved a total of 200 articles. Standardised mean differences (SMDs) and 95% confidence intervals (CI) were calculated.

RESULTS

The study included a total of 8 trials and involved 756 KOA patients. The results indicated that compared to the control group, Yoga exercise showed significant improvements in alleviating pain (SMD = -0.92; 95% CI = -1.64 ~ - 0.20; P = 0.01, I2 = 94%), stiffness (SMD = -0.51; 95% CI = -0.91 ~ -0.12; P = 0.01; I2 = 66%) and physical function (SMD = -0.53; 95% CI = -0.89 ~ -0.17; P = 0.004; I2 = 59%) among KOA patients. However, there was no significant improvement observed in terms of activities of activity of daily living (ADL) (SMD = 1.03; 95% CI = -0.01 ~ 2.07; P = 0.05; I2 = 84%), and quality of life (QOL) (SMD = 0.21; 95% CI = -0.33 ~ 0.74; P = 0.44; I2 = 83%) with the practice of Yoga.

CONCLUSIONS

In general, Yoga has been found to be effective in reducing pain and stiffness in KOA patients, it can also improve the physical function of patients. However, there is limited evidence to suggest significant improvements in terms of ADL and QOL.

Association between traditional Chinese Medicine and osteoarthritis outcome: A 5-year matched cohort study

Objective

The aim of this study was to investigate the relationship between Traditional Chinese medicine (TCM) and pain reduction, hospital readmission, and joint replacement in patients with osteoarthritis (OA). Chinese herbal medicine (CHM) prescription patterns were further analyzed to confirm the association with prognosis and quality of life in OA patients.

Methods

We retrospectively followed 3,850 hospitalized patients with osteoarthritis between January 2018 and December 2022 using the hospital's HIS system. Propensity score matching (PSM) was used for data matching. Cox's proportional risk model was used to assess the impact of various factors on the outcomes of patients with OA, including pain worsening, readmission, and joint replacement. The Kaplan-Meier survival curve was applied to determine the impact of TCM intervention time on patient outcomes. Data mining methods including association rules, cluster analysis, and random walks have been used to assess the efficacy of TCM.

Results

The utilization rate of TCM in OA patients was 67.01% (2,511/3,747). After PSM matching, 1,228 TCM non-user patients and 1,228 TCM user patients were eventually included. The outcomes of pain worsening, re-admission rate, and joint replacement rate of the TCM non-user group were observably higher than those of the TCM user group with OA (p < 0.05). Based on the Cox proportional risk model, TCM is an independent protective factor. Compared with non-TCM users, TCM users had 58.4% lower rates of pain, 51.1% lower rates of re-admission, and 42% lower rates of joint replacement. In addition, patients in the high-exposure subgroup (TCM＞24 months) had a markedly lower risk of outcome events than those in the low-exposure subgroup (TCM ≤24 months). Data mining methods have shown that TCM therapy can significantly improve immune-inflammatory indices, VAS scores, and SF-36 scale scores in OA patients.

Conclusion

s TCM acts as a protective factor to improve the prognosis of patients with OA, and the benefits of long-term use of herbal medicines are even greater.

Growing Trends in Scientific Publication in Physiotherapy Treatment of Knee Osteoarthritis: A Bibliometric Literature Analysis

There has been an increase in the life expectancy of people worldwide, especially in developing countries like India. Osteoarthritis, a condition that usually onsets during later decades of life, has also been on the rise, even with advancing technology. This has led osteoarthritis of the knee to become a global disabling condition of the lower extremity that increases dependency on the affected individual. A bibliometric study has not been conducted on knee osteoarthritis research. Therefore, a bibliometric analysis which includes statistical analysis of recent articles, books, and other forms of publications is done for evaluation of scientific output and to find the importance of scientific studies in terms of quality as well as quantity. The aim of this analysis was to evaluate the productivity of research articles indexed in PubMed related to the condition. The PubMed database was used and articles related to osteoarthritis of the knee, phonophoresis, and start excursion balance test were extracted. In the bib text format, all the files were downloaded and placed together. The R studio software (R Foundation for Statistical Computing, Vienna, Austria) for bibliometric analysis was then used, into which the research data was uploaded and a data framework of bibliometric analysis was made. Analysis of bibliometric publications related to knee osteoarthritis, phonophoresis, Otago exercises, star excursion balance test, ultrasound, and exercise therapy generated between 1989 and 2021 lists a total of 120 relevant documents from 75 sources with an average of 4.53 articles per year of publication. The use of an advanced PubMed database enables the extraction of adequate articles and powerful bibliometric analysis of the studies conducted on osteoarthritis of the knee published from 1989 to 2021. It includes an assessment of the contributions from major countries. This study allowed us to validate our methodology which can be used to evaluate research policies and promote international collaboration.

Effect of multi-component exercises program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint

BACKGROUND

Osteoarthritis of the knee causes pain and gait disturbances, as well as a distinct gait pattern. Patients with knee OA have decreased range of motion (ROM) and increased ground reaction force. OA reduces stride length and walking speed.

OBJECTIVES

To determine the effect of a multi-component exercise program on pain-related gait adaptations among individuals with osteoarthritis of the knee joint and to compare the effect of multi-component exercises with traditional exercises on pain-related gait adaptations among individuals with osteoarthritis of the knee joint.

MATERIALS AND METHODS

This was an experimental study done between 120 patients having knee OA, of both genders, and between the age group of 50-65 years. These individuals were residents of the city of Karad and they were randomly divided into group A (conventional/traditional) and group B (experimental). A pretest assessment was done and the treatment was given for 6 weeks. The later posttest assessment was done and further statistical tests like paired and unpaired t tests were used.

RESULTS

Among the 120 subjects with OA knee, the age group of 60-65 years (44%) was found to be commonly affected. Thirty-nine were males (32.5%) and 81 were females (67.5%). Fifty-eight subjects (48%) were found to be commonly overweight. Thirty-two subjects (27%) had Genu Valgum deformity, and 88 subjects (73%) had Genu Varum deformity at the knee joint. The Pvalue within both group A and group B was found to be statistically significant for the entire outcome measures used for assessment. The pretest vs post test values of the WOMAC scale for patients with knee OA within both groups were found to be extremely significant (P < 0.0001). As for the MMT score in these patients, the Knee Flexors of Group A were not significant for right side (P = 0.7088) as well as for left side (P = 0.083) and in Group B they were extremely significant (P < 0.0001) for both sides. For the ROM scores within both groups, Knee Flexion of Group A for both sides was found to be extremely significant (P < 0.0001) for both sides. And for the pretest vs posttest values of within the groups'gait parameters among these patients with OA knees, for cadence both groups B were found to be extremely significant (P < 0.0001). The stride length for Group A was found to be very significant (P = 0.0060) and for Group B it was (P < 0.0001). Also, the P values of the various outcome measures between both groups were found to have statistical significance of their own.

CONCLUSION

Effect of Multi-Component Exercise Program on Pain-Related Gait Adaptations Among Individuals with Osteoarthritis of the Knee joint was found to be significant in pain reduction, improving strength, range of motion, and the gait parameters such as an increase in cadence, stride length, step length and decrease in the step width.

Complementary and alternative therapies for knee osteoarthritis: A protocol for systematic review and network meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is a degenerative disease, making a unique contribution to chronic pain, edema, and limited mobility of knee joint. This disease is an important factor affecting the quality of life of middle-aged and elderly people. Complementary and alternative medicine (CAM) therapies have been used clinically to treat KOA; however, the selection strategies of different CAM interventions in clinical practice are still uncertain, and the purpose of this study is to evaluate the efficacy and acceptability of different CAM therapies using systematic review and network meta-analysis.

METHODS

According to the strategy, the authors will retrieve a total of 7 electronic databases by October 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of CAM therapies for the KOA. Finally, the evidence grade of the results will be evaluated.

RESULTS

This study will provide a reliable evidence for the selection of CAM therapies for KOA.

CONCLUSION

The results of this study will provide references for evaluating the influence of different CAM therapies for KOA, and provide decision-making references for clinical research.

ETHICS AND DISSEMINATION

This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/GJMF4.