Exercise therapy in hip osteoarthritis--a randomized controlled trial

BACKGROUND

Roughly one in ten persons in the industrialized world suffers from hip osteoarthritis, a disease for which there is no cure. The goal of conservative therapy is to relieve symptoms, preferably with methods that let patients assume responsibility for their own treatment, e.g., physical training.

METHOD

In a randomized controlled trial, we studied the effectiveness of twelve weeks of exercise therapy in patients with hip osteoarthritis (THüKo), compared to no treatment (control group) and placebo ultrasound treatment of the hip (placebo ultrasound group). The primary endpoint was a comparison of the pain scores of the intervention versus control groups on the generic SF-36 health questionnaire. Secondary endpoints included comparisons across all three study groups of scores on the 7 other scales of the SF-36 and on the pain, physical function, and stiffness scales of the osteoarthritis-specific WOMAC Index. The statistical analysis was performed with ANCOVA, with baseline values as a covariate. Between-group effects were subsequently tested pairwise (two-tailed t-tests, alpha = 0.05).

RESULTS

As for the primary endpoint, pain reduction was significantly greater in the intervention than in the control group (mean difference 5.7 points, 95% confidence interval [CI] 0.4-11.1 points, p = 0.034). The comparisons across all three study groups (i.e., secondary endpoints, with 71 subjects in the intervention group, 68 in the control group, and 70 in the placebo group) revealed no significant between-group effects with respect to the SF-36. On the WOMAC Index, however, statistically significant differences were found for pain reduction between the intervention and control group (mean difference 7.4 points, 95% CI 3.0-11.8, p = 0.001) and between the intervention and placebo group (mean difference 5.1 points, 95% CI 0.7-9.4, p = 0.024). Comparable mean differences were also found for functional improvement.

CONCLUSION

Twelve weeks of exercise therapy in hip osteoarthritis patients of normal vitality reduced pain and improved physical function. No significant improvement was found in these patients' general health-related quality of life.

Conventional Electrolyte and Inactive Electrode Materials in Lithium-Ion Batteries: Determining Cumulative Impact of Oxidative Decomposition at High Voltage

High-voltage electrodes based on, for example, LiNi0.5 Mn1.5 04 (LNMO) active material require oxidative stability of inactive materials up to 4.95 V vs. Li|Li+ . Referring to literature, they are frequently supposed to be unstable, though conclusions are still controversial and clearly depend on the used investigation method. For example, the galvanostatic method, as a common method in battery research, points to the opposite, thus to a stability of the inactive materials, which can be derived from, for example, the high decomposition plateau at 5.56 V vs. Li|Li+ and stable performance of the LNMO charge/discharge cycling. This work aims to unravel this apparent contradiction of the galvanostatic method with the literature by a thorough investigation of possible trace oxidation reactions in cumulative manner, that is, over many charge/discharge cycles. Indeed, the cumulated irreversible specific capacity amounts to ≈10 mAh g-1 during the initial 50 charge/discharge cycles, which is determined by imitating extreme LNMO high-voltage conditions using electrodes solely consisting of inactive materials. This can explain the ambiguities in stability interpretations of the galvanostatic method and the literature, as the respective irreversible specific capacity is obviously too low for distinct detection in conventional galvanostatic approaches and can be only detected at extreme high-voltage conditions. In this regard, the technique of chronoamperometry is shown to be an effective and proper complementary tool for electrochemical stability research in a qualitative and quantitative manner.

A 12-week exercise program for patients with hip osteoarthritis has no influence on gait parameters: A secondary analysis of a randomized controlled trial

BACKGROUND

Hip osteoarthritis is a major musculoskeletal disorder in the elderly. Evidence is given for the efficacy of exercise interventions in terms of self-reported physical functioning and pain. However, it has not yet been fully examined whether exercises influence gait.

RESEARCH QUESTION

The purpose of this RCT therefore was to evaluate effects of a 12-week exercise program on kinematic gait variables in subjects with hip osteoarthritis.

METHODS

210 participants were randomly assigned to exercise, non-treated control, or placebo ultrasound groups. The 12-week exercise intervention combined a weekly group session with home-based exercises (2/week), which entailed exercises for motor learning, flexibility, strengthening, and balance. Placebo ultrasound was given once a week. A 6-camera motion capture system was used for data collection. Data were derived from shod walking at self-selected speeds. Spatio-temporal and hip and knee joint angles of the stance phase were calculated. Data were averaged across five trials. Measurements were taken prior to and immediately after the intervention period. ANOVA/Kruskall-Wallis-Tests were used to analyze between-group effects for differences between test days. Pairwise comparisons were subsequently conducted in case of significant model effects. Data were analyzed per protocol (n = 185).

RESULTS

No statistically significant differences were detected for any of the outcome measures.

SIGNIFICANCE

Although hip muscle strength and gait quality are related, strength training of the hip-surrounding musculature without specific gait training elements cannot improve spatio-temporal gait characteristics or hip and knee joint angles in subjects with mild to moderate hip osteoarthritis. If gait should explicitly be improved through exercise, interventions must incorporate a relevant portion of gait-related tasks.

Correlates of physical activity enjoyment in children and adolescents for a new perspective on the treatment of overweight: A systematic literature review

The purpose of this systematic literature review was to systematically compile the state of knowledge on correlates of physical activity enjoyment in children and adolescents to influence the perspective of future physical activity promotion approaches especially for children and adolescents affected by overweight or obesity. The electronic database search was executed in the five databases PubMed, PsychINFO, SPORTDiscus, Web of Science, and BISp-SURF, from inception to December 6, 2021. A semi-quantitative method was used for summarizing the resulted correlates. For final analysis, 85 studies comprising 48,144 children and adolescents were included. Fifty-seven variables could be coded for their relationship with physical activity enjoyment. Of these, 12 psychological variables, for example, the basic psychological needs, task orientation, or self-efficacy; six interpersonal variables, for example, peer/group acceptance, parental support, and autonomy support; and one behavioral variable, the higher self-reported physical activity, are consistent positively associated to physical activity enjoyment. A scientifically based overview could be extracted for the promotion of physical activity enjoyment in children and adolescents. There is a gap in literature focusing the perception of physical activity enjoyment in the subgroup of children and adolescents affected by overweight or obesity. Therefore, recommendations were made to enable the development of further innovative research approaches in this population.