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Liu XY, Ma Y, Huang ZY, Xiao XX, Guan L. The Efficacy of Acupuncture, Exercise Rehabilitation, and Their Combination in the Treatment of Knee Osteoarthritis: A Randomized Controlled Trial. J Pain Res 2024; 17:2837-2849. [PMID: 39247172 PMCID: PMC11379033 DOI: 10.2147/jpr.s465058] [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: 04/10/2024] [Accepted: 08/07/2024] [Indexed: 09/10/2024] Open
Abstract
Objective To assess the effectiveness of acupuncture, exercise rehabilitation, and their combination in treating knee osteoarthritis (KOA). Methods This randomized controlled trial was done on patients with KOA, who were randomly allocated to three groups: acupuncture (AP), exercise rehabilitation (ER), or a combination of acupuncture and exercise rehabilitation (AE). The study lasted 12 weeks with 4 weeks of treatment and 8 weeks of follow-up. The primary outcome was the response rate, which was determined by the percentage of participants who experienced a significant improvement in pain and function by the fourth week. The primary analysis utilized a Z test for proportions in the modified intent-to-treat population, consisting of all randomized participants with at least one post-baseline measurement. Results Out of the 120 patients initially enrolled in the study, 110 completed the trial and were included in the intention-to-treat analysis. Response rates at week 4 were 65.7% (23 out of 35), 58.3% (21 out of 36), and 83.3% (32 out of 39) in the AP, ER, and AE groups, respectively. The response rate in the AE group was found to be significantly higher than that in the ER group at week 4. No significant differences were observed in the overall response rates between the AP and ER groups, as well as between the AP and AE groups. Conclusion Our research indicates that both acupuncture and exercise rehabilitation can effectively enhance pain relief, functional improvement, and joint mobility in individuals aged 45 to 70 with moderate to severe chronic KOA. Furthermore, the AE group demonstrated the highest response rate. These beneficial outcomes were sustained for a minimum of 8 weeks post-treatment. The combination of acupuncture and exercise rehabilitation appears to enhance the overall therapeutic efficacy for KOA patients, suggesting a synergistic effect that may be particularly advantageous for those with moderate to severe symptoms.
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Affiliation(s)
- Xin-Yuan Liu
- Department of Acupuncture and Moxibustion, Sixth Medical Center, Chinese People's Liberation Army General Hospital, Beijing,People's Republic of China
| | - Yue Ma
- Graduate School, Chinese People's Liberation Army Medical College, Beijing, People's Republic of China
| | - Zong-Yue Huang
- Graduate School, Chinese People's Liberation Army Medical College, Beijing, People's Republic of China
| | - Xin-Xin Xiao
- Graduate School, Chinese People's Liberation Army Medical College, Beijing, People's Republic of China
| | - Ling Guan
- Department of Acupuncture and Moxibustion, Sixth Medical Center, Chinese People's Liberation Army General Hospital, Beijing,People's Republic of China
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Wang Y, Shen Z, Xing X, Ge L, Pan F, Cai G. Association of physical activity trajectories over 8 years and risk of knee replacement: data from the osteoarthritis initiative. BMC Musculoskelet Disord 2024; 25:586. [PMID: 39061027 PMCID: PMC11282720 DOI: 10.1186/s12891-024-07710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND To identify physical activity (PA) trajectories in adults with or at risk of knee osteoarthritis and to evaluate the association of PA trajectories with incident knee replacement (KR). METHODS This study used data from the Osteoarthritis Initiative. The Physical Activity Scale for the Elderly and the KR were assessed annually from baseline to 9 years. Individuals were included if they did not undergo KR surgery at baseline and had data on PA at ≥ 1 visit before KR. Latent class growth mixture Modeling was used to identify the optimal trajectories of PA before KR. Log-binomial regression models were used to assess the association between PA trajectories and the risk of KR. Data analyses were conducted in all individuals and those with radiographic osteoarthritis (ROA) and significant knee pain (Western Ontario and McMaster Osteoarthritis Index pain score of ≥ 5 on a 0-20 scale) at baseline, respectively. RESULTS Of 4731 participants (mean age 61.1 years, 58.5% female), four distinct and slightly declined PA trajectories were identified. Compared to individuals with a "Low" PA trajectory, those with "Medium-low", "Medium-high", or "High" PA trajectories were not significantly associated with the risk of KR (risk ratios: 0.97-1.19, all p > 0.05). Similar PA trajectories and associations with the risk of KR were observed in the subgroups of individuals with radiographic osteoarthritis and those with significant knee pain at baseline, respectively. CONCLUSION In participants with or at risk of knee osteoarthritis, PA slightly declines over time and may play no role in the risk of KR.
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Affiliation(s)
- Yining Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Ziyuan Shen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Xing Xing
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Liru Ge
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
| | - Faming Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China
- The Inflammation and Immune-Mediated Diseases Laboratory of Anhui Province, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Guoqi Cai
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia.
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Tao T, Shi MP, Tan BY, Zhang XS, Sun FL, Liu BR, Li SJ, Li ZH. Evaluation of traditional Chinese exercise for knee osteoarthritis (KOA): an overview of systematic reviews. Syst Rev 2024; 13:187. [PMID: 39026375 PMCID: PMC11256411 DOI: 10.1186/s13643-024-02606-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 07/07/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) has become a public health issue. Several systematic reviews (SRs) and meta-analyses (MAs) indicate that traditional Chinese exercise (TCE) may be an effective treatment for reducing pain and stiffness and improving physical function in people with knee osteoarthritis (KOA). OBJECTIVES To evaluate the literature quality and evidence for the systematic reviews of TCE for KOA and provide evidence to support the clinical application of TCE for KOA. METHODS Eight databases were searched from their inception to January 3, 2023, to retrieve relevant literature, including China National Knowledge Infrastructure (CNKI), Wanfang, Chinese Scientific Journal Database (VIP), China Biology Medical literature database (CBM), PubMed, Embase, Web of Science and Cochrane Library, without restrictions on publication date or language. AMSTAR-2 and PRISMA 2020 assessed the methodological and reporting quality of included SRs/MAs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was utilized to evaluate the quality of evidence. RESULTS A total of 18 SRs/MAs were included. The methodological quality was "very low" based on AMSTAR-2. The overall reporting quality was deficient based on PRISMA 2020. The quality of Chinese and English literature differed, with English literature being superior in methodological and reporting quality. Among 93 pieces of evidence obtained, 46 (49.46%) were of very low quality, 34 (36.56%) were of low quality, 13 (13.98%) were of moderate quality, and none were of high quality. TCE was supported by 76 pieces of evidence (81.72%). CONCLUSION TCE appears beneficial and safe for managing KOA. However, due to the relatively low methodological and evidentiary quality of included SRs/MAs, clinicians should interpret these findings cautiously.
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Affiliation(s)
- Tao Tao
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Ming-Peng Shi
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Bo-Yang Tan
- College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Xian-Shuai Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, 130117, China
| | - Feng-Ling Sun
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Bao-Ren Liu
- Taojiatun Town Health Center, Gongzhuling City, Changchun, 136104, China
| | - Shao-Jun Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China
| | - Zhen-Hua Li
- Affiliated Hospital of the Changchun University of Chinese Medicine, Changchun, 130021, China.
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Ma X, Zhang K, Ma C, Zhang Y, Ma J. Physical activity and the osteoarthritis of the knee: A Mendelian randomization study. Medicine (Baltimore) 2024; 103:e38650. [PMID: 38941438 DOI: 10.1097/md.0000000000038650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2024] Open
Abstract
Previous studies have reported an association between physical activity and the occurrence and progression of knee osteoarthritis (KOA). However, the existing evidence remains limited and of low-quality. This study aimed to examine the causal relationship between different levels of physical activity and KOA. Instrumental variables, represented by single nucleotide polymorphisms (SNPs), were utilized to capture sedentary behavior, appropriate physical exercise, and excessive physical activity. Aggregated statistics from the UK Biobank genome-wide association study dataset were used to assess the impact of these SNPs on KOA. Causality was estimated using inverse variance weighting (IVW), MR Egger, simple model, weighted median, and weighted model approaches. The stability of the results was assessed through heterogeneity and sensitivity analyses. Mendelian randomization (MR) analysis revealed a strong association between sedentary behavior and KOA, with an odds ratio (OR) of 2.096 (95% CI: 1.506-2.917) and a P value of 1.14 × 10-5. Appropriate physical exercise behavior exhibited a strong negative association with KOA, with an OR of 0.147 (95% CI: 0.037-0.582) and a P value of 0.006. Conversely, excessive physical activity behavior showed a significant positive association with KOA, with an OR of 2.162 (95% CI: 1.327-3.521) and a P value of .002. Our findings indicate that sedentary behavior and excessive physical activity are identified as risk factors for KOA, whereas engaging in appropriate physical exercise emerges as a protective factor against the development of KOA.
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Affiliation(s)
- Xilong Ma
- The Third Clinical Medical School, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Kai Zhang
- The Third Clinical Medical School, Ningxia Medical University, Yinchuan, Ningxia, China
| | - Chao Ma
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
| | - Yahui Zhang
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
| | - Jun Ma
- Department of Orthopedics, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China
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Coffee Z, Cheng K, Slebodnik M, Mulligan K, Yu CH, Vanderah TW, Gordon JS. The Impact of Nonpharmacological Interventions on Opioid Use for Chronic Noncancer Pain: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:794. [PMID: 38929040 PMCID: PMC11203961 DOI: 10.3390/ijerph21060794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/06/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Despite the lack of evidence, opioids are still routinely used as a solution to long-term management for chronic noncancer pain (CNCP). Given the significant risks associated with long-term opioid use, including the increased number of unregulated opioid pills at large in the opioid ecosystem, opioid cessation or reduction may be the desired goal of the patient and clinician. Viable nonpharmacological interventions (NPIs) to complement and/or replace opioids for CNCP are needed. Comprehensive reviews that address the impact of NPIs to help adults with CNCP reduce opioid use safely are lacking. We conducted a literature search in PubMed, CINAHL, Embase, PsycINFO, and Scopus for studies published in English. The initial search was conducted in April 2021, and updated in January 2024. The literature search yielded 19,190 relevant articles. Thirty-nine studies met the eligibility criteria and underwent data extraction. Of these, nineteen (49%) were randomized controlled trials, eighteen (46%) were observational studies, and two (5%) were secondary analyses. Among adults with CNCP who use opioids for pain management, studies on mindfulness, yoga, educational programs, certain devices or digital technology, chiropractic, and combination NPIs suggest that they might be an effective approach for reducing both pain intensity and opioid use, but other NPIs did not show a significant effect (e.g., hypnosis, virtual reality). This review revealed there is a small to moderate body of literature demonstrating that some NPIs might be an effective and safe approach for reducing pain and opioid use, concurrently.
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Affiliation(s)
- Zhanette Coffee
- College of Nursing, University of Arizona, Tucson, AZ 85721, USA;
| | - Kevin Cheng
- College of Medicine, University of Arizona, Tucson, AZ 85721, USA;
| | | | - Kimberly Mulligan
- Veterans Health Administration, Central California, Fresno, CA 93706, USA
| | - Chong Ho Yu
- Department of Mathematics, Hawaii Pacific University, Honolulu, HI 96813, USA;
| | - Todd W. Vanderah
- Department of Pharmacology, Comprehensive Center for Pain and Addiction, University of Arizona, Tucson, AZ 85721, USA;
| | - Judith S. Gordon
- College of Nursing, University of Arizona, Tucson, AZ 85721, USA;
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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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Sönmez DZ, Taşcı S. The Effect of St. John's Wort Oil (Hypericum Perforatum L.) in Knee Osteoarthritis: A Randomized Controlled and Qualitative Study. Pain Manag Nurs 2024; 25:e115-e125. [PMID: 38242739 DOI: 10.1016/j.pmn.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 11/07/2023] [Accepted: 12/10/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Reducing pain and improving physical function are critical in the treatment of osteoarthritis. Although individuals use St. John's Wort oil to relieve pain due to osteoarthritis, no scientific research has been found investigating its effectiveness. AIM This study investigated the effect of St. John's Wort oil on pain intensity and physical functions in people with knee osteoarthritis. METHODS This study adopted a single-blind, randomized, placebo-controlled, and qualitative mixed design. The sample consisted of 60 patients randomized into intervention (n = 30) and placebo control (n=30) groups. The experimental group participants were treated with topically St. John's Wort oil three times a week for 3 weeks, and the placebo control group participants were treated with olive oil three times a week for 3 weeks. Quantitative data were collected using a patient identification form, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Visual Analogue Scale. Qualitative data were collected through semi-structured interviews. RESULTS The experimental group had a significantly lower mean Visual Analog Scale score in the first, third, and fourth follow-ups than the control group. The experimental group had significantly lower mean WOMAC-pain, WOMAC-stiffness, and WOMAC-physical function subscale scores in the last follow-up than in the first follow-up. The qualitative data agreed with the quantitative data. CONCLUSIONS The results show that St. John's Wort oil helps people with knee osteoarthritis feel less pain and become physically more active. Additional research is warranted to better understand the effect of St. John's Wort oil on pain intensity and physical functions in people with knee osteoarthritis.
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Affiliation(s)
- Deniz Zeynep Sönmez
- From the Osmaniye Korkut Ata University Faculty of Health Sciences Midwifery Department, Osmaniye, Turkey.
| | - Sultan Taşcı
- Erciyes University Faculty of Health Sciences Nursing Department, Erciyes University, Kayseri, Turkey
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Zhang F, Chen X, Yang M, Shen X, Wang Y, Zhong D, Zeng F, Jin R. Metabolic impairments associated with type 2 diabetes mellitus and the potential effects of exercise therapy: An exploratory randomized trial based on untargeted metabolomics. PLoS One 2024; 19:e0300593. [PMID: 38517904 PMCID: PMC10959348 DOI: 10.1371/journal.pone.0300593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/26/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a common condition that is characterized by metabolic impairments. Exercise therapy has proven effective in improving the physiological and psychological states of patients with T2DM; however, the influence of different exercise modalities on metabolic profiles is not fully understood. This study first aimed to investigate the metabolic changes associated with T2DM among patients and then to evaluate the potential physiological effects of different exercise modalities (Tai Chi and brisk walking) on their metabolic profiles. METHODS This study included 20 T2DM patients and 11 healthy subjects. Patients were randomly allocated to either the Tai Chi or walking group to perform Dijia simplified 24-form Tai Chi or brisk walking (80-100 m/min), with 90 minutes each time, three times per week for 12 weeks, for a total of 36 sessions. The healthy group maintained daily living habits without intervention. Glycemic tests were conducted at the baseline and after 12 weeks. Serum and urine samples were collected for untargeted metabolomic analyses at baseline and 12 weeks to examine the differential metabolic profiles between T2DM and healthy subjects, and the metabolic alterations of T2DM patients before and after exercise therapy. RESULTS Compared to the healthy group, T2DM patients exhibited metabolic disturbances in carbohydrates (fructose, mannose, galactose, glycolysis/gluconeogenesis), lipids (inositol phosphate), and amino acids (arginine, proline, cysteine, methionine, valine, leucine, and isoleucine) metabolism, including 20 differential metabolites in the serum and six in the urine. After exercise, the glycemic results showed insignificant changes. However, patients who practiced Tai Chi showed significant improvements in their post-treatment metabolic profiles compared to baseline, with nine serum and six urine metabolites, including branch-chained amino acids (BCAAs); while those in the walking group had significantly altered nine serum and four urine metabolites concerning steroid hormone biosynthesis and arachidonic acid metabolism compared to baseline. CONCLUSION T2DM patients displayed impaired carbohydrate, lipid, and amino acid metabolism, and exercise therapy improved their metabolic health. Different modalities may act through different pathways. Tai Chi may improve disrupted BCAAs metabolism, whereas brisk walking mainly regulates steroid hormone biosynthesis and arachidonic acid metabolism.
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Affiliation(s)
- Furong Zhang
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xixi Chen
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Mingxiao Yang
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Xiaoyu Shen
- Second Affiliated Hospital of Chengdu Medical College/Nuclear Industry 416 Hospital, Chengdu, Sichuan, China
| | - Yiliang Wang
- Chongqing University Three Gorges Hospital, Chongqing, China
| | - Dongling Zhong
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Fang Zeng
- College of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Rongjiang Jin
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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Qiao H, Hao X, Wang G. Effects of mind-body exercise on knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. BMC Musculoskelet Disord 2024; 25:229. [PMID: 38515124 PMCID: PMC10958976 DOI: 10.1186/s12891-024-07278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 02/13/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE To evaluate the effect of mind-body exercise on improving knee osteoarthritis (KOA) and thereby informing osteoarthritis exercise rehabilitation. METHODS The China National Knowledge Infrastructure (CNKI), Wanfang, PubMed/Medline, Cochrane Library, Web of Science, EBSCO, Embase, Scopus, and ProQuest databases were searched to identify randomized controlled trials (RCTs) that involved tai chi, yoga, and baduanjin interventions for KOA. The search period ranged from inception to October 25, 2022. The methodological quality of the included studies was evaluated by the Cochrane risk of bias assessment tool, and the included data were statistically analyzed and plotted using Review Manager 5.3 and Stata 14.0 software. RESULTS We included 17 articles with a total of 1122 patients. Compared with the control group, mind-body exercise significantly improved patient pain (standardized mean difference (SMD) = -0.65, 95% confidence interval (CI) [-0.87, -0.42], p < 0.00001), stiffness (SMD = -0.75, 95% CI [-1.05, -0.45], p < 0.00001), physical function (SMD = -0.82, 95% CI [-1.03, -0.62], p < 0.00001), mental health (SMD = 0.31, 95% CI [0.11, 0.51], p = 0.002), and depression (SMD = -0.32, 95% CI [-0.50, -0.15], p = 0.0003). In terms of motor ability, mind-body exercise significantly increased the 6-min walking distance (SMD = 18.45, 95% CI [5.80, 31.10], p = 0.004) and decreased timed up and go test time (SMD = -1.15, 95% CI [-1.71, -0.59], p < 0.0001). CONCLUSIONS The current study showed that mind-body exercise is safe and effective for KOA patients. However, given the methodological limitations of the included studies, additional high-quality evidence is needed to support the conclusions of this study.
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Affiliation(s)
- Hujun Qiao
- School of Physical Education, Soochow University, Suzhou, 215021, China.
- Changzhi University, Changzhi, 046000, China.
| | - Xin Hao
- Changzhi University, Changzhi, 046000, China
| | - Guoxiang Wang
- School of Physical Education, Soochow University, Suzhou, 215021, China.
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10
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Zeng Q, Liu X, Li L, Zhang Q, Luo C, Yang S, Wu S, Yang A, Li J. Bibliometric Analysis of Research on Traditional Chinese Exercise and Osteoarthritis. J Pain Res 2024; 17:559-569. [PMID: 38347853 PMCID: PMC10860586 DOI: 10.2147/jpr.s436457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/28/2024] [Indexed: 02/15/2024] Open
Abstract
Background Osteoarthritis (OA) is a common disease in geriatric rehabilitation medicine caused by the progressive destruction of articular cartilage. Traditional Chinese exercise (TCE) is an important component of traditional sports in China and aims to stretch the musculoskeletal tract and relieve joint pain. Bibliometrics can help researchers find suitable partners and understand the research hotspots and trends in a certain field. However, there is still a lack of bibliometric analysis in the field of TCE and OA. Methods All the literature was obtained from the Web of Science Core Collection database. The last search was performed on July 28, 2023. The bibliometric indicators, such as publications, citations, and H-index, were recorded. Bibliometrix and CiteSpace were used for visualization analysis. In addition, randomized controlled trials were included to summarize the exercise prescription of TCE for OA. Results A total of 170 articles were included. The field of OA with TCE had great development potential and was in the rising period. The countries, institutions, and authors with the most publications were the United States, Tufts Medical Center, and Harvey WF, respectively. The most popular journal was Osteoarthritis and Cartilage. The recent burst keywords in this field were mainly "hip", "pilot", and "risk". Tai Chi was the most studied TCE with the most detailed content of exercise prescription, followed by Baduanjin and Wuqinxi. Conclusion Our study provides a basis for researchers in this field to choose appropriate partner and academic journals. Moreover, pain, muscle strength, and quality of life management of elderly OA patients are research hotspots in this field. The intervention of hip OA risk through TCE is expected to become a research direction for emerging teams. The TCE prescription we summarized can better provide researchers with more treatment details.
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Affiliation(s)
- Qiu Zeng
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Xiaoyi Liu
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Lina Li
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Qin Zhang
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Chengping Luo
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Shu Yang
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Shuqiang Wu
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - An Yang
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
| | - Jie Li
- Department of Rehabilitation Medicine, The Sixth People’s Hospital of Yibin, Yibin, Sichuan, People’s Republic of China
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Bao Y, Liang Q, Ji J, Cheng C, Dong C, Zhao R. Effects of exercise on depression in patients with rheumatic diseases: a systematic review and meta-analysis. Z Rheumatol 2024; 83:40-47. [PMID: 37079036 DOI: 10.1007/s00393-023-01321-w] [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] [Accepted: 01/07/2023] [Indexed: 04/21/2023]
Abstract
OBJECTIVE To assess the effects of exercise intervention on depression in rheumatic diseases by means of a meta-analysis. METHODS The Cochrane Library, Embase, Medline, PubMed, and relevant records were searched. The qualities of randomized controlled trials were evaluated. Meta-analysis of the obtained related data was completed using RevMan 5.3. Heterogeneity was also evaluated with χ2 test and I2. RESULTS Twelve RCTs were reviewed. Compared with baseline, the meta-analysis results showed that there was significant difference in the improvement of depression assessed by HADs, BDI, CES‑D, and AIMS in patients with rheumatic diseases (post exercise vs. baseline, -0.73 [-1.05, -0.4], P < 0.0001, I2 = 0%). In subgroup analysis, although none of these trends in BDI and CES‑D subgroups were significant at P < 0.05, there were clear trends towards improvement in depression. CONCLUSION As an alternative or supplementary treatment, the effect of exercise on rheumatism is obvious. Rheumatologists can consider exercise as an integral part of the treatment of patients with rheumatism.
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Affiliation(s)
- Yanfeng Bao
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Qian Liang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
- Medical College, Nantong University, 226001, Nantong, China
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China
| | - Juan Ji
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China
| | - Chun Cheng
- Nanjing University of Traditional Chinese Medicine, 210023, Nanjing, China
| | - Chen Dong
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Medical College, Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
| | - Rui Zhao
- Department of Rheumatology, Affiliated Hospital of Nantong University, 226001, Nantong, China.
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, China.
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12
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Zhang F, Chen X, Liu X, Shen X, Liu T, Zeng F, Jin R. Lifestyle intervention Tai Chi for adult patients with type 2 diabetes mellitus: a PRIO-harms based overview of 17 systematic reviews. Front Endocrinol (Lausanne) 2024; 14:1208202. [PMID: 38298189 PMCID: PMC10829778 DOI: 10.3389/fendo.2023.1208202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/06/2023] [Indexed: 02/02/2024] Open
Abstract
Objective To systematically summarize current evidence and determine the clinical effectiveness and safety of Tai Chi for type 2 diabetes mellitus (T2DM) in adults by conducting an overview of systematic reviews (SRs). Methods A systematic search encompassing five electronic databases was conducted until July 30, 2023, to identify relevant systematic reviews (SRs) based on randomized controlled trials (RCTs) concerning Tai Chi for T2DM. The methodological quality of the included SRs was assessed using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2) and the Risk of Bias in Systematic Reviews (ROBIS) tool. The Preferred Reporting Items for Overview of Systematic Review (PRIO-harms) checklist was used to promote a more balanced reporting of benefits and harms in this overview. Corrected covered area (CCA) was used to calculate the degree of overlapping primary studies. Primary outcome measures were glycosylated hemoglobin (HbA1c) and fasting blood glucose (FBG), while secondary outcomes encompassed health-related quality measures. The GRADE (Grades of Recommendations, Assessment, Development, and Evaluation) framework was utilized to assess the quality of evidence for the outcome measures. Results A total of 17 eligible SRs were included in this overview. One SR reported negative conclusions, while the remaining 16 reported positive ones on different outcomes. A total of 4 SRs reported adverse events, either absent or minor. Most of the SRs exhibited critically low quality (15/17) and a high risk of bias (14/17), as indicated by AMSTAR2 and ROBIS, respectively. The CCA was 12.14%, indicating a high degree of primary study overlapping. Evidence from 135 results for 24 outcomes concerning Tai Chi for T2DM was evaluated using the GRADE approach, most of which were rated very low. Conclusion Tai Chi shows promise as a potentially effective and safe lifestyle intervention for adults with T2DM, particularly in improving HbA1c, FBG, BMI, and overall quality of life (QoL). However, these results should be cautiously interpreted due to methodological flaws observed in the current SRs and the low quality of the SRs based on GRADE. Furthermore, there is a compelling need for additional well-designed, high-quality RCTs and SRs to establish robust and conclusive evidence regarding the efficacy of Tai Chi for managing T2DM in the future. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42019140988.
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Affiliation(s)
- Furong Zhang
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xixi Chen
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xicen Liu
- Rehabilitation Department, Chengdu Second People’s Hospital, Chengdu, China
| | - Xiaoyu Shen
- Rehabilitation Department, Nuclear Industry 416 Hospital, Chengdu, China
| | - Tianyu Liu
- College of Sports and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Fang Zeng
- Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rongjiang Jin
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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13
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Tan B, Yan Y, Zhou Q, Ran Q, Chen H, Sun S, Lu W, Chen W, Wang J. Kinesitherapy for Knee Osteoarthritis Patients Physical and Psychological Health Based on "Traditional Chinese Exercise" Management Modalities: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Orthop Surg 2024; 16:3-16. [PMID: 38018392 PMCID: PMC10782256 DOI: 10.1111/os.13920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/07/2023] [Accepted: 09/13/2023] [Indexed: 11/30/2023] Open
Abstract
Traditional Chinese exercise ("TCE" management modalities), including but not limited to Tai Chi, Baduanjin, and Yijinjing, has a good effect on improving the physical function of patients with knee osteoarthritis, but less attention has been paid to the impact on the psychological health of patients, and currently there is insufficient evidence to support it. We conducted this study to provide a systematic synthesis of best evidence regarding the physical and mental health of patients with knee osteoarthritis treated by traditional Chinese exercise. Literature on the effectiveness of traditional Chinese exercise (Tai Chi, Baduanjin, Yijinjing, Qigong, etc.) versus conventional therapy (muscle-strength training of the lower extremity and aerobic training, wellness education, quadriceps strengthening exercises, etc.) on Western Ontario and McMaster Universities Arthritis Index (WOMAC), visual analog scale (VAS), Short Form-36 (SF-36), Timed Up and Go Test (TUG), and Berg Balance Scale (BBS) in knee osteoarthritis (KOA) from Pubmed, Web of Science, Ovid Technologies, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang Database, and SinoMed were collected from their inception to April 2022. Thirty-three studies with 2621 cases were included in this study. The study's results indicated that compared with conventional therapy, traditional Chinese exercise had more advantages on patients' WOMAC score, significantly reducing patients' overall WOMAC score (SMD = -0.99; 95% CI: -1.38, -0.60; p < 0.00001) and relieving pain (SMD = -0.76; 95% CI: -1.11, -0.40; p < 0.0001) in patients with KOA. It also has advantages over conventional therapy in improving mental component score (MCS) (SMD = 0.32; 95% CI: -0.00, 0.65; p = 0.05) and physical component score (PCS) (SMD = 0.34; 95% CI: 0.05, 0.62; p = 0.02). Compared with conventional therapy, traditional Chinese exercise can significantly reduce the effect on timed up and go test (TUG) score (SMD = -0.30; 95% CI: -0.50, -0.11; p = 0.002), beck depression inventory (DBI) score (SMD = -0.62; 95% CI: -1.03, -0.22; p = 0.002), and increase the impact on Berg Balance Scale (BBS) score (SMD = 0.60; 95% CI: 0.37, 0.83; p < 0.00001). The findings of this study indicated that traditional Chinese exercise improved body function and mental health in patients with knee osteoarthritis significantly. More high-quality clinical evidence-based data was needed to confirm the therapeutic effect of traditional Chinese exercise on the physical and mental health in KOA patients.
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Affiliation(s)
- Biao Tan
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Yan Yan
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Qiujun Zhou
- Department of First Clinical Medical CollegeZhejiang Chinese Medical UniversityHangzhouChina
| | - Qiang Ran
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Hong Chen
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Shiyi Sun
- Department of OrthopaedicsChina Academy of Chinese Medical Sciences, Wangjing HospitalBeijingChina
| | - Weizhong Lu
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
| | - Weiheng Chen
- The Third Affiliated Hospital of Beijing University of Chinese MedicineBeijingChina
| | - Jiajun Wang
- Department of OrthopaedicsChongqing Hospital Of Traditional Chinese MedicineChongqingChina
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Liu J, Liu W, Huang J, Wang Y, Zhao B, Zeng P, Cai G, Chen R, Hu K, Tu Y, Lin M, Kong J, Tao J, Chen L. The modulation effects of the mind-body and physical exercises on the basolateral amygdala-temporal pole pathway on individuals with knee osteoarthritis. Int J Clin Health Psychol 2024; 24:100421. [PMID: 38077287 PMCID: PMC10709058 DOI: 10.1016/j.ijchp.2023.100421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 10/30/2023] [Indexed: 02/12/2024] Open
Abstract
Background/Objective To investigate the modulatory effects of different physical exercise modalities on connectivity of amygdala subregions and its association with pain symptoms in patients with knee osteoarthritis (KOA). Methods 140 patients with KOA were randomly allocated either to the Tai Chi, Baduanjin, Stationary cycling, or health education group and conducted a 12 week-long intervention in one of the four groups. The behavioral, magnetic resonance imaging (MRI), and blood data were collected at baseline and the end of the study. Results Compared to the control group, all physical exercise modalities lead to significant increases in Knee Injury and Osteoarthritis Outcome Score (KOOS) pain score (pain relief) and serum Programmed Death-1 (PD-1) levels. Additionally, all physical exercise modalities resulted in decreased resting state functional connectivity (rsFC) of the basolateral amygdala (BA)-temporal pole and BA-medial prefrontal cortex (mPFC). The overlapping BA-temporal pole rsFC observed in both Tai Chi and Baduanjin groups was significantly associated with pain relief, while the BA-mPFC rsFC was significantly associated with PD-1 levels. In addition, we found increased fractional anisotropy (FA) values, a measurement of water diffusion anisotropy of tissue that responded to changes in brain microstructure, within the mind-body exercise groups' BA-temporal pole pathway. The average FA value of this pathway was positively correlated with KOOS pain score at baseline across all subjects. Conclusions Our findings suggest that physical exercise has the potential to modulate both functional and anatomical connectivity of the amygdala subregions, indicating a possible shared pathway for various physical exercise modalities.
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Affiliation(s)
- Jiao Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, United States
| | - Weilin Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
| | - Jia Huang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Yajun Wang
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Baoru Zhao
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Peiling Zeng
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Guiyan Cai
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Ruilin Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Kun Hu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - YouXue Tu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Meiqin Lin
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, United States
| | - Jing Tao
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese, China
| | - Lidian Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, China
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese, China
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15
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Sattler L, Kan A, Hing W, Vertullo C. The addition of structured lifestyle modifications to a traditional exercise program for the management of patients with knee osteoarthritis: A systematic review and meta-analysis of randomised trials. Musculoskelet Sci Pract 2023; 68:102858. [PMID: 37793243 DOI: 10.1016/j.msksp.2023.102858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/02/2023] [Accepted: 09/12/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Guidelines recommend exercise for the management of knee osteoarthritis (OA), however, recently it has been suggested that including additional lifestyle modifications with a traditional exercise program may elicit greater benefits than exercise alone. OBJECTIVES To investigate the influence of the addition of lifestyle modifications to a traditional exercise program, with respect to functional outcomes and quality of life among individuals with knee OA. DESIGN Systematic review and meta-analysis. METHODS Four databases were searched to identify randomised controlled trials comparing an exercise program, which included the addition of lifestyle modifications, to an exercise program alone in individuals with knee OA. Methodological quality of included studies was assessed via the PEDro scale. Results synthesis through meta-analysis using a random effects model was conducted to determine the pooled effect on eligible outcomes and a GRADE approach was utilised to rate the certainty of evidence. RESULTS Meta-analysis of seven studies showed the inclusion of lifestyle modifications to an exercise program can further decrease pain intensity (SMD -0.68 [95% CI -1.26 to -0.10]), improve joint stiffness (MD -0.69 [95% CI -1.21, -0.17]) and increase physical function (MD -1.26 s ([95% CI -1.34, -1.17]) at six-months. Individual results showed improvements in quality of life with the addition of lifestyle modifications, however, this was not demonstrated through meta-analysis. CONCLUSION This systematic review supports the inclusion of additional lifestyle modifications to a traditional exercise program, for pain intensity, joint stiffness and physical function for individuals with knee OA. TRIAL REGISTRATION PROSPERO registration number: CRD42021279594.
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Affiliation(s)
- Larissa Sattler
- Institution: Bond University, Bond Institute of Health and Sport, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Adrian Kan
- Institution: Bond University, Bond Institute of Health and Sport, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Wayne Hing
- Institution: Bond University, Bond Institute of Health and Sport, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Christopher Vertullo
- Institution: Knee Research Australia, 8-10 Carrara Street, Benowa, QLD, 4217, Australia.
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16
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Liu H, Gong H, Chen P, Zhang L, Cen H, Fan Y. Biomechanical effects of typical lower limb movements of Chen-style Tai Chi on knee joint. Med Biol Eng Comput 2023; 61:3087-3101. [PMID: 37624535 DOI: 10.1007/s11517-023-02906-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
The load and stress distribution on cartilage and meniscus of the knee joint in typical lower limb movements of Chen-style Tai Chi (TC) and deep squat (DS) were analyzed using finite element (FE) analysis. The loadings for this analysis consisted of muscle forces and ground reaction force (GRF), which were calculated through the inverse dynamic approach based on kinematics and force plate measurements obtained from motion capture experiments. Thirteen experienced practitioners performed four typical TC movements, namely, single whip (SW), brush knee and twist step (BKTS), stretch down (SD), and part the wild horse's mane (PWHM), which exhibit lower posture and greater lower limb force compared to other TC styles. The results indicated that TC required greater lower limb muscle strength than DS, resulting in greater knee joint forces. The stress on the medial cartilage in SW and BKTS fell within a range conductive to maintaining the balance between anabolism and catabolism of cartilage matrix. This was due to the fact that SW and BKTS reduce the medial to total tibiofemoral contact force ratios through knee abduction, which may effectively alleviate mild medial knee osteoarthritis (KOA). However, the greater medial contact force ratios observed in SD and PWHM resulted in great contact stresses that may aggravate the pain of patients with KOA. To mitigate these effects, practitioners should consider elevating their postures appropriately to reduce knee flexion angles, especially during the single-leg support phase. This adjustment can decrease the required muscle strength, load and stress on the knee joint.
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Affiliation(s)
- Haibo Liu
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - He Gong
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China.
| | - Peng Chen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Le Zhang
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Haipeng Cen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
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17
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Marriott KA, Birmingham TB. Fundamentals of osteoarthritis. Rehabilitation: Exercise, diet, biomechanics, and physical therapist-delivered interventions. Osteoarthritis Cartilage 2023; 31:1312-1326. [PMID: 37423596 DOI: 10.1016/j.joca.2023.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 06/02/2023] [Accepted: 06/05/2023] [Indexed: 07/11/2023]
Abstract
Insights related to the pathogenesis of osteoarthritis (OA) have informed rehabilitative treatments that aim to mitigate the influence of several known impairments and risk factors for OA, with the goal to improve pain, function, and quality of life. The purpose of this invited narrative review is to provide fundamental knowledge to non-specialists about exercise and education, diet, biomechanical interventions, and other physical therapist-delivered treatments. In addition to summarizing the rationale for common rehabilitative therapies, we provide a synthesis of current core recommendations. Robust evidence based on randomized clinical trials supports exercise with education and diet as core treatments for OA. Structured, supervised exercise therapy is advised. The mode of exercise may vary but should be individualized. The dose should be based on an initial assessment, the desired physiological changes, and progressed when appropriate. Diet combined with exercise is strongly recommended and studies demonstrate a dose-response relationship between the magnitude of weight loss and symptom improvement. Recent evidence suggests the use of technology to remotely deliver exercise, diet and education interventions is cost-effective. Although several studies support the mechanisms for biomechanical interventions (e.g., bracing, shoe inserts) and physical therapist-delivered (passive) treatments (e.g., manual therapy, electrotherapeutic modalities) fewer rigorous randomized trials support their clinical use; these therapies are sometimes recommended as adjuncts to core treatments. The mechanisms of action for all rehabilitative interventions include contextual factors such as attention and placebo effects. These effects can challenge our interpretation of treatment efficacy from clinical trials, yet also provide opportunities to maximize patient outcomes in clinical practice. When evaluating rehabilitative interventions, the field may benefit from increased emphasis on research that considers contextual factors while evaluating mechanistic, longer-term, clinically-important and policy-relevant outcome measures.
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Affiliation(s)
- Kendal A Marriott
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
| | - Trevor B Birmingham
- School of Physical Therapy, Faculty of Health Sciences, Bone and Joint Institute, University of Western Ontario, London, Ontario, Canada.
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18
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Zhang N, Cui H, Li H, Yang Y, Gao Z, Zeng X, Sun X, Bu H, Wang H. Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses. Complement Ther Med 2023; 77:102978. [PMID: 37634763 DOI: 10.1016/j.ctim.2023.102978] [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: 03/08/2023] [Revised: 06/13/2023] [Accepted: 08/24/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE Tai Chi (TC) is a complementary therapy for knee osteoarthritis (KOA). Although systematic reviews (SRs) and meta-analyses (Mas) of efficacy studies have been published, the results remain uncertain, and their quality has not yet been fully evaluated. Here, we summarize the existing SRs/Mas, evaluate their quality and level of evidence, and provide a reference for the effectiveness of TC. METHODS SRs/Mas of TC therapy for KOA published before February 2023 were retrieved from eight databases in Chinese and English. The Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020, and the Risk of Bias in Systematic (ROBIS) scale were used to assess methodological quality, reporting quality, and risk of bias. RESULTS Seven SRs/Mas were finally included. One was deemed high quality by AMASTAR-2, while the rest were of critically low quality. In the PRISMA2020 assessment, the response rate of "Yes" for Q7, Q15, Q22, Q24, and Q27 was less than 50%. In the ROBIS assessment, three reports in Phase 3 were high risk and four were low risk. In the efficacy assessment, TC has shown varying degrees of improvement in physical function, pain, stiffness, 6-minute walk test, mental quality of life, TUG, and balance in patients with KOA. CONCLUSION TC effectively treats KOA-associated pain, stiffness, body function, and mental quality of life. However, the low methodological quality of the studies and the high risk of migration reduced their reliability. Therefore, these conclusions should be taken with caution. High-quality, large-sample research is needed to provide stronger and more scientific evidence.
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Affiliation(s)
- Naijin Zhang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huaixing Cui
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongyu Li
- Department of Orthopedics, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Heilongjiang, China
| | - Yuhang Yang
- Department of Orthopedics, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Zhuo Gao
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xianyue Zeng
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xuan Sun
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Huaien Bu
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongwu Wang
- School of Public Health, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
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Salami AA, Kanmodi KK, Leuke Bandara D, Aladelusi TO, Amzat J, Lin D, Ojo TO, Jayasinghe RD. The use of Qigong and Tai Chi in the management of temporomandibular joint dysfunction: A systematic review. Health Sci Rep 2023; 6:e1639. [PMID: 37877129 PMCID: PMC10591026 DOI: 10.1002/hsr2.1639] [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: 04/25/2023] [Revised: 09/15/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
Background and Aims Qigong and Tai Chi (QTC) are mind-body exercises involving a sequence of graceful movements, which promote self-healing, meditation, and self-cultivation. There is growing evidence that Qigong and/or Tai Chi therapy may improve the physical and psychological health among adults with multiple health conditions including joint movement. This systematic review aims to synthesize the available evidence on the type and effectiveness of QTC therapies used in the management of temporomandibular joint (TMJ) dysfunction. Methods This systematic review followed the AMSTAR-2 guideline, and it was reported based on guidelines in the PRISMA checklist. The review involved a systematic search of nine electronic databases. After deduplication and screening of the literature retrieved from the search, only one article was included based on the review's inclusion criteria. Data was extracted from this article and synthesized. Results The only included article was on a non-randomized control trial which investigated the role of Tai Chi Qigong (a form of Qigong) therapy in improving joint mobility and alleviating trismus among 52 survivors of nasopharyngeal carcinoma who had TMJ disorders. The study reported, at different time intervals (at pretest; at mid-intervention; at posttest; and at follow-up posttest), that no significant difference (p > 0.05) was observed concerning mouth opening capacity between the intervention group and the control group. However, over time, less severe deterioration in mouth-opening was noted among the participants in the intervention group (p = 0.181) as compared to the control group (p < 0.001). Conclusion The role of QTC therapies in improving joint mobility and alleviating trismus is not yet fully understood, but it seems promising. The available evidence is inadequate to categorically conclude on the efficacy of these therapies. Further studies will be required to fully assess the effectiveness of QTC therapies in the management of TMJ dysfunction.
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Affiliation(s)
- Afeez A. Salami
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Kehinde K. Kanmodi
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of DentistryUniversity of RwandaKigaliRwanda
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Dhanushka Leuke Bandara
- Department of Oral Medicine & Periodontology, Faculty of Dental SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
| | - Timothy O. Aladelusi
- Department of Oral and Maxillofacial SurgeryUniversity College HospitalIbadanNigeria
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
- Department of SociologyUniversity of JohannesburgJohannesburgSouth Africa
| | - Dan Lin
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Temitope O. Ojo
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Ruwan D. Jayasinghe
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
- Department of Oral Medicine & Periodontology, Faculty of Dental SciencesUniversity of PeradeniyaPeradeniyaSri Lanka
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20
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Yue H, Li Y, Ma J, Xie C, Xie F, Cai J, Fang M, Yao F. Effect of Tai Chi on knee pain and muscle strength in middle-aged and older adults with knee osteoarthritis: a randomized controlled trial protocol. BMC Complement Med Ther 2023; 23:256. [PMID: 37474949 PMCID: PMC10360298 DOI: 10.1186/s12906-023-04070-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a common public health problem and a leading cause of long-term pain, decreased muscle strength, and even disability. Tai Chi has been proved effective and highly recommended for KOA management worldwide. However, little is known about its benefits on quadriceps strength which is closely associated with relieving knee pain. This trial is designed to evaluate the efficacy and safety of Tai Chi on knee pain and muscle strength in middle-aged and older adults with KOA. METHODS A total of 100 participants will be randomly divided into a Tai Chi group (TC group) (1x/week for 12 weeks) and a control group with a health education and stretching program (1x/week for 12 weeks) with a follow-up period of 6 weeks. The primary outcome is the change of Western Ontario and McMaster Universities (WOMAC) pain subscale at week 12 compared with baseline. Secondary outcomes include WOMAC stiffness and function subscales, data from isokinetic dynamometry, gait analysis with electromyography (EMG), and a 36-item short form health survey (SF-36). The daily dose of pain-relieving medication will also be recorded. All adverse effects will be assessed by the Treatment Emergent Symptom Scale (TESS). DISCUSSION We expect this randomized trial to evaluate the effectiveness of Tai Chi on relieving pain and increasing quadriceps strength in KOA patients. This protocol, if proven effective, will contribute to providing a promising alternative intervention for middle-aged and older adults with KOA. TRIALS REGISTRATION NUMBER This trial has been registered in the China Clinical Trials Registry (registration number: ChiCTR2300069339).
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Affiliation(s)
- Hongyu Yue
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yang Li
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianwen Ma
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chaoqun Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Xie
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junhao Cai
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Fei Yao
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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21
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Zhang S, Huang R, Guo G, Kong L, Li J, Zhu Q, Fang M. Efficacy of traditional Chinese exercise for the treatment of pain and disability on knee osteoarthritis patients: a systematic review and meta-analysis of randomized controlled trials. Front Public Health 2023; 11:1168167. [PMID: 37361162 PMCID: PMC10285305 DOI: 10.3389/fpubh.2023.1168167] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/12/2023] [Indexed: 06/28/2023] Open
Abstract
Objective To evaluate the efficacy of Traditional Chinese Exercises (TCEs) in treating knee osteoarthritis (KOA). Methods Four databases without language or publication status restrictions were searched until April 1, 2022. Based on the principle of Population, Intervention, Comparison, Outcomes and Study design, the researchers searched for randomized controlled trials of TCEs in treating KOA. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain was defined as the primary outcome, whereas stiffness and physical function were the secondary outcomes. Subsequently, two researchers conducted the process independently, and the data were analyzed using the RevManV.5.3 software. Results Overall, 17 randomized trials involving 1174 participants met the inclusion criteria. The synthesized data of TCEs showed a significant improvement in WOMAC pain score [standardized mean difference (SMD) = -0.31; 95% confidence interval (CI): -0.52 to -0.10; p = 0.004], stiffness score (SMD = -0.63; 95% CI: -1.01 to -0.25; p = 0.001) and physical function score (SMD = -0.38; 95% CI: -0.61 to -0.15; p = 0.001) compared with the control group. Sensitivity analyses were performed to determine the combined results' stability, which was unstable after excluding articles with greater heterogeneity. A further subgroup analysis showed that it might be the reason for the heterogeneity of the different traditional exercise intervention methods. Additionally, it showed that the Taijiquan group improved pain (SMD = 0.74; 95% CI: -1.09 to 0.38; p < 0.0001; I2 = 50%), stiffness (SMD = -0.67; 95% CI -1.14 to 0.20; p = 0.005) and physical function score (SMD = -0.35; 95% CI: -0.54 to 0.16; p = 0.0003; I2 = 0%) better than the control group. The Baduanjin group improved stiffness (SMD = -1.30; 95% CI: -2.32 to 0.28; p = 0.01) and physical function (SMD = -0.52; 95% CI: -0.97 to 0.07; p = 0.02) better than the control group. However, the other interventions showed no difference compared with the control group. Conclusion This systematic review provides partial evidence of the benefits of TCEs for knee pain and dysfunction. However, due to the heterogeneity of exercise, more high-quality clinical studies should be conducted to verify the efficacy. Systematic review registration https://inplasy.com/inplasy-2022-4-0154/, identifier: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) [INPLSY202240154].
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Affiliation(s)
- Shuaipan Zhang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruixin Huang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Guangxin Guo
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai, China
- School of Acupuncture-Moxibustion and Tuina, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Jianhua Li
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qingguang Zhu
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Tuina Department, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
- Tuina Department, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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22
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Li C, Wei P, Wang L, Wang Q, Wang H, Zhang Y. Integrated Analysis of Transcriptome Changes in Osteoarthritis: Gene Expression, Pathways and Alternative Splicing. Cartilage 2023; 14:235-246. [PMID: 36799242 PMCID: PMC10416206 DOI: 10.1177/19476035231154511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Osteoarthritis (OA) is the most prevalent joint disease characterized by the degeneration of articular cartilage and the remodeling of its underlying bones, resulting in pain and loss of function in the knees and hips. As far as we know, no curative treatments are available except for the joint replacement. The precise molecular mechanisms which are involved in the degradation of cartilage matrix and development of osteoarthritis are still unclear. DESIGN By analyzing RNA-seq data, we found the molecular changes at the transcriptome level such as alternative splicing, gene expression, and molecular pathways in OA knees cartilage. RESULTS Expression analysis have identified 457 differential expressed genes including 266 up-regulated genes such as TNFSF15, ST6GALNAC5, TGFBI, ASPM, and TYM, and 191 down-regulated genes such as ADM, JUN, IRE2, PIGA, and MAFF. Gene set enrichment analysis (GSEA) analysis identified down-regulated pathways related to translation, transcription, immunity, PI3K/AKT, and circadian as well as disturbed pathways related to extracellular matrix and collagen. Splicing analysis identified 442 differential alternative splicing events within 284 genes in osteoarthritis, including genes involved in extracellular matrix (ECM) and alternative splicing, and TIA1 was identified as a key regulator of these splicing events. CONCLUSIONS These findings provide insights into disease etiology, and offer favorable information to support the development of more effective interventions in response to the global clinical challenge of osteoarthritis.
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Affiliation(s)
- Congming Li
- Department of Orthopedic Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Pengli Wei
- Department of Emergency, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Lei Wang
- Department of Orthopedic Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Qiang Wang
- Department of Orthopedic Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Hong Wang
- Department of Orthopedic Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, P.R. China
| | - Yangjun Zhang
- Department of Biological Repositories, Zhongnan Hospital of Wuhan University, Wuhan, P.R. China
- Cancer Precision Diagnosis and Treatment and Translational Medicine Hubei Engineering Research Center, Zhongnan Hospital of Wuhan University, Wuhan, P.R. China
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23
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Guan C, Gu Y, Cheng Z, Xie F, Yao F. Global trends of traditional Chinese exercises for musculoskeletal disorders treatment research from 2000 to 2022: A bibliometric analysis. Front Neurosci 2023; 17:1096789. [PMID: 36845420 PMCID: PMC9950260 DOI: 10.3389/fnins.2023.1096789] [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: 11/12/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Background Traditional Chinese exercise has been shown to be effective in relieving long-term chronic pain, physical dysfunction, decreased ability to participate in society and decreased quality of life in musculoskeletal diseases. In recent years, there has been a steady increase in publications on the treatment of musculoskeletal disorders by traditional Chinese exercises. The purpose of this study is to review the characteristics and trends of Chinese traditional exercise studies on musculoskeletal diseases published since 2000 through bibliometric analysis, and identify current research hotspots, so as to guide the direction of future research. Methods Publications regarding traditional Chinese exercises for musculoskeletal disorders from 2000 to 2022 were downloaded from the Web of Science Core Collection. VOSviewer 1.6.18 and CiteSpace V software were used for bibliometric analyses. Bibliometric visualization and comparative analysis were conducted for authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords. Results A total of 432 articles were obtained, with an upward trend over time. The most productive countries and institutions in this field are the USA (183) and Harvard University (70). Evidence-based Complementary and Alternative Medicine (20) was the most prolific journal, Cochrane Database System Review (758) was the most commonly cited journal. Wang Chenchen published the largest number of articles (18). According to high frequency keywords, the hot spot musculoskeletal disorder and the type of traditional Chinese exercise are knee osteoarthritis and Tai Chi. Conclusion This study provides a scientific perspective for the research of traditional Chinese exercises for musculoskeletal disorders and provides valuable information for researchers to discover the current research status, hot spots and new trends of future research.
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Affiliation(s)
| | | | - Ziji Cheng
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Xie
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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24
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Niles BL, Grossman S, McQuade M, Grossman D, Kaiser AP, Muccio B, Warner B, Wang C, Mori DL. Study protocol for a revised randomized trial: Remotely delivered Tai Chi and wellness for Gulf War illness. Contemp Clin Trials 2023; 125:107045. [PMID: 36494045 PMCID: PMC9918688 DOI: 10.1016/j.cct.2022.107045] [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: 09/30/2022] [Revised: 12/02/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Many of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991 have since reported health symptoms of unknown etiology. This cluster of symptoms has been labeled Gulf War Illness and include chronic musculoskeletal pain, fatigue, headaches, memory and attention difficulties, gastrointestinal complaints, skin abnormalities, breathing problems, and mood and sleep problems [1,2]. There have been few high-quality intervention trials and no strong evidence to support available treatments [3]. Tai Chi is an ancient Chinese martial art with benefits that include enhancing physical and mental health and improving quality of life for those with chronic conditions. PROPOSED METHODS In this randomized controlled trial, GW Veterans are randomly assigned to either Tai Chi or a Wellness control condition, with both remotely delivered intervention groups meeting twice a week for 12 weeks. The primary aim is to examine if Tai Chi is associated with greater improvements in GWI symptoms in Veterans with GWI compared to a Wellness intervention. Participants will receive assessments at baseline, 12 weeks (post-intervention), and follow-up assessments 3- and 9-months post-intervention. The primary outcome measure is the Brief Pain Inventory that examines pain intensity and pain interference. CONCLUSION This trial will produce valuable results that can have a meaningful impact on healthcare practices for GWI. If proven as a helpful treatment for individuals with GWI, it would support the implementation of remotely delivered Tai Chi classes that Veterans can access from their own homes.
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Affiliation(s)
- Barbara L Niles
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America.
| | - Stephanie Grossman
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America
| | - Maria McQuade
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America
| | - Daniel Grossman
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America
| | - Anica Pless Kaiser
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America
| | - Brian Muccio
- Body Movement Solutions, 2700 N. Highway A1A, 2-101, Indialantic, FL 32903, United States of America
| | - Ben Warner
- Yang Martial Arts Association Boston, 756 South Street, Roslindale, MA, 02131, United States of America
| | - Chenchen Wang
- Center for Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States of America
| | - DeAnna L Mori
- VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, United States of America
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25
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Wu H, Wang Q, Wen G, Wu J, Wang Y. The effects of Tai Chi on physical function and safety in patients with rheumatoid arthritis: A systematic review and meta-analysis. Front Physiol 2023; 14:1079841. [PMID: 36776976 PMCID: PMC9909273 DOI: 10.3389/fphys.2023.1079841] [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: 10/25/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease that results in the destruction of joints, connective tissues, muscle, tendons and fibrous tissue. Until now, there are no cure therapies. Objective: We aimed to assess the effectiveness of Tai Chi (TC) on RA patients by meta-analysis. Methods: The PubMed, Cochrane Library, EMBASE, web of science, China National Knowledge Infrastructure and Google Scholar were searched up to January 2023. We included randomized controlled trials (RCTs) or controlled clinical trials (CCTs) comparing TC to control conditions for RA patients. Review Manager (Version 5.3) software was used to analyze outcomes of time to walk 50 feet, joint tenderness, number of swollen joints or tender joints, handgrip strength, pain, the Health Assessment Questionnaire (HAQ) and withdraws overall. Results: A total of 351 patients with RA from six RCTs and three CCTs were included for meta-analysis. TC could also significantly decrease withdrawals overall in studies (OR = 0.28, 95% CI 0.12 to 0.67, p = 0.002). No significant treatment effects of physical function were identified of the other outcomes. Conclusion: Our findings indicated that TC was safe to RA patients, but it cannot improve physical function and pain. However, there is still lack of more evidence. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=367498], identifier [CRD42022367498].
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Affiliation(s)
- Haiyang Wu
- Huangpu Branch, Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Qiang Wang
- Shanghai Traditional Chinese Medicine (TCM)—Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Guowei Wen
- Huangpu Branch, Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Junhao Wu
- Huangpu Branch, Shanghai Ninth People’s Hospital affiliated to Shanghai Jiaotong University, Shanghai, China
| | - Yiru Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Abstract
Opioid-induced constipation (OIC) is a common condition in older adults who may not be responsive to traditional laxative therapy. OIC is defined as new or worsening constipation symptoms that occur with initiation of or altering the dose of opioid analgesia. For adult patients with OIC and noncancer pain, we recommend considering nonpharmacologic interventions (eg, dietary measures, increased physical activity, and biofeedback training) and over-the-counter laxatives, followed by prescription opioid receptor antagonists (methylnaltrexone, naloxegol, and naldemedine) if traditional over-the-counter laxatives fail. Other options may include lubiprostone, linaclotide, plecanatide, and prucalopride; however, these are not indicated for OIC specifically or studied in older adults. Because of the complex nature of absorption, distribution, metabolism, and excretion in the aging population, all agents used to treat OIC must be evaluated individually and reevaluated as patients continue to age. This review will serve as a guide to managing OIC in older adults.
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27
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Wang CC, Li K, Gaylord A S. Trends and characteristics of Tai Chi and Qi Gong use among U.S. adults: Results from the 2007-2017 National Health Interview Survey. Complement Ther Med 2022; 71:102890. [PMID: 36162718 DOI: 10.1016/j.ctim.2022.102890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 09/04/2022] [Accepted: 09/22/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To provide updated information about the prevalence, patterns, and predicting factors of Tai Chi and Qigong (TCQ) use among U.S. adults to better inform the future directions of TCQ application and research. METHODS Using 2007, 2012, and 2017 National Health Interview Survey, we examined the trends and characteristics of TCQ use by descriptive analysis, Wald F chi-square test, and multivariable logistic regression models among U.S. adults (n = 85,360), adjusting for the complex sampling design. RESULTS The prevalence use of TCQ among U.S. adults use was 1.17% in 2007, 1.27% in 2012, and 1.70% in 2017, which presents a 64% increase from 2007 to 2017 (p < 0.0001). Correlates of TCQ use are older adults (≥ 65 years old), Asians, having higher education levels, having lower income, and being more physically active (p < 0.001). The greater prevalence of TCQ use in 2017 than in 2012 occurred in some vulnerable demographic subgroups, including older adults, people with income less than $35,000/year, and those who were physically inactive. Those with delayed access to the conventional medical care system (e.g., had difficulty getting through on phone; couldn't get an appointment soon enough; had to wait too long to see doctor;)were also more likely to use TCQ (p < 0.001). CONCLUSIONS The use of TCQ has significantly increased among U.S. adults from 2007 to 2017. Given that the greatest increases in use of TCQ were among older adults, females, low-income individuals, and people who were physically inactive, TCQ may serve as age-appropriate, cost-effective, mind-body exercises for these groups of populations to help ameliorate health disparities.
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Affiliation(s)
- Claudia Chunyun Wang
- School of Physical Education, Pingdingshan University, South Weilai Rd, Pingdingshan City New District, Pingdingshan, Henan Province 467000, People's Republic of China.
| | - Kaigang Li
- Colorado State University, Department of Health & Exercise Science, Fort Collins, CO 80523, USA.
| | - Susan Gaylord A
- University of North Carolina at Chapel Hill, School of Medicine, Department of Physical Medicine & Rehabilitation, Chapel Hill, NC 27516, USA.
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28
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Staller K, Paz M, Rones R, Macklin EA, Garcia-Fischer I, Murray HB, Kuo B. Virtual Tai Chi program for patients with irritable bowel syndrome with constipation: Proof-of-concept feasibility trial. Neurogastroenterol Motil 2022; 34:e14429. [PMID: 35833716 PMCID: PMC11294908 DOI: 10.1111/nmo.14429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/18/2022] [Accepted: 06/18/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Satisfaction with current treatment options for irritable bowel syndrome with constipation (IBS-C) is low, with many patients turning to complementary treatments. Tai Chi is a mind-body medicine practice with proven efficacy in other functional disorders. As a proof-of-concept, we tested the feasibility and preliminary clinical outcomes associated with a Tai Chi program designed for IBS-C. METHODS A total of 27 IBS-C patients participated in a single-arm trial of 8 sessions of Tai Chi delivered weekly over 7 weeks via live videoconferencing in group format. Clinical improvement was assessed via change in IBS Symptom Severity Score (IBS-SSS) from baseline to 4 weeks posttreatment (week 11) with secondary outcomes exploring symptom ratings, IBS-related quality of life (IBS-QOL), GI-specific anxiety, abdominal distention, and psychological factors. KEY RESULTS Despite substantial dropout (n = 7; 26%), the treatment protocol had moderate to excellent feasibility for other criteria. Treatment satisfaction was excellent. Exit interviews confirmed high satisfaction with the program among completers, but a high burden of data collection was noted. One participant experienced an adverse event (mild, exacerbation of sciatica). There was a significant improvement in intra-individual IBS-SSS between baseline and posttreatment (average change -66.5, 95% CI -118.6 to -14.3, p = 0.01). Secondary outcomes were notable for improvements in other IBS symptom scoring measures, IBS-QOL, measured abdominal diameter, and leg strength. CONCLUSIONS AND INFERENCES Our data provide preliminary evidence of the feasibility of a Tai Chi intervention for IBS-C, show promise for improving outcomes, and identify more streamlined data collection as an area for further program improvement.
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Affiliation(s)
- Kyle Staller
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, MA, USA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA, USA
| | - Mary Paz
- Institute of Health Professions, Massachusetts General Hospital, Charlestown, MA, USA
| | - Ramel Rones
- Mind Body Consultant, Tufts Medical Center, Mass General Hospital, Dana Farber Cancer Institute, Boston, MA, USA
| | - Eric A. Macklin
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School Boston, Boston, MA, USA
| | - Isabelle Garcia-Fischer
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, MA, USA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA, USA
| | - Helen Burton Murray
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, MA, USA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA, USA
| | - Braden Kuo
- Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School Boston, MA, USA
- Center for Neurointestinal Health, Massachusetts General Hospital, Boston, MA, USA
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29
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Tuan RS, Zhang Y, Chen L, Guo Q, Yung PSH, Jiang Q, Lai Y, Yu J, Luo J, Xia J, Xu C, Lei G, Su J, Luo X, Zou W, Qu J, Song B, Zhao X, Ouyang H, Li G, Ding C, Wan C, Chan BP, Yang L, Xiao G, Shi D, Xu J, Cheung LWH, Bai X, Xie H, Xu R, Li ZA, Chen D, Qin L. Current progress and trends in musculoskeletal research: Highlights of NSFC-CUHK academic symposium on bone and joint degeneration and regeneration. J Orthop Translat 2022; 37:175-184. [PMID: 36605329 PMCID: PMC9791426 DOI: 10.1016/j.jot.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Rocky S. Tuan
- The Chinese University of Hong Kong, Hong Kong SAR, China
| | | | - Lin Chen
- Daping Hospital, The Third Military (Army) Medical University, China
| | - Quanyi Guo
- Chinese PLA General Hospital, Chinese PLA Medical School, China
| | - Patrick SH. Yung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Qing Jiang
- Nanjing Drum Tower Hospital, Nanjing University, China
| | - Yuxiao Lai
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China
| | - Jiakuo Yu
- Peking University Third Hospital, China
| | - Jian Luo
- School of Medicine, Tongji University, China
| | - Jiang Xia
- Department of Chemistry, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chenjie Xu
- Department of Biomedical Engineering, City University of Hong Kong, Hong Kong SAR, China
| | - Guanghua Lei
- Xiangya Hospital Central South University, China
| | - Jiacan Su
- Changhai Hospital, People's Liberation Army Naval Medical University, China
| | | | - Weiguo Zou
- Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, China
| | - Jing Qu
- Institute of Zoology, Chinese Academy of Sciences, China
| | - Bing Song
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China
| | - Xin Zhao
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Gang Li
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Changhai Ding
- Zhujiang Hospital of Southern Medical University, Menzies Institute of Medical Research, University of Tasmania, Australia
| | - Chao Wan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Barbara P. Chan
- Faculty of Engineering, The University of Hong Kong, Hong Kong SAR, China
| | - Liu Yang
- Institute of Orthopaedics, Xijing Hospital, Air Force Medical University, China
| | - Guozhi Xiao
- Department of Biology, Southern University of Science and Technology, China
| | - Dongquan Shi
- Nanjing Drum Tower Hospital, Nanjing University, China
| | - Jiankun Xu
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Louis WH. Cheung
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Xiaochun Bai
- School of Basic Medical Sciences, Southern Medical University, China
| | - Hui Xie
- Xiangya Hospital Central South University, China
| | - Ren Xu
- State Key Laboratory of Cellular Stress Biology, Xiamen University, China
| | - Zhong Alan Li
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Di Chen
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, China
| | - Ling Qin
- Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR, China
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Dong W, Zhang F, Lian D, Chen X, Zhou H, Gong T, Wang C. Efficacy and safety of tai chi for hyperlipidaemia: a protocol for systematic review and meta-analysis. BMJ Open 2022; 12:e053867. [PMID: 36215161 PMCID: PMC9438025 DOI: 10.1136/bmjopen-2021-053867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION The prevalence of hyperlipidaemia is increasing, and patients with hyperlipidaemia are at increased risk of cardiovascular disease and atherosclerosis. In recent years, there has been a growing number of studies on tai chi for hyperlipidaemia. However, a systematic review on its efficacy and safety is not available. Therefore, this study aims to evaluate the efficacy and safety of tai chi for hyperlipidaemia. METHODS AND ANALYSIS Four English databases and four Chinese databases will be searched from their inception to May 2021: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database and Wanfang Database. Chinese and English randomised controlled trials related to tai chi for hyperlipidaemia will be included. Two reviewers should independently carry out study selection, data extraction and risk assessment of bias. The risk of bias in the study will be assessed by the Cochrane risk of bias tool. RevMan (V.5.4) statistical software will be applied for meta-analysis. The Grading of Recommendations Assessment, Development and Evaluation system approach will be employed to assess the quality of evidence. ETHICS AND DISSEMINATION Ethical approval is not required because this protocol will not involve patients' individual information and jeopardise the rights of patients. The meta-analysis result will be reported in peer-reviewed journals or disseminated at related conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/79D2S.
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Affiliation(s)
- Weitao Dong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Feng Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Daoshi Lian
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Xingliang Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Hongchi Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Tingting Gong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
| | - Chao Wang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine-Shierqiao Campus, Chengdu, Sichuan, China
- Sub-Health Center, Sichuan Integrative Medicine Hospital, Chengdu, China
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Cioroianu GO, Florescu A, Mușetescu AE, Sas TN, Rogoveanu OC. Colchicine versus Physical Therapy in Knee Osteoarthritis. Life (Basel) 2022; 12:life12091297. [PMID: 36143334 PMCID: PMC9500941 DOI: 10.3390/life12091297] [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: 07/17/2022] [Revised: 08/02/2022] [Accepted: 08/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background: The treatment of osteoarthritis remains a major challenge due to the unavailability of a disease-modifying medication and the limitations of current therapeutic perspectives, which mainly target the symptoms, not the disease itself. The purpose of our study is to compare the efficacy of colchicine treatment versus physical therapy. Methods: The study included 62 patients diagnosed with knee osteoarthritis (KOA) according to the American College of Rheumatology (ACR) criteria, hospitalized within the time frame of October 2020−March 2022 in the Department of Rehabilitation Medicine and Physical Therapy of the Emergency Clinical County Hospital of Craiova. The participants were randomly divided into two groups. The observation period was 16 weeks long. The first group (31 patients) received colchicine at a dosage of 1 mg/day together with analgesics (acetaminophen < 2 g/day), while the second group (31 patients) received analgesics (acetaminophen < 2 g/day) together with a 16-week plan of physiotherapy. Results: Group II, in which patients underwent physical therapy, demonstrated a statistically significant decrease in both left (p < 0.001) and right (p = 0.012) knee VAS and WOMAC (p = 0.038) scores at 16 weeks, compared to the group treated with colchicine. Regarding the MSUS examination at 16 weeks, there were no significant changes in the structural abnormalities and no improvement in cartilage aspect or thickness. Higher BMI was associated with higher WOMAC score (p = 0.012), but not with higher VAS score (p = 0.062). Cholesterol and triglyceride levels were associated with high WOMAC (p < 0.001; p = 0.021) and high VAS (p = 0.023; p < 0.001) scores. Conclusions: Our study monitored VAS and WOMAC scores in two groups of patients with KOA, showing that physical therapy is more effective than colchicine in reducing symptoms. We found no statistically significant difference in musculoskeletal ultrasound (MSUS) feature improvement during the 16-week study.
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Affiliation(s)
- George Ovidiu Cioroianu
- Doctoral School of the University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Alesandra Florescu
- Department of Rheumatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (A.F.); (A.E.M.)
| | - Anca Emanuela Mușetescu
- Department of Rheumatology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
- Correspondence: (A.F.); (A.E.M.)
| | - Teodor Nicușor Sas
- Department of Radiology and Medical Imaging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Otilia Constantina Rogoveanu
- Department of Physical Medicine and Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
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Wen YR, Shi J, Wang YF, Lin YY, Hu ZY, Lin YT, Wang XQ, Wang YL. Are Mind-Body Exercise Beneficial for Treating Pain, Function, and Quality of Life in Middle-Aged and Old People With Chronic Pain? A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 14:921069. [PMID: 35800981 PMCID: PMC9255956 DOI: 10.3389/fnagi.2022.921069] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Aging is a significant risk factor in chronic pain development with extensive disability and greater health care costs. Mind-body exercise (MBE) has been scientifically proven to affect the pain intensity and physical health. Objectives To assess the effects of MBE modes (Tai Chi, yoga, and qigong) for treating chronic pain among middle-aged and old people, compared with nonactive and active treatment, as well as function, quality of life, and adverse events. Methods We searched PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Scientific Journals Full-Text Database (VIP) till March 2022. No restrictions were chartered within the year and language of publication. We included randomized controlled trials of MBE treatment in middle-aged and elderly people with chronic pain. The overall certainty of evidence was evaluated by using the GRADE approach. Results A total of 17 studies (n = 1,332) were included in this review. There was low-certainty evidence indicating that MBE had a moderate effect on reducing pain compared with the nonactive and active control group (standard mean difference (SMD): -0.64, 95% confidence interval (CI): -0.86 to -0.42, P < 0.001). Very-low-certainty evidence showed that the pooled SMD for the functional improvement was -0.75 (95% CI: -1.13 to -0.37, P < 0.001). Low-certainty evidence presented that no influence was observed in physical component summary (SMD: 0.23, 95% CI: -0.16 to 0.62, P = 0.24) and mental component summary (SMD: -0.01, 95% CI -0.39 to 0.36, P = 0.95). Conclusion Our results indicated that MBE was an effective treatment for reducing symptoms of middle-aged and elderly people with chronic pain compared with nonactive and active control groups. TC and qigong had obvious benefits for knee osteoarthritis in self-reported function, but the efficacy of chronic low back pain was uncertain. No significant benefit of MBE on quality of life in older adults with chronic pain was found. More high-quality RCTs should be conducted to explore the efficacy and mechanism of MBE on chronic pain in middle-aged and elderly people from various dimensions, such as affective and cognitive dimensions. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=316591, identifier CRD42022316591.
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Affiliation(s)
- Yu-Rong Wen
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jian Shi
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ya-Fei Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yang-Yang Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zheng-Yu Hu
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - You-Tian Lin
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Yu-Ling Wang
- Rehabilitation Medicine Center, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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Wang R, Zhu D, Wang L, Liu J, Zou J, Sun Y, Jiang Y, Hu HY, Deng ZW, Weng LM, Zheng KY, Kiartivich S, Wang XQ. Tai Chi Quan Versus Physical Therapy on Pain and Cognitive Performance for Elderly People With Chronic Low Back Pain: Study Protocol for a Randomized Controlled Trial. Front Aging Neurosci 2022; 14:900430. [PMID: 35783144 PMCID: PMC9243751 DOI: 10.3389/fnagi.2022.900430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/19/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesChronic low back pain has become a major cause of global disability and caused a huge economic burden to society. Physical therapy is a vital strategy for rehabilitation of chronic low back pain. Although several trials have shown that Tai Chi Quan is a beneficial treatment, the comparative effectiveness of Tai Chi Quan versus physical therapy is unknown. We are conducting a randomized controlled trial to assess the effectiveness of Tai Chi Quan versus that of physical therapy in treating chronic low back pain.MethodsWe will perform a single-blind randomized controlled trial on elderly people with chronic low back pain. 138 participants will be randomly assigned to the Tai Chi Quan group (60-min classes, three times per week for 12 weeks) or physical therapy group (10 min of evaluation and warm-up, 40 min of therapist-directed exercise therapy, and 10 min of relaxation, three times per week for 12 weeks) with an allocation of 1:1. The participants will be followed up for 40 weeks for the study of long-term effects. The primary outcomes include pain intensity and back-related function at 12 weeks. Secondary outcomes include lumbar quantitative sensory testing, balance, cognitive function, psychosocial function, cost-effectiveness, compliance and adverse events. We will perform the intention-to-treat analysis for withdrawal and missing data.DiscussionThe study will be the first randomized trial with comparative-effectiveness of Tai Chi Quan and physical therapy for chronic low back pain. Standardized protocol, large sample size, and comprehensive outcomes are important features in this trial. This study aims to determine the feasibility and effectiveness of Tai Chi Quan for low back pain. The results of this study will be beneficial for elderly people with low back pain and medical rehabilitation personnel.Clinical Trial Registrationwww.chictr.org.cn, identifier ChiCTR2000029723.
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Affiliation(s)
- Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Dong Zhu
- School of International Education, Shanghai University of Sport, Shanghai, China
| | - Lin Wang
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Jing Liu
- Department of Martial Arts, Shanghai University of Sport, Shanghai, China
| | - Jun Zou
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yang Sun
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yan Jiang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Hao-Yu Hu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Zhi-Wei Deng
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Lin-Man Weng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Kang-Yong Zheng
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Suparata Kiartivich
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
- *Correspondence: Xue-Qiang Wang,
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Song J, Wei L, Cheng K, Lin Q, Xia P, Wang X, Wang X, Yang T, Chen B, Ding A, Sun M, Chen A, Li X. The Effect of Modified Tai Chi Exercises on the Physical Function and Quality of Life in Elderly Women With Knee Osteoarthritis. Front Aging Neurosci 2022; 14:860762. [PMID: 35721018 PMCID: PMC9204295 DOI: 10.3389/fnagi.2022.860762] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/19/2022] [Indexed: 11/29/2022] Open
Abstract
Background Knee osteoarthritis (KOA) is the leading cause of pain and stiffness, affecting older adults’ physical function and quality of life. As a form of mind-body exercise, Tai Chi has been recommended as an exercise prescription for KOA patients. This study examined the effects and continuation of modified Tai Chi exercises on physical function and quality of life in elderly women with KOA. Methods We conducted a single-blind, randomized controlled trial (RCT) on 40 older women with KOA. The participants were randomized to a 12 weeks Tai Chi or control group. The Tai Chi group attended a kind of modified Tai Chi training sessions three times per week; the control group attended wellness education sessions once a week. The primary outcome was the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Secondary outcomes were the Berg Balance Scale (BBS), Timed Up and Go (TUG), Short-Form 36 (SF-36), Pittsburgh Sleep Quality of Index (PSQI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS). Results After the 12-weeks the Tai Chi group showed significan improvement in the WOMAC pain (mean difference, −5.09 points, p = 0.001), WOMAC stiffness (mean difference, −3.60 points, p = 0.002), WOMAC physical function (mean difference, −11.21 points, p = 0.001) compared to the control group. In addition, the Tai Chi group had also significant improvement in the BBS (mean difference, 1.70 points, p = 0.008), TUG (mean difference, −0.52s, p = 0.001), SF-36PCS (mean difference, 7.60 points, p = 0.001), MCS (mean difference, 7.30 points, p = 0.001), PSQI (mean difference, −3.71 points, p = 0.001), SDS (mean difference, −5.37 points, p = 0.025) and SAS (mean difference, −5.06 points, p = 0.002). Conclusion The modified Tai Chi exercises are an effective treatment for improved physical function and quality of life in elderly women with KOA. Clinical Trial Registration The trial was registered in Chinese Clinical Trial Registry (ChiCTR2000040721), http://www.chictr.org.cn/edit.aspx?pid=65419&htm=4.
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Affiliation(s)
- Jiulong Song
- Department of Sports and Health, Nanjing Sport Institute, Nanjing, China
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lijun Wei
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Kai Cheng
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Qiang Lin
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Peng Xia
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xinwei Wang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xiaoju Wang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ting Yang
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Baoyi Chen
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Aimei Ding
- Maigaoqiao Community Health Service Center, Nanjing, China
| | - Mingyi Sun
- Department of Tourism and Social Management, Nanjing Xiaozhuang University, Nanjing, China
| | - Anliang Chen
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Anliang Chen Xueping Li
| | - Xueping Li
- Department of Rehabilitation Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Anliang Chen Xueping Li
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Xing H, Shen J, Gong L, Li J, Shao S, Chu Y, He P, Chen H, Kang Z, Dai D. Protocol-optimizing study of combining Tuina and horse-riding squat exercise for knee osteoarthritis. JOURNAL OF ACUPUNCTURE AND TUINA SCIENCE 2022. [DOI: 10.1007/s11726-022-1305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kelley GA, Kelley KS, Callahan LF. Clinical relevance of Tai Chi on pain and physical function in adults with knee osteoarthritis: An ancillary meta-analysis of randomized controlled trials. Sci Prog 2022; 105:368504221088375. [PMID: 35379041 PMCID: PMC10450487 DOI: 10.1177/00368504221088375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The clinical relevance of Tai Chi on pain, stiffness, and physical function in adults with knee osteoarthritis (KOA) has not been established. Therefore, the purpose of the current study was to address this gap. Eight randomized controlled trials from a recent meta-analysis representing 407 participants (216 Tai Chi, 191 control) in adults ≥18 years of age with KOA and included the assessment of pain, stiffness, and physical function using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) were assessed. The inverse variance heterogeneity model (IVhet) was first used to pool standardized mean difference effect sizes (ES) for each outcome. Clinical relevance, i.e., number-needed-to treat (NNT) ≤10 and relative risk reduction (RRR) ≥25% was calculated across assumed controlled risks (ACR) ranging from 0.01 to 0.99. Statistically significant improvements were found for pain (ES, -0.75, 95% CI, -0.99, -0.51; Q = 8.9, p = 0.26; I2 = 21%), stiffness (ES, -0.70, 95% CI, -0.95, -0.46; Q = 9.6, p = 0.21; I2 = 27%), and physical function (ES, -0.91, 95% CI, -1.12, -0.70; Q = 7.2, p = 0.40; I2 = 3%). The intersection of results for a NNT ≤10 and RRR ≥25% yielded high evidence and clinically relevant improvements across a wide range of ACR for pain (0.15 to 0.88), stiffness (0.15 to 0.87), and physical function (0.13 to 0.97). These findings suggest that Tai Chi results in statistically significant as well as clinically important improvements in pain, stiffness, and physical function across a wide range of ACR in adults with KOA.
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Affiliation(s)
- George A Kelley
- Department of Epidemiology and Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Epidemiology and Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Leigh F Callahan
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
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Lim WB, Al-Dadah O. Conservative treatment of knee osteoarthritis: A review of the literature. World J Orthop 2022; 13:212-229. [PMID: 35317254 PMCID: PMC8935331 DOI: 10.5312/wjo.v13.i3.212] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/29/2021] [Accepted: 01/29/2022] [Indexed: 02/06/2023] Open
Abstract
Knee osteoarthritis (KOA) is a common chronic debilitating disease with an estimated prevalence of 23.9% in the general adult population. The condition is characterised by joint pain, functional impairment and significant reduction in quality of life. Management for KOA can generally be divided into conservative (non-operative) and surgical (operative) measures. Conservative management broadly compromises pharmacological and non-pharmacological options and is conventionally the first line treatment to avoid or delay the need for surgical management. The aim of this study is to provide an overview of the current recommendations, efficacy and safety profile of different conservative treatments through a review of the literature.
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Affiliation(s)
- Wei Boon Lim
- The Medical School, Newcastle University, Newcastle-upon-Tyne NE2 4HH, United Kingdom
| | - Oday Al-Dadah
- Department of Trauma and Orthopaedic Surgery, South Tyneside District Hospital, South Tyneside NE34 0PL, United Kingdom
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle-upon-Tyne NE2 4HH, United Kingdom
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Knee osteoarthritis in midlife women. Menopause 2022; 29:748-755. [DOI: 10.1097/gme.0000000000001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Niles BL, Reid KF, Whitworth JW, Alligood E, Williston SK, Grossman DH, McQuade MM, Mori DL. Tai Chi and Qigong for trauma exposed populations: A systematic review. Ment Health Phys Act 2022; 22:10.1016/j.mhpa.2022.100449. [PMID: 37885833 PMCID: PMC10601358 DOI: 10.1016/j.mhpa.2022.100449] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Trauma exposure and posttraumatic stress are highly prevalent and comorbid with health problems. Despite the apparent systemic nature of post-traumatic stress, recommended treatments neglect trauma's deleterious effects on health. Integrative mind-body treatments for posttraumatic stress, such as Tai Chi and Qigong (TCQ), may offer a promising adjunct to first-line treatments. Method A systematic search was conducted to identify trials that examined Tai Chi and/or Qigong as treatments for trauma-exposed populations. Studies were examined for rigor; design, sample and intervention characteristics, dropout, attendance, satisfaction, acceptability, and key findings were systematically extracted. Results The 6 studies included are all pilot or feasibility trials with descriptive or mixed-methods outcomes. No randomized trials or rigorous studies were identified. Dropout rates ranged widely, and adverse reactions were not evident. Reported satisfaction was high and benefits of relaxation, reductions in mental health symptoms, and improvements in pain and physical and cognitive functioning were noted. Limitations All the studies were non-rigorous and relatively small, with no comparison groups, or follow-up assessments; in many cases, posttraumatic stress symptoms were not formally assessed. Conclusions The paucity and lack of rigor of the studies identified for this review highlights the need for larger, methodologically sound clinical trials. The reviewed studies suggest that TCQ practices have the potential to reduce symptoms and improve functioning for individuals exposed to trauma and provide evidence that TCQ is feasible, acceptable, and low risk in these populations. Possible mechanistic pathways supporting TCQ as a treatment for posttraumatic stress are considered.
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Affiliation(s)
- Barbara L. Niles
- National Center for PTSD – Behavioral Science Division 150 S Huntington Ave, Boston, MA, 02130, USA
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
- Boston University School of Medicine, 72 E Concord St, Boston, 02118, MA, USA
| | - Kieran F. Reid
- Laboratory of Exercise Physiology and Physical Performance, Brigham and Women’s Hospital, Harvard Medical School, 221 Longwood Avenue, Boston, 02115, MA, USA
| | - James W. Whitworth
- National Center for PTSD – Behavioral Science Division 150 S Huntington Ave, Boston, MA, 02130, USA
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
- Boston University School of Medicine, 72 E Concord St, Boston, 02118, MA, USA
| | - Elaine Alligood
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
| | - Sarah Krill Williston
- National Center for PTSD – Behavioral Science Division 150 S Huntington Ave, Boston, MA, 02130, USA
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
- Boston University School of Medicine, 72 E Concord St, Boston, 02118, MA, USA
| | - Daniel H. Grossman
- National Center for PTSD – Behavioral Science Division 150 S Huntington Ave, Boston, MA, 02130, USA
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
| | - Maria M. McQuade
- National Center for PTSD – Behavioral Science Division 150 S Huntington Ave, Boston, MA, 02130, USA
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
| | - DeAnna L. Mori
- VA Boston Healthcare System, 150 S Huntington Ave, Boston, 02130, MA, USA
- Boston University School of Medicine, 72 E Concord St, Boston, 02118, MA, USA
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He G, Zhang X, Yan T, Wang J, Li Q, Liu T, Oh YP. The efficacy of Tai Chi for depression: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28330. [PMID: 35119001 PMCID: PMC8812674 DOI: 10.1097/md.0000000000028330] [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: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Depression is a commonly occurring and recurrent mental disorder cross the world. Tai Chi is a traditional Chinese mind-body exercise which could be used to treat mental disorders including depression. This study aimed to conduct a systematic review and meta-analysis to assess the efficiency of Tai Chi for patients with depression. METHODS This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol statement. Literature will be searched at PubMed, EMBASE, Web of Science, Cochrane Library, China Biology Medicine Database, China National Knowledge Infrastructure, Technology Journal Database, and Wan Fang database from the start date to September 2021. The Review Manager 5.3 software will be used to manage literature. After literature screening, 2 reviewers will extract data from the respects of general information, methodology, and results. The data analysis will be conducted with Review Manager and Stata 16 software, and the publication bias and literature quality will be both evaluated. RESULTS The results will contain the evaluation of clinical efficacy of Tai Chi practice for depression, as well as the assessment of literature quality and publication bias. CONCLUSION The current review will provide new evidence on whether and to what extent patients with depression can benefit from Tai Chi practice.Registration number: DOI: 10.17605/OSF.IO/AUDNQ (https://osf.io/audnq).
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Affiliation(s)
- Guojian He
- Physical Education Department, Hebei University of Economics and Business, Shijiazhuang, Hebei, China
| | - Xiucai Zhang
- School of International Education, University of Electronic Science and Technology, Chengdu, Sichuan, China
| | - Ting Yan
- School of Sport, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jiayi Wang
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qi Li
- School of Sport, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Tianyu Liu
- School of Sport, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Youn-Poong Oh
- Department of Physical Education, Kunsan National University, Gunsan, Korea
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Wang R, Chang XL, Kiartivich S, Wang XQ. Effect of Tai Chi Quan on the Pressure Pain Thresholds of Lower Back Muscles in Healthy Women. J Pain Res 2022; 15:403-412. [PMID: 35173478 PMCID: PMC8842641 DOI: 10.2147/jpr.s353465] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/01/2022] [Indexed: 01/31/2023] Open
Abstract
Purpose Patients and Methods Results Conclusion
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Affiliation(s)
- Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Xiao-Long Chang
- School of Physical Education and Training, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Suparata Kiartivich
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, People’s Republic of China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, People’s Republic of China
- Correspondence: Xue-Qiang Wang, Department of Sport Rehabilitation, Shanghai University of Sport, 399 Changhai Road, Shanghai, 200438, People’s Republic of China, Tel +86 186 0161 2741, Email
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Shen CL, Watkins BA, Kahathuduwa C, Chyu MC, Zabet-Moghaddam M, Elmassry MM, Luk HY, Brismée JM, Knox A, Lee J, Zumwalt M, Wang R, Wager TD, Neugebauer V. Tai Chi Improves Brain Functional Connectivity and Plasma Lysophosphatidylcholines in Postmenopausal Women With Knee Osteoarthritis: An Exploratory Pilot Study. Front Med (Lausanne) 2022; 8:775344. [PMID: 35047525 PMCID: PMC8761802 DOI: 10.3389/fmed.2021.775344] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 11/15/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: A pre/post pilot study was designed to investigate neurobiological mechanisms and plasma metabolites in an 8-week Tai-Chi (TC) group intervention in subjects with knee osteoarthritis. Methods: Twelve postmenopausal women underwent Tai-Chi group exercise for 8 weeks (60 min/session, three times/week). Outcomes were measured before and after Tai Chi intervention including pain intensity (VAS), Brief Pain Inventory (BPI), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), plasma metabolites (amino acids and lipids), as well as resting-state functional magnetic resonance imaging (rs-fMRI, 10 min, eyes open), diffusion tensor imaging (DTI, 12 min), and structural MRI (4.5 min) in a subgroup. Clinical data was analyzed using paired t-tests; plasma metabolites were analyzed using Wilcoxon signed-rank tests; and rs-fMRI data were analyzed using seed-based correlations of the left and right amygdala in a two-level mixed-effects model (FSL software). Correlations between amygdala-medial prefrontal cortex (mPFC) connectivity and corresponding changes in clinical outcomes were examined. DTI connectivity of each amygdala was modeled using a Bayesian approach and probabilistic tractography. The associations between neurobiological effects and pain/physical function were examined. Results: Significant pre/post changes were observed with reduced knee pain (VAS with most pain: p = 0.018; WOMAC-pain: p = 0.021; BPI with worst level: p = 0.018) and stiffness (WOMAC-stiffness, p = 0.020), that likely contributed to improved physical function (WOMAC-physical function: p = 0.018) with TC. Moderate to large effect sizes pre/post increase in rs-fMRI connectivity were observed between bilateral mPFC and the amygdala seed regions (i.e., left: d = 0.988, p = 0.355; right: d = 0.600, p = 0.282). Increased DTI connectivity was observed between bilateral mPFC and left amygdala (d = 0.720, p = 0.156). There were moderate-high correlations (r = 0.28–0.60) between TC-associated pre-post changes in amygdala-mPFC functional connectivity and pain/physical function improvement. Significantly higher levels of lysophosphatidylcholines were observed after TC but lower levels of some essential amino acids. Amino acid levels (alanine, lysine, and methionine) were lower after 8 weeks of TC and many of the lipid metabolites were higher after TC. Further, plasma non-HDL cholesterol levels were lower after TC. Conclusion: This pilot study showed moderate to large effect sizes, suggesting an important role that cortico-amygdala interactions related to TC have on pain and physical function in subjects with knee osteoarthritis pain. Metabolite analyses revealed a metabolic shift of higher lyso-lipids and lower amino acids that might suggest greater fatty acid catabolism, protein turnover and changes in lipid redistribution in response to TC exercise. The results also support therapeutic strategies aimed at strengthening functional and structural connectivity between the mPFC and the amygdala. Controlled clinical trials are warranted to confirm these observed preliminary effects.
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Affiliation(s)
- Chwan-Li Shen
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Bruce A Watkins
- Department of Nutrition, University of California, Davis, Davis, CA, United States
| | - Chanaka Kahathuduwa
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Laboratory Sciences and Primary Care, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Psychiatry, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Ming-Chien Chyu
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Medical Engineering, Texas Tech University, Lubbock, TX, United States
| | - Masoud Zabet-Moghaddam
- Center for Biotechnology and Genomics, Texas Tech University, Lubbock, TX, United States
| | - Moamen M Elmassry
- Department of Biological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Hui-Ying Luk
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX, United States
| | - Jean-Michel Brismée
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Rehabilitation Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Ami Knox
- Clinical Research Institute, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Jaehoon Lee
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Educational Psychology and Leadership, Texas Tech University, Lubbock, TX, United States
| | - Mimi Zumwalt
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Orthopedic Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Rui Wang
- Department of Pathology, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
| | - Volker Neugebauer
- Center of Excellence for Integrative Health, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, United States.,Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, United States
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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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Zhuang SZ, Chen PJ, Han J, Xiao WH. Beneficial Effects and Potential Mechanisms of Tai Chi on Lower Limb Osteoarthritis: A Biopsychosocial Perspective. Chin J Integr Med 2021; 29:368-376. [PMID: 34921649 DOI: 10.1007/s11655-021-3529-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 01/15/2023]
Abstract
Lower limb osteoarthritis (OA) is a chronic, multifactorial disease characterized by impaired physical function, chronic pain, compromised psychological health and decreased social functioning. Chronic inflammation plays a critical role in the pathophysiology of OA. Tai Chi is a type of classical mind-body exercise derived from ancient Chinese martial arts. Evidence supports that Tai Chi has significant benefits for relieving lower limb OA symptoms. Using a biopsychosocial framework, this review aims to elucidate the beneficial effects of Tai Chi in lower limb OA and disentangle its potential mechanisms from the perspective of biology, psychology, and social factors. Complex biomechanical, biochemical, neurological, psychological, and social mechanisms, including strengthening of muscles, proprioception improvement, joint mechanical stress reduction, change of brain activation and sensitization, attenuation of inflammation, emotion modulation and social support, are discussed.
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Affiliation(s)
- Shu-Zhao Zhuang
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Pei-Jie Chen
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Jia Han
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China
| | - Wei-Hua Xiao
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
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Chen B, Duan J, Wen S, Pang J, Zhang M, Zhan H, Zheng Y. An Updated Systematic Review and Meta-analysis of Duloxetine for Knee Osteoarthritis Pain. Clin J Pain 2021; 37:852-862. [PMID: 34483232 PMCID: PMC8500362 DOI: 10.1097/ajp.0000000000000975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/28/2021] [Accepted: 07/12/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE We conducted the updated systematic review and meta-analysis of the best available quantitative and qualitative evidence to evaluate the effects and safety of duloxetine for the treatment of knee osteoarthritis (OA) pain. METHODS A comprehensive literature search used 3 English and 4 Chinese biomedical databases from inception through July 10, 2020. We included randomized controlled trials of duloxetine with intervention duration of 2 weeks or longer for knee OA. The primary outcome was pain intensity measured by Brief Pain Inventory and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale. Secondary outcome measurements included 36-Item Short Form Health Survey, Patient's Global Impression of Improvement, Clinical Global Impressions of Severity, and adverse events (AEs). The quality of all included studies was evaluated using the Cochrane risk-of-bias criteria. The review was registered in the PROSPERO (CRD 42020194072). RESULTS Six studies totaling 2059 patients met the eligibility criteria. Duloxetine had significant reductions in Brief Pain Inventory 24 hours average pain (mean difference [MD]=-0.74; 95% confidence interval [CI], -0.92 to -0.57; P<0.00001; I2=13%; 5 trials; 1695 patients); patient general activity (MD=-0.76; 95% CI, -0.96 to -0.56; P<0.00001; I2=0%; 5 trials; 1694 patients) WOMAC physical function subscale (MD=-4.22; 95% CI, -5.14 to -3.30; P<0.00001; I2=26%; 5 trials; 1986 patients); Patient's Global Impression of Improvement (MD=-0.48; 95% CI, -0.58 to -0.37; P<0.00001; I2=29%; 5 trials; 1741 patients); and Clinical Global Impressions of Severity (MD=-0.34; 95% CI, -0.44 to -0.24; P<0.00001; I2=0%; 4 trials; 1178 patients) compared with placebo control. However, no difference on WOMAC pain subscale (standard mean difference=-1.68; 95% CI, -3.45 to 0.08; P=0.06; I2=100%; 3 trials; 1104 patients) and in serious AEs (risk ratio=0.92; 95% CI, 0.40-2.11; P=0.84; I2=0%; 5 trials; 1762 patients) between duloxetine and placebo. Furthermore, duloxetine failed to show superior effects for improving the life quality and demonstrated more treatment-emergent AEs. CONCLUSION Duloxetine may be an effective treatment option for knee OA patients but further rigorously designed and well-controlled randomized trials are warranted.
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Hsu YI, Chen YC, Lee CL, Chang NJ. Effects of Diet Control and Telemedicine-Based Resistance Exercise Intervention on Patients with Obesity and Knee Osteoarthritis: A Randomized Control Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157744. [PMID: 34360036 PMCID: PMC8345675 DOI: 10.3390/ijerph18157744] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/23/2022]
Abstract
This study investigated the effects of home-based nutritional and telemedicine-based resistance exercise interventions on improving body composition, blood biochemistry, and lower-limb functional performance. In total, 66 obese patients with mild-to-moderate knee osteoarthritis were randomly divided into a diet control group (D), elastic band resistance exercise group (E), and diet control plus elastic band exercise group (D + E). Each group was supervised by a clinical dietitian and follow-up was conducted via telephone calls or a communication application to track the participants’ progress. After 12 weeks of intervention, the D (p < 0.001) and D + E (p < 0.001) groups achieved significant weight loss. The D + E group exhibited a significant reduction in body fat relative to the D (p = 0.019) and E (p = 0.012) groups. Compared with the D (p = 0.002) and E (p = 0.019) groups, the D + E group achieved significant improvements in the timed up-and-go test and Western Ontario and McMaster Universities Osteoarthritis total scale. The D + E group experienced significant improvements in total cholesterol (p = 0.001), low-density lipoprotein cholesterol (p = 0.01), and triglyceride levels (p = 0.007) relative to other groups. In conclusion, individual diet control intervention combined with telemedicine-based resistance exercise intervention significantly improved the body composition, blood biochemistry, and lower-limb functional performance of the investigated population with comorbid conditions.
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Affiliation(s)
- Yen-I Hsu
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Nutritional Therapy, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
| | - Ying-Chou Chen
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang-Gung University College of Medicine, Kaohsiung 833, Taiwan;
| | - Chia-Lun Lee
- Center for Physical and Health Education, National Sun Yat-Sen University, Kaohsiung 804, Taiwan;
| | - Nai-Jen Chang
- Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan;
- Ph.D. Program in Biomedical Engineering, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Regenerative Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
- Correspondence: ; Tel.:+886-7-312-1101 (ext. 2646); Fax: +886-7-313-8359
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Fonseca-Rodrigues D, Rodrigues A, Martins T, Pinto J, Amorim D, Almeida A, Pinto-Ribeiro F. Correlation between pain severity and levels of anxiety and depression in osteoarthritis patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2021; 61:53-75. [PMID: 34152386 DOI: 10.1093/rheumatology/keab512] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Osteoarthritis (OA) is a chronic degenerative musculoskeletal disease that causes articular damage and chronic pain, with a prevalence of up to 50% in individuals >60 years of age. Patients suffering from chronic painful conditions, including OA, also frequently report anxiety or depression. A systematic review and meta-analysis were performed to assess the correlation between pain severity and depressive and anxious symptomatology in OA patients. METHODS A systematic search was conducted using four databases (PubMed, Medline, Scopus, and Web of Science) from inception up to 14th January of 2020. We included original articles evaluating pain severity and anxiety and/or depression severity in OA-diagnosed patients. Detailed data were extracted from each study, including patients' characteristics and pain, anxiety, and depression severity. When available, the Pearson correlation coefficient between pain and depression severity and pain and anxiety severity was collected and a meta-analysis of random effects was applied. RESULTS This systematic review included 121 studies, with a total of 38085 participants. The mean age was 64.3 years old and subjects were predominantly female (63%). The most used scale to evaluate pain severity was the Western Ontario and the McMaster Universities Osteoarthritis Index, while for anxiety and depression, the Hospital Anxiety and Depression Scale was the most used. The meta-analysis showed a moderate positive correlation between pain severity and both anxious (r = 0.31, p < 0.001) and depressive symptomatology (r = 0.36, p < 0.001). CONCLUSIONS Our results demonstrate a significant correlation between pain and depression/anxiety severity in OA patients, highlighting the need for its routine evaluation by clinicians.
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Affiliation(s)
- Diana Fonseca-Rodrigues
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - André Rodrigues
- School of Medicine, University of Minho, Braga, Portugal.,Anesthesiology Department, Coimbra Hospital and Universitary Centre (CHUC), Praceta Prof. Mota Pinto, Coimbra, Portugal
| | - Teresa Martins
- School of Medicine, University of Minho, Braga, Portugal
| | - Joana Pinto
- School of Medicine, University of Minho, Braga, Portugal
| | - Diana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Armando Almeida
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
| | - Filipa Pinto-Ribeiro
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,School of Medicine, University of Minho, Braga, Portugal
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Zhang W, Roster K, Hays RD, Wang C. Analysis of Movement-Based Mind-Body Interventions to Guide the Implementation of Osteoarthritis Exercise Programs: A Descriptive Review of Randomized Controlled Trials. J Altern Complement Med 2021; 27:442-457. [PMID: 33902322 DOI: 10.1089/acm.2020.0420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Clear and complete reporting of the components of complex interventions is required in clinical trials to ensure that research can be reliably replicated and successfully translated into clinical practice. Movement-based mind-body exercises, such as Tai Chi, qigong, and Yoga (TQY), are considered complex interventions and recommended for individuals with osteoarthritis in the latest guidelines of the American College of Rheumatology. This review analyzes the intervention reporting of randomized controlled trials of TQY to guide the implementation in osteoarthritis exercise programs. Methods: We searched PubMed, Cochrane Central Register of Controlled Trials, and EMBASE for TQY exercise trials in osteoarthritis between 2000 and 2020. Pairs of researchers independently screened the records, extracted study characteristics, and assessed 19 items on the Consensus on Exercise Reporting Template (CERT) checklist. For each of these items, the numbers of studies that clearly reported the item were calculated. We then identified the items in the studies that are key to delivering home-based exercises for further analysis. Results: We included 27 publications reporting 22 TQY interventions in the analysis. None of the studies reported sufficient details on all the 19 CERT items. The median completeness of reporting score was 11 and ranged from 6 to 15 of 19. The most frequently incompletely reported items (number reporting and percentage of studies) were "starting level rule" (n = 1, 5%) and "progression rule" (n = 1, 5%). Other incompletely reported items included "fidelity or adherence (planned)" (n = 9, 41%), "motivations" (n = 9, 41%), and "progression description" (n = 5, 23%). Conclusions: The content analysis highlights motivational strategies for long-term adherence to home-based exercises, which may help clinicians develop interventions for their patients. Details of TQY exercises interventions for osteoarthritis are incompletely reported in the included studies. The study suggests that improvements in content reporting are especially needed on items related to exercise intensity and program progression decisions, and motivational strategies in future implementation.
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Affiliation(s)
- Weijun Zhang
- Center for East-West Medicine, Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Ron D Hays
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Chenchen Wang
- Center for Complementary and Integrative Medicine, Division of Rheumatology, Department of Medicine, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
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49
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Zhang M, Du G, Liu C, Li W, Yang J, Chen B, Yu X, Xiong Y, Jiang E, Gao N, Jiang S, Xu Z, Wang X, Zhan H. Efficacy and safety of Shi-style cervical manipulation therapy for treating acute and subacute neck pain: study protocol for a randomized controlled trial. Trials 2021; 22:123. [PMID: 33557898 PMCID: PMC7869462 DOI: 10.1186/s13063-021-05062-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Neck pain is a common clinical disease, which seriously affects people’s mental health and quality of life and results in loss of social productivity. Improving neck pain’s curative effect and reducing its recurrence rate are major medical problems. Shi’s manipulation therapy has unique advantages and technical features that aid in the diagnosis and treatment of neck pain. Compared with first-line non-steroidal anti-inflammatory drug (NSAID) treatment of neck pain, Shi’s cervical manipulation lacks the relevant research basis of therapeutic advantage, safety, and satisfaction for treating acute and subacute neck pain. Herein, we aim to confirm our hypothesis in a clinical trial that the safety and efficacy of Shi’s cervical manipulation will be more effective, safer, and more satisfactory than NSAIDs to treat acute and subacute neck pain. Methods In this multicenter, positive-controlled, randomized clinical trial, traditional analgesic drug (NSAID) is used to evaluate and show that Shi’s manipulation is more effective, safe, and satisfactory for treating acute and subacute neck pain. Overall, 240 subjects are randomly divided into the trial and control groups, with both groups treated by the corresponding main intervention method for up to 12 weeks. Clinical data will be collected before the intervention and immediately after the first treatment; at 3 days and 1, 2, 4, 8, and 12 weeks after the intervention; and at 26 and 52 weeks after treatment follow-up of clinical observation index data collection. The clinical observation indices are as follows: (1) cervical pain is the primary observation index, measured by Numerical Rating Scale. The secondary indices include the following: (2) cervical dysfunction index, measured by patient self-evaluation using cervical Neck Disability Index; (3) cervical activity measurement, measured by the cervical vertebra mobility measurement program of Android mobile phone system; (4) overall improvement, measured by patient self-evaluation with SF-36; and (5) satisfactory treatment, determined by patient self-evaluation. Discussion We will discuss whether Shi’s cervical manipulation has greater advantages in efficacy, safety, and satisfaction of acute and subacute neck pain than traditional NSAIDs, to provide a scientific basis for the dissemination and application of Shi’s cervical manipulation. Trial registration China Registered Clinical Trial Registration Center ChiCTR1900021371. Registered on 17 February 2019
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Affiliation(s)
- Mingcai Zhang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Guoqing Du
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Congying Liu
- Shanghai University of TCM, Shanghai, People's Republic of China
| | - Wei Li
- Jing'an District Central Hospital of Shanghai, Shanghai, People's Republic of China
| | - Jiayu Yang
- Xiangshan TCM Hospital, Huangpu District, Shanghai, People's Republic of China
| | - Bo Chen
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Xiaoyue Yu
- Jing'an District Central Hospital of Shanghai, Shanghai, People's Republic of China
| | - Yizhe Xiong
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Enyu Jiang
- Xiangshan TCM Hospital, Huangpu District, Shanghai, People's Republic of China
| | - Ningyang Gao
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Sumin Jiang
- Jing'an District Central Hospital of Shanghai, Shanghai, People's Republic of China
| | - Zhenqiu Xu
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Xiang Wang
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China
| | - Hongsheng Zhan
- Shi's Center of Orthopedics and Traumatology, Shuguang Hospital Affiliated to Shanghai University of TCM, Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, People's Republic of China.
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Li Y, Zhong D, Dong C, Shi L, Zheng Y, Liu Y, Li Q, Zheng H, Li J, Liu T, Jin R. The effectiveness and safety of Tai Chi for patients with essential hypertension: study protocol for an open-label single-center randomized controlled trial. BMC Complement Med Ther 2021; 21:23. [PMID: 33413354 PMCID: PMC7792191 DOI: 10.1186/s12906-020-03192-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Evidence showed that Tai Chi may have beneficial effects among hypertensive individuals, although the results are not convincing. We aim to conduct a high-quality clinical trial with 24-h BP measurement to provide robust evidence of Tai Chi for essential hypertension. METHODS This is an open-label single-center randomized controlled trial with 3 parallel arms. We will compare Tai Chi with walking and waiting-list control. We will recruit 234 hypertensive patients with mild to moderate essential hypertension and randomly assign them to 3 different groups. Participants in Tai Chi group will receive a group-format Yang style 24-form Tai Chi exercise program, 3 sessions per week for 12 weeks. The walking group will be asked to walk, 3 sessions per week for 12 weeks. The waiting-list group will not receive any interventions and/or exercise training. The primary outcome is the change in average 24-h systolic blood pressure (SBP) between baseline and 12 weeks after randomization. The secondary outcomes include 24-h Diastolic Blood Pressure (DBP), average SBP and average DBP during the daytime and night-time, blood pressure (BP) variability, SBP load and DBP load, circadian rhythm of BP, and morning BP surge, endothelial functional indicators, home measured BP, quality of life, adverse events and so on. DISCUSSION We expect findings of this trial will provide important insight into application of Tai Chi as an effective and acceptable method for hypertensive patients. Successful completion of this proposed study will also contribute to promotion of Tai Chi in the community in the future. TRIAL REGISTRATION Clinicaltrials.gov registry: https://clinicaltrials.gov/ct2/show/NCT04267471 , date: February 12, 2020.
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Affiliation(s)
- Yuxi Li
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dongling Zhong
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chao Dong
- The General Hospital of Western Theater Command, Chengdu, China
| | - Lihong Shi
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yaling Zheng
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yongguo Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Qiaoqin Li
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Hui Zheng
- School of Acupuncture-Moxibustion and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Juan Li
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Tianyu Liu
- School of Sports, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Rongjiang Jin
- School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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