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Oliveira LKR, Marques AP, Andrade KFA, Assis JCSD, Brito AL, Souza GS, Callegari B. Virtual Reality in Improving Anticipatory Postural Adjustments to Step Initiation in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial. Games Health J 2024; 13:100-108. [PMID: 38436585 DOI: 10.1089/g4h.2023.0154] [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] [Indexed: 03/05/2024] Open
Abstract
Background: Virtual reality (VR) has been suggested as a new therapeutic approach in various sectors of rehabilitation, including the treatment of patients with knee osteoarthritis (OA), and one of its treatment goals is to improve the gait pattern and walking ability of patients. Objective: This study aimed to evaluate if VR, along with conventional physiotherapy treatment (CT), has superior effects to kinesiotherapy alone on pain, physical capacity, balance, and the parameters of anticipatory postural adjustments (APAs) in patients with knee OA. Design: This study is a single-blind randomized controlled trial. Setting: Secondary care at Hospital SARAH Network of Rehabilitation Hospitals, Brazil. Participants: Forty participants (31 women and 9 men) with knee OA in at least one knee and able to ambulate independently. Intervention: A rehabilitation program (8 consecutive weeks, 50-minute session, twice a week). Patients were randomized into the intervention groups CT or VR. Main Outcome Measures: Primary-latency of APA, amplitude of APA, and time to reach the maximum acceleration amplitude. Secondary-balance control by Mini-Balance Evaluation Systems Test, pain, and physical capacity by Western Ontario and McMaster Universities Arthritis Index. Results: The results of the study showed that conventional treatment significantly improved pain intensity, physical capacity, and balance in individuals with knee OA; however, only the group that used VR showed improvement in the APA parameters. Conclusion: This study demonstrated that VR associated with conventional treatment improved APAs in patients with knee OA.
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Affiliation(s)
- Luana Karine Resende Oliveira
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- SARAH Network of Rehabilitation Hospitals, Brasília, Distrito Federal, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Amélia Pasqual Marques
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil
| | | | - Jéssica Cristina Santos de Assis
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Aymee Lobato Brito
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Givago Silva Souza
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratório de Estudos da Motricidade Humana, Belém, Pará, Brazil
- Programa de Pós Graduação em Ciências do Movimento, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Neurociências e Biologia Celular, Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Pará, Brazil
- Programa de Pós Graduação em Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Pará, Brazil
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de Souza DM, Malange KF, Nishijima CM, de Melo Lima BH, Capetini VC, de Oliveira ALR, Anhê GF, Tambeli CH, Parada CA. Intraarticular monomethyl fumarate as a perspective therapy for osteoarthritis by macrophage polarization. Inflammopharmacology 2024; 32:1239-1252. [PMID: 38472616 DOI: 10.1007/s10787-024-01443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Osteoarthritis (OA) is a chronic disease that may lead to joint structure degeneration, cartilage destruction, osteophyte formation, subchondral bone disruption, and pain. In this scenario, a higher proportion of the proinflammatory macrophage type 1 (M1) than the anti-inflammatory macrophage type 2 (M2) could be highlighted as a hallmark of OA progression. The balance between these two macrophage types emerges as a new therapeutic target in OA. This study aimed to evaluate the analgesia and macrophage profile in the treatment of experimental osteoarthritis (EOA) with systemic dimethyl fumarate (DMF) or local intra-articular monomethyl fumarate (MMF). RESULTS DMF via gavage or MMF via intra-articular in the right knee of EOA rats showed improvements in gait parameters and the nociceptive recovery of the mechanical threshold assessment by adapted electronic von Frey treatment on the twenty-first day (long-lasting phase). DMF treatment decreased proinflammatory TNF-α while increasing anti-inflammatory IL-10 cytokines from the macerated capsule on the fifth day (inflammatory phase). MMF treatment showed joint capsule mRNA extraction downregulating iNOS and TNF-α gene expression while upregulating IL-10 and MCP-1. However, CD206 was not significant but higher than untreated EOA rats' joints on the seventh day (inflammatory phase). CONCLUSIONS Our studies with EOA model induced by MIA suggest a new perspective for human treatment committed with OA based on macrophage polarization as a therapeutic target, switching the proinflammatory profile M1 to the anti-inflammatory profile M2 with DMF systematic or by MMF locally treatment according to the OA severity.
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Affiliation(s)
- Douglas Menezes de Souza
- Department of Pharmacology, School of Medical Sciences, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126Campinas, Sao Paulo, 13083-887, Brazil.
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil.
| | - Kauê Franco Malange
- Department of Anesthesiology, University of California, La Jolla, San Diego, CA, 92037, USA
| | - Catarine Massucato Nishijima
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil
| | - Bruno Henrique de Melo Lima
- Laboratory of Nerve Regeneration, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Monteiro Lobato, 255, Campinas, Sao Paulo, 13083-862, Brazil
| | - Vinicius Cooper Capetini
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126, Campinas, Sao Paulo, 13083-887, Brazil
| | - Alexandre L R de Oliveira
- Laboratory of Nerve Regeneration, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Monteiro Lobato, 255, Campinas, Sao Paulo, 13083-862, Brazil
| | - Gabriel Forato Anhê
- Department of Translational Medicine, School of Medical Sciences, University of Campinas, Cidade Universitária Zeferino Vaz, Rua Tessália Vieira de Camargo, 126, Campinas, Sao Paulo, 13083-887, Brazil
| | - Claudia Herrera Tambeli
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil
| | - Carlos Amilcar Parada
- Department of Structural and Functional Biology, Institute of Biology, University of Campinas (UNICAMP), Cidade Universitária Zeferino Vaz, Rua Carl Von Linnaeus, Campinas, Sao Paulo, 13083-864, Brazil.
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Nogueira RMDR, de Souza Moura J, Costa CPS, Novais TM, de Lourdes Oliveira P, Ribeiro MJ, Maduro PA, de Jesus Furtado Almeida F, Soares SL, Schwingel PA, Gambassi BB. Adherence to Exercise Training and Physical Function in Older Adults Diagnosed with Knee Osteoarthritis. Can Geriatr J 2023; 26:511-516. [PMID: 38045884 PMCID: PMC10684300 DOI: 10.5770/cgj.26.674] [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] [Indexed: 12/05/2023] Open
Abstract
Background Knee osteoarthritis (KOA) provokes pain, muscle weakness, and consequent impairment in activities of daily living. On the other hand, adherence to exercise training (ET) is associated with the attenuation of the impairments. The aims of the present study were to a) investigate adherence to ET in older adults with KOA diagnosed attending public service; and b) to analyze the physical function of the older adults with KOA who did not adhere to the ET in public service. Methods The adherence to ET programs was analyzed retrospectively from each patient's date of KOA diagnosis. After assessing the adherence to ET, the physical function of these older adults diagnosed with KOA (n=19) was analyzed and compared with another group composed of asymptomatic sedentary older adults without evidence of KOA (ASKOA) (n=17). Results Although all older adults with KOA received guidelines to practice ET, only 58% were able to start a program. Additionally, 100% of the sample could not perform ET uninterruptedly. According to the findings, close to 80% of older adults had difficulties scheduling ET sessions in public places. Subjects with KOA (12.1±3.1; IC95%:10.6-13.6) had worse lower limb functional capacity than ASKOA (8.1±1.0; IC95%:7.6-8.6; p<.001; δ=4.0 sec; d=1.7). Likewise, they had a lower dynamic balance than KOA (12.4±2.7; IC95%:11.1-13.7 vs. 8.0±1.1; IC95%:7.4-8.6; p<.001; δ=4.4 sec; d=2.1). Conclusions The investigated sample has a lack of ET adherence by difficulties in scheduling ET sessions in public places. In addition, it demonstrated impairment in physical function in older adults with KOA.
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Affiliation(s)
| | | | | | | | | | | | - Paula Andreatta Maduro
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina
| | | | - Stela Lopes Soares
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina
- Centro Universitário Inta (UNINTA), Tianguá, Brazil
| | - Paulo Adriano Schwingel
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina
| | - Bruno Bavaresco Gambassi
- Programa de Pós-Graduação em Gestão de Programas e Serviços de Saúde (PPGGPSS), Universidade Ceuma, São Luís
- Universidade Ceuma, São Luís
- Laboratório de Pesquisas em Desempenho Humano (LAPEDH), Universidade de Pernambuco (UPE), Petrolina
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Eyles JP, Sharma S, Telles RW, Namane M, Hunter DJ, Bowden JL. Implementation of Best-Evidence Osteoarthritis Care: Perspectives on Challenges for, and Opportunities From, Low and Middle-Income Countries. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:826765. [PMID: 36188801 PMCID: PMC9397802 DOI: 10.3389/fresc.2021.826765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/24/2021] [Indexed: 12/04/2022]
Abstract
The "Joint Effort Initiative" (JEI) is an international consortium of clinicians, researchers, and consumers under the auspices of the Osteoarthritis Research Society International (OARSI). The JEI was formed with a vision to improve the implementation of coordinated programs of best evidence osteoarthritis care globally. To better understand some of the issues around osteoarthritis care in low- and middle-income countries (LMICs), the JEI invited clinician researcher representatives from South Africa, Brazil, and Nepal to discuss their perspectives on challenges and opportunities to implementing best-evidence osteoarthritis care at the OARSI World Pre-Congress Workshop. We summarize and discuss the main themes of the presentations in this paper. The challenges to implementing evidence-based osteoarthritis care identified in LMICs include health inequities, unaffordability of osteoarthritis management and the failure to recognize osteoarthritis as an important disease. Fragmented healthcare services and a lack of health professional knowledge and skills are also important factors affecting osteoarthritis care in LMICs. We discuss considerations for developing strategies to improve osteoarthritis care in LMICs. Existing opportunities may be leveraged to facilitate the implementation of best-evidence osteoarthritis care. We also discuss strategies to support the implementation, such as the provision of high-quality healthcare professional and consumer education, and systemic healthcare reforms.
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Affiliation(s)
- Jillian P. Eyles
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Rosa Weiss Telles
- Universidade Federal de Minas Gerais, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Musculoskeletal, Belo Horizonte, Brazil
| | - Mosedi Namane
- School of Public Health and Family Medicine, The University of Cape Town, Cape Town, South Africa
| | - David J. Hunter
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- Rheumatology Department, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Jocelyn L. Bowden
- Kolling Institute of Medical Research, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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Monteiro NRO, Pegorari MS, Ohara DG, Ferreira VTK, Matos AP. The basis of information to guide clinical decision-making in knee osteoarthritis management: A survey with Brazilian physical therapists. J Eval Clin Pract 2021; 27:1216-1222. [PMID: 33386671 DOI: 10.1111/jep.13532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES Several health information sources are available to assist physical therapists in the clinical decision-making process, with a notable increase in the importance of using evidence-based practice (EBP). The aim of this study is to investigate the health information sources most used by Brazilian physical therapists to guide their clinical decision making for knee osteoarthritis (OA) management, use of Physiotherapy Evidence Database (PEDro), knowledge about the existence of clinical practice guidelines (CPGs), and associated factors. METHODS A cross-sectional study using an electronic survey was conducted. Physical therapists registered in a Regional Physical Therapy Council in Brazil were invited to participate. Sociodemographic data, professional training, health information sources, frequency of use of PEDro, and knowledge about CPGs were collected. Descriptive analysis of the data was performed, and the chi square test and multinomial and binary logistic regression were used to verify association between the variables. RESULTS The survey was completed by 370 professionals. The three health information sources most used by Brazilian physical therapists were clinical experience, courses, and books. Among these professionals, only 12.1% use PEDro frequently, and 60.5% know that CPGs for knee OA management exist. Level of education was associated with PEDro use and knowledge about the existence of CPGs (P < .05). CONCLUSIONS The study results indicated a significant deficiency in engagement with research evidence by Brazilian physical therapists to guide their clinical decision making for knee OA. Further investigations on educational needs and the development of new strategies to narrow the gap between research evidence and clinical practice should be performed.
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Affiliation(s)
- Nívea Renata Oliveira Monteiro
- Ribeirão Preto Clinical Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Maycon Sousa Pegorari
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Daniela Gonçalves Ohara
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Vânia Tiê Koga Ferreira
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
| | - Areolino Pena Matos
- Department of Biological and Health Sciences, Physiotherapy Course, Federal University of Amapá, Macapá, Brazil
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Translation, cultural adaptation and reproducibility of a Portuguese version of the Functional Index for Hand OsteoArthritis (FIHOA). Adv Rheumatol 2021; 61:30. [PMID: 34090513 DOI: 10.1186/s42358-021-00189-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Functional Index for Hand Osteoarthritis (FIHOA) is a simple, reliable, and reproducible specific instrument to evaluate hand OA that can be applied both in clinical practice and research protocols. In order to be used in Brazil, FIHOA has to be translated into Portuguese, culturally adapted and have the reliability of the translated FIHOA version tested, which is the purpose of this study. METHODS The FIHOA was translated into Brazilian Portuguese and administered to 68 patients with hand OA recruited between May 2019 and February 2020. The test-retest was applied to 32 patients and the reliability was assessed using Spearman's correlation coefficient and intraclass correlation coefficient (ICC). The internal consistency reliability was evaluated using Cronbach's alpha. External construction validity was assessed using the Spearman's correlation test between FIHOA and pain, assessed with a Visual Analogue Scale (VAS), the Cochin Hand Functional Scale (CHFS) and Health Assessment Questionnaire (HAQ). RESULTS The 30 participants that initially answered the translated version of the FiHOA did not report difficulties in understanding or interpreting the translated version. The test-retest reliability for the total score was strong (r = 0.86; ICC = 0.89). Mean differences (1.37 ± 0.68) using Bland Altman's analysis did not significantly differ from zero and no systematic bias was observed. Cronbach's alpha was also high (0.89) suggesting a strong internal coherence in the test items. There were also correlations between FIHOA and the CHFS (r = 0.88), HAQ (r = 0.64) and pain in the hands both at rest (r = 0.55) and in motion (r = 0.44). CONCLUSION The translation of the FIHOA into Brazilian Portuguese proved a valid instrument for measuring the functional capacity of patients with hand OA who understand Brazilian Portuguese.
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Dantas LO, Carvalho C, Prando BC, McAlindon TE, da Silva Serrão PRM. Mobile health technologies for the management of rheumatic diseases: a systematic review of online stores in Brazil. Clin Rheumatol 2021; 40:2601-2609. [PMID: 33389312 DOI: 10.1007/s10067-020-05561-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 11/29/2020] [Accepted: 12/21/2020] [Indexed: 01/17/2023]
Abstract
Rheumatic diseases are serious conditions with a low uptake of conservative treatments. Mobile health (mHealth) applications (apps) offer potential to assist the self-management of rheumatic diseases. Our goal was to perform a systematic review of available mHealth apps for rheumatic diseases in Brazil. We focused on the most prevalent rheumatic diseases: osteoarthritis, rheumatoid arthritis, fibromyalgia, systemic lupus erythematosus, osteoporosis, and axial spondylarthritis. Google Play Store and AppStore in Brazil were queried by two independent reviewers on September 2020, and the quality of eligible mHealth apps was assessed using the Mobile App Rating Scale (MARS). Of the 3173 mHealth apps found, five were eligible for inclusion. Two for fibromyalgia and two for axial spondylarthritis offered exercise, educational content, and tools to track patient-reported symptoms; and one for osteoporosis offered educational content and tracking tools only. The included apps scored moderately on the MARS quality scale, with a mean score (SD) of 3.1 (0.7) on a 0-5 scale. Most apps scored poorly based on credibility, user interface and experience, and engagement. There is growing interest in the development of mHealth technologies to support rheumatic diseases patients. Although the majority of the included apps came from non-profit organizations, they are still of poor quality and limited functionality. This study is a call for to the development of new user-centered mHealth apps that can empower rheumatic diseases patients in Brazil, especially in the area of osteoarthritis, rheumatoid arthritis, and lupus, since no apps were found.
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Affiliation(s)
- Lucas Ogura Dantas
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
| | - Cristiano Carvalho
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
| | - Beatriz Cardinal Prando
- Physical Therapy Department, Federal University of São Carlos, São Carlos, 13565-905, Brazil
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