A controlled randomized trial with a 12-week follow-up investigating the effects of medium-frequency neuromuscular electrical stimulation on pain, VMO thickness, and functionality in patients with knee osteoarthritis

BACKGROUND

One of the major contributors to disability in Knee osteoarthritis (KOA) patients is weakness in the Quadriceps Femoris muscle. Neuromuscular electrical stimulation (NMES) has been used in rehabilitation for patients suffering from muscle weakness. Thus, the purpose of the study was to assess the effectiveness of NMES and exercise therapy, for improving pain, muscle weakness and function among patients with KOA.

METHODS

A randomized controlled trial was conducted with 75 female patients diagnosed with KOA. Participants were divided into three intervention groups: NMES-only, exercise therapy (Exs) alone, and a combination of NMES and exercise (NMES + Exs). All patients underwent 12 supervised treatment sessions, three times a week. Outcome measures included pain intensity measured by visual analog scale (VAS), knee flexion range of motion (FROM), thigh muscle girth (TG), thickness of the Vastus Medialis Oblique (VMO), timed up and go test (TUG), six-minute walk test (6MWT), and WOMAC scores. Statistical analyses (ANOVA and Kruskal-Wallis) methods were done to compare the amounts at the baseline, immediately after treatment and after 12 weeks.

RESULTS

The NMES group exhibited a significant reduction in pain at the 12-week follow-up compared to the other groups(p = 0.022). The NMES + Exs group showed better outcomes in terms of FROM, TG, and VMO thickness post-intervention (p < 0.0001, p < 0.004, p = 0.003, respectively) and at the 12-week follow-up (p < 0.0001, p < 0.0001, p < 0.0001, respectively). Additionally, NMES was superior in improving TUG and 6MWT post-intervention (p < 0.0001, p = 0.038, respectively) and during the follow-up assessments (p < 0.0001, p = 0.029, respectively). The NMES + Exs group achieved better WOMAC stiffness scores at both post-intervention and follow-up evaluations (p < 0.0001, p < 0.0001, respectively). Furthermore, at the 12-week follow-up, NMES + Exs group outperformed the others in WOMAC pain and function subscales (p = 0.003, p = 0.017, respectively), while the NMES group demonstrated better WOMAC total scores compared to the other groups (p = 0.007).

CONCLUSION

The combination of NMES and exercise seems to be an efficient approach for managing KOA, as it enhances knee flexion range and TG, increases VMO thickness, and improves WOMAC scores. On the other hand, NMES alone was found to be effective in improving the physical function of KOA patients.

TRIAL REGISTRATION

IRCT20101228005486N7 (06-02-2020).

Effectiveness of Thermostable Vaccine for Newcastle Disease Produced by the Razi Institute on Backyard Poultry in Iran during 2015

Newcastle disease causes many economic losses to the poultry industry in most countries. This disease is endemic in Iran. Backyard poultry is considered the reservoir of Newcastle virus; however, there is either no vaccination program against Newcastle, or it is performed in a restricted manner. Commercial live vaccines are inactive and sensitive to temperature; moreover, vaccine delivery to villages and remote areas requires special equipment and high cost to maintain the cold chain. This study evaluated the effectiveness of a thermostable Newcastle vaccine produced by the Razi Institute (ND.TR.IR) on the backyard poultry. In four provinces, at least 4 villages were selected as the treatment group, and the same number was selected as the control group. At least, 30 birds were sampled in each village. In each group, blood samples were collected before vaccination and 2 weeks later, and the serum titer of the samples was examined with the haemagglutination inhibition test. The arithmetic mean and standard deviation of the sample titers at the rural level were compared using paired t-test before and after vaccination in each group. Moreover, Repeated Measures ANOVA was utilized to compare the vaccinated and control groups in terms of the titer changes before and after vaccination. In this study, 584 and 389 samples were taken from the treatment (53 households in 20 villages) and control groups (33 households in 14 villages). The mean serum titer values of Newcastle were 4.51&amp;plusmn;3.03 and 6.64&amp;plusmn;2.48 in the treatment group before and after vaccination, respectively (P&amp;lt;0.001). The increase in mean titer of the treatment group (2.31 log) was statistically higher than that in the control group (0.66 log) (P&amp;lt;0.001). Out of 584 birds, 517 (88.5%) ones had titer above 3 in the second turn in the treatment group. The thermostable vaccine (ND.TR.IR) produced by the Razi institute is suitable for backyard poultry, which immunizes them against Newcastle disease. Appropriate vaccination programs for backyard poultry should be made; moreover, vaccination of backyard poultry can be effective in preventing the circulation of the field viruses.

Immunogenicity and Efficacy of Live Infectious Bronchitis 793/B.08IR Vaccine in SPF Chickens

Infectious bronchitis virus (IBV) has a variety of serotypes with relatively limited cross-protection leading the disease to be a major problem in the poultry industry. The IBV 793/B strain has identified to circulate in Iran; therefore, the development of a specific vaccine to protect against the virulent virus has received attention. In this regard, the live IB 793/B vaccine (793/B.08IR) was developed in the Razi Vaccine and Serum Research Institute. In this study, the immunogenicity of 793/B.08IR vaccine via different routes of vaccination and efficacy of the vaccine were determined in specific-pathogen-free (SPF) chickens. Three treatment groups of 10 SPF chickens received the vaccine via eye drops, spray, and drinking water. The sera were collected from the chicks at 3 and 6 weeks after the vaccination, and IBV specific antibody was measured using enzyme-linked immunosorbent assay (ELISA) and serum neutralization (SN) test. To evaluate 793/B.08IR vaccine efficacy, 10 SPF chickens were vaccinated using eye drops. Moreover, 10 unvaccinated chickens were separately retained as negative controls. The birds were challenged with the virulent virus 3 weeks following the vaccination. Five days after the challenge, the tracheal swab was taken for virus reisolation. In the immunogenicity test, the ELISA titers of three vaccinated groups were significantly higher than the background values obtained in the control group (p&amp;lt;0.0001). The mean value of ELISA titer in the spray vaccinated group was higher than the spray and drinking water vaccinated groups 3 weeks following the vaccination; however, the difference was not statistically significant. No differences were observed in antibody titers among the three vaccinated groups 6 weeks after the vaccination. The results of the SN test confirmed the data obtained from the ELISA. The results of antibody titer and its increasing trend in chickens showed that 793/B.08IR vaccine induce proper immunity against the virus. In the efficacy test, IBV was isolated from 90% of the unvaccinated controls and 10% of vaccinated groups. The results of the recovery of the virus after the challenge showed that 793/B.08IR vaccine can provide a significantly improved protection against the pathogen in SPF vaccinated chickens.

The Characteristics of an Ovine Lymphoid Cell-Line sensitive to Vaccinal Infectious Bursal Disease Virus Strain

Infectious bursal disease (IBD), also known as Gumboro disease, is a globally well-known disease with a significant socio-economic effect. For control of IBD, several commercial egg- and cell-based vaccines are prepared. The cell-based IBD vaccines are significantly cost-effective; however, it is essential to confirm their safety and efficacy. The main cell line used to product the cell-based IBD vaccines, is a primary chicken embryo fibroblast (CEF). Nevertheless, manipulation of CEF is extremely challenging and time-consuming. This study aimed to characterize a sensitive suspension cell culture from ovine lymphoid, according to WHO technical report series; No. 978, Annex III. This authentication covered the growth curves, sensitivity, stability, karyotyping and identifying the adventitious agents. This cell line passed all defined tests and was considered as a suitable one for IBD vaccine preparation in a large scale.