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Moradi K, Mohajer B, Mohammadi S, Guermazi A, Ibad HA, Roemer FW, Cao X, Link TM, Demehri S. Thigh Muscle Composition Changes in Knee Osteoarthritis Patients During Weight Loss: Sex-Specific Analysis Using Data from Osteoarthritis Initiative. Osteoarthritis Cartilage 2024:S1063-4584(24)01213-5. [PMID: 38851527 DOI: 10.1016/j.joca.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 05/15/2024] [Accepted: 05/31/2024] [Indexed: 06/10/2024]
Abstract
OBJECTIVES Sex of patients with knee osteoarthritis (KOA) may impact changes in thigh muscle composition during weight loss, the most well-known disease-modifying intervention. We investigated longitudinal sex-based changes in thigh muscle quality during weight loss in participants with KOA. METHODS Using Osteoarthritis Initiative (OAI) cohort data, we included females and males with baseline radiographic KOA who experienced >5% reduction in BMI over four years. Using a previously validated deep-learning algorithm, we measured MRI-derived biomarkers of thigh muscles at baseline and year-4. Outcomes were the intra- and inter-muscular adipose tissue (Intra-MAT and Inter-MAT) and contractile percentage of thigh muscles between females and males. The analysis adjusted for potential confounders, such as demographics, risk factors, BMI change, physical activity, diet, and KOA status. RESULTS A retrospective selection of available thigh MRIs from KOA participants who also had a 4-year weight loss (>5% of BMI) yielded a sample comprising 313 thighs (192 females and 121 males). Female and male participants exhibited a comparable degree of weight loss (females: -9.72±4.38, males: -8.83±3.64, P-value=0.060). However, the changes in thigh muscle quality were less beneficial for females compared to males, as shown by a less degree of longitudinal decrease in Intra-MAT (change difference,95%CI: 783.44 mm2/4-year, 505.70 to 1061.19, P-value<0.001) and longitudinal increase in contractile percentage (change difference,95%CI: -3.9%/4-year, -6.5 to -1.4, P-value=0.019). CONCLUSIONS In participants with KOA and 4-year weight loss, the longitudinal changes in thigh muscle quality were overall beneficial but to a less degree in females compared to males. Further research is warranted to investigate the underlying mechanisms and develop sex-specific interventions to optimize muscle quality during weight loss.
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Affiliation(s)
- Kamyar Moradi
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Bahram Mohajer
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Soheil Mohammadi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ali Guermazi
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA.
| | - Hamza Ahmed Ibad
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Frank W Roemer
- Department of Radiology, Chobanian & Avedisian Boston University School of Medicine, Boston, Massachusetts, USA; Department of Radiology, Universitätsklinikum Erlangen & Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
| | - Xu Cao
- Department of Orthopedic Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Thomas M Link
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, 94158, USA.
| | - Shadpour Demehri
- Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Suwankanit K, Shimizu M. Effects of Neuromuscular Electrical Stimulation and Therapeutic Ultrasound on Quadriceps Contracture of Immobilized Rats. Vet Sci 2024; 11:158. [PMID: 38668425 PMCID: PMC11054819 DOI: 10.3390/vetsci11040158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 03/27/2024] [Accepted: 03/27/2024] [Indexed: 04/29/2024] Open
Abstract
Quadriceps contracture is a condition where the muscle-tendon unit is abnormally shortened. The treatment prognosis is guarded to poor depending on the progress of the disease. To improve the prognosis, we investigated the effectiveness of therapeutic ultrasound and NMES in treating quadriceps contracture in an immobilized rat model. Thirty-six Wistar rats were randomized into control, immobilization alone, immobilization and spontaneous recovery, immobilization and therapeutic ultrasound, immobilization and NMES, and immobilization and therapeutic ultrasound and NMES combination groups. The continuous therapeutic ultrasound (frequency, 3 MHz, intensity 1 W/cm2) and NMES (TENS mode, frequency 50 Hz; intensity 5.0 ± 0.8 mA) were performed on the quadriceps muscle. On Day 15, immobilization-induced quadriceps contracture resulted in a decreased ROM of the stifle joint, reduction in the sarcomere length, muscle atrophy, and muscle fibrosis. On Day 43, therapeutic ultrasound, NMES, and combining both methods improved muscle atrophy and shortening and decreased collagen type I and III and α-SMA protein. The combination of therapeutic ultrasound and NMES significantly reduced the mRNA expression of IL-1β, TGF-β1, and HIF-1α and increased TGF-β3. Therefore, the combination of therapeutic ultrasound and NMES is the most potent rehabilitation program for treating quadriceps contracture.
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Affiliation(s)
- Kanokwan Suwankanit
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu 183-0054, Tokyo, Japan;
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom 73170, Thailand
| | - Miki Shimizu
- Department of Veterinary Diagnostic Imaging, Faculty of Agriculture, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu 183-0054, Tokyo, Japan;
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Uçar N, Öner H, Kuş MA, Karaca H, Fırat T. The effect of neuromuscular electrical stimulation applied at different muscle lengths on muscle architecture and sarcomere morphology in rats. Anat Rec (Hoboken) 2024; 307:356-371. [PMID: 37194371 DOI: 10.1002/ar.25240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 04/04/2023] [Accepted: 04/26/2023] [Indexed: 05/18/2023]
Abstract
Neuromuscular electrical stimulation (NMES) is often used to increase muscle strength and functionality. Muscle architecture is important for the skeletal muscle functionality. The aim of this study was to investigate the effects of NMES applied at different muscle lengths on skeletal muscle architecture. Twenty-four rats were randomly assigned to four groups (two NMES groups and two control groups). NMES was applied on the extensor digitorum longus muscle at long muscle length, which is the longest and stretched position of the muscle at 170° plantar flexion, and at medium muscle length, which is the length of the muscle at 90° plantar flexion. A control group was created for each NMES group. NMES was applied for 8 weeks, 10 min/day, 3 days/week. After 8 weeks, muscle samples were removed at the NMES intervention lengths and examined macroscopically, and microscopically using a transmission electron microscope and streo-microscope. Muscle damage, and architectural properties of the muscle including pennation angle, fibre length, muscle length, muscle mass, physiological cross-sectional area, fibre length/muscle length, sarcomere length, sarcomere number were then evaluated. There was an increase in fibre length and sarcomere number, and a decrease in pennation angle at both lengths. In the long muscle length group, muscle length was increased, but widespread muscle damage was observed. These results suggest that the intervention of NMES at long muscle length can increase the muscle length but also causes muscle damage. In addition, the greater longitudinal increase in muscle length may be a result of the continuous degeneration-regeneration cycle.
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Affiliation(s)
- Nehir Uçar
- Department of Therapy and Rehabilitation, Vocational School of Health Sciences, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Hakan Öner
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Murat Abdulgani Kuş
- Department of Emergency Aid and Disaster Management, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Harun Karaca
- Department of Histology and Embryology, Faculty of Veterinary Medicine, University of Burdur Mehmet Akif Ersoy, Burdur, Turkey
| | - Tüzün Fırat
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Wang XY, Bao CC, An R, Wu T, Wang D, Zhang YJ, He CQ. Evaluation of the effect of physical therapy on pain and dysfunction of knee osteoarthritis based on fNIRS: a randomized controlled trial protocol. BMC Musculoskelet Disord 2023; 24:152. [PMID: 36855073 PMCID: PMC9972641 DOI: 10.1186/s12891-022-06074-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 12/07/2022] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic musculoskeletal disease that can cause joint pain and dysfunction, affecting the quality of life of patients. Nonsurgical treatment is the conventional treatment of KOA, among which physical therapy is widely used because of its simplicity, convenience and effectiveness. The functional biomarker will add to the clinical fidelity and diagnostic accuracy. Therefore, our study chose a more objective evaluation indicator, functional near-infrared spectroscopy (fNIRS), to identify between healthy people and KOA patients, and to detect the pain change before and after treatment of KOA patients. METHODS The study will be conducted in the Rehabilitation Medical Center of West China Hospital of Sichuan University and divided into 2 stages. In the first stage, we will compare and determine the differences in baseline data between healthy volunteers and KOA patients. In the second stage, 72 KOA patients will be randomly divided into two groups: the drug therapy group (DT) and the combination therapy group (CT) for 10 treatments. Outcome measures will be measured at baseline and on the 5th and 10th days after the intervention, including the numerical rating scale (NRS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain catastrophizing scale (PCS), the association of pain severity with task-state functional connectivity fNIRS and association of pain severity with task-activated fNIRS. DISCUSSION By analyzing the fNIRS data of healthy volunteers and KOA patients, our study will be determined whether fNIRS can be used as a new indicator to reflect the severity of pain in KOA patients. Subsequently, the same fNIRS data for KOA patients before and after the intervention will be collected to provide an accurate evaluation criterion for the effect of physical therapy on KOA. TRIAL REGISTRATION The study was registered on the Chinese Registry website (registered in ChiCTR.org with the identifiers ChiCTR2200064175 and 29/09/2022).
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Affiliation(s)
- Xiao-yi Wang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Chun-cha Bao
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Ran An
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Tao Wu
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Dun Wang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Yu-jia Zhang
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
| | - Cheng-qi He
- grid.412901.f0000 0004 1770 1022Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, 610041 Sichuan People’s Republic of China ,grid.412901.f0000 0004 1770 1022Key Laboratory of Rehabilitation Medicine, West China Hospital, Sichuan University, 610041 Chengdu, People’s Republic of China
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Koh E, Freedman BR, Ramazani F, Gross J, Graham A, Kuttler A, Weber E, Mooney DJ. Controlled Delivery of Corticosteroids Using Tunable Tough Adhesives. Adv Healthc Mater 2023; 12:e2201000. [PMID: 36285360 PMCID: PMC11046305 DOI: 10.1002/adhm.202201000] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 09/27/2022] [Indexed: 01/26/2023]
Abstract
Hydrogel-based drug delivery systems typically aim to release drugs locally to tissue in an extended manner. Tissue adhesive alginate-polyacrylamide tough hydrogels are recently demonstrated to serve as an extended-release system for the corticosteroid triamcinolone acetonide. Here, the stimuli-responsive controlled release of triamcinolone acetonide from the alginate-polyacrylamide tough hydrogel drug delivery systems (TADDS) and evolving new approaches to combine alginate-polyacrylamide tough hydrogel with drug-loaded nano and microparticles, generating composite TADDS is described. Stimulation with ultrasound pulses or temperature changes is demonstrated to control the release of triamcinolone acetonide from the TADDS. The incorporation of laponite nanoparticles or PLGA microparticles into the tough hydrogel is shown to further enhance the versatility to control and modulate the release of triamcinolone acetonide. A first technical exploration of a TADDS shelf-life concept is performed using lyophilization, where lyophilized TADDS are physically stable and the bioactive integrity of released triamcinolone acetonide is demonstrated. Given the tunability of properties, the TADDS are a suggested technology platform for controlled drug delivery.
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Affiliation(s)
- Esther Koh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
| | - Benjamin R Freedman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
| | - Farshad Ramazani
- Novartis Pharma AG, Technical Research and Development, Basel, 4056, Switzerland
| | - Johannes Gross
- Novartis Pharma AG, Technical Research and Development, Basel, 4056, Switzerland
| | - Adam Graham
- Center for Nanoscale Systems, Harvard University, Cambridge, MA, 02138, USA
| | - Andreas Kuttler
- Novartis Institutes for Biomedical Research, Basel, 4056, Switzerland
| | - Eckhard Weber
- Novartis Institutes for Biomedical Research, Basel, 4056, Switzerland
| | - David J Mooney
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, 02138, USA
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, 02115, USA
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Mohajer B, Dolatshahi M, Moradi K, Najafzadeh N, Eng J, Zikria B, Wan M, Cao X, Roemer FW, Guermazi A, Demehri S. Role of Thigh Muscle Changes in Knee Osteoarthritis Outcomes: Osteoarthritis Initiative Data. Radiology 2022; 305:169-178. [PMID: 35727152 PMCID: PMC9524577 DOI: 10.1148/radiol.212771] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 04/12/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022]
Abstract
Background Longitudinal data on the association of quantitative thigh muscle MRI markers with knee osteoarthritis (KOA) outcomes are scarce. These associations are of clinical importance, with potential use for thigh muscle-directed disease-modifying interventions. Purpose To measure KOA-associated longitudinal changes in MRI-derived muscle cross-sectional area (CSA) and adipose tissue and their association with downstream symptom worsening and knee replacement (KR). Materials and Methods In a secondary analysis of the Osteoarthritis Initiative multicenter prospective cohort (February 2004 through October 2015), knees of participants with available good-quality thigh MRI scans at baseline and at least one follow-up visit were included and classified as with and without KOA according to baseline radiographic Kellgren-Lawrence grade of 2 or higher and matched for confounders with use of propensity score matching. An automated deep learning model for thigh MRI two-dimensional segmentation was developed and tested. Markers of muscle CSA and intramuscular adipose tissue (intra-MAT) were measured at baseline and 2nd- and 4th-year follow-up (period 1) and compared between knees with and without KOA by using linear mixed-effect regression models. Furthermore, in knees with KOA, the association of period 1 changes in muscle markers with risk of KR (Cox proportional hazards) and symptom worsening (mixed-effect models) during the 4th to 9th year (period 2) was evaluated. Results This study included 4634 matched thighs (2317 with and 2317 without KOA) of 2344 participants (mean age, 62 years ± 9 [SD]; 1292 women). Compared with those without, knees with KOA had a decrease in quadriceps CSA (mean difference, -8.21 mm2/year; P = .004) and an increase in quadriceps intra-MAT (1.98 mm2/year; P = .007). Decreased CSA and increased intra-MAT of quadriceps during period 1 was predictive of downstream (period 2) KOA symptom worsening (Western Ontario and McMaster Universities Osteoarthritis Index total score: odds ratio, 0.24 [negative association] [P < .001] and 1.38 [P = .012], respectively). Quadriceps CSA changes were negatively associated with higher future KR risk (hazard ratio, 0.70; P < .001). Conclusion Knee osteoarthritis was associated with longitudinal MRI-derived decreased quadriceps cross-sectional area and increased intramuscular adipose tissue. These potentially modifiable risk factors were predictive of downstream symptom worsening and knee replacement. Clinical trial registration no. NCT00080171 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Bahram Mohajer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mahsa Dolatshahi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Kamyar Moradi
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Nima Najafzadeh
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - John Eng
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Bashir Zikria
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Mei Wan
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Xu Cao
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
| | - Frank W. Roemer
- From the Division of Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science (B.M., S.D.), Russell H. Morgan Department of Radiology and Radiological Science (J.E.), and Department of Orthopedic Surgery (B.Z., M.W., X.C.), Johns Hopkins University School of Medicine, 601 N Caroline St, JHOC 3142, Baltimore, MD 21287; Tehran University of Medical Sciences, School of Medicine, Tehran, Iran (M.D., K.M.); Sharif University of Technology, Tehran, Iran (N.N.); Department of Radiology, Boston University School of Medicine, Boston, Mass (F.W.R., A.G.); and Department of Radiology, University of Erlangen-Nuremberg, Erlangen, Germany (F.W.R.)
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Joshi MV, Phansopkar P. High-Risk Fall Rehabilitation With Modified Otago Exercises and Medicinal Nano Gel Phonophoresis for Symptomatic Relief in Osteoarthritis of Knee. Cureus 2022; 14:e29308. [PMID: 36277568 PMCID: PMC9580610 DOI: 10.7759/cureus.29308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 09/18/2022] [Indexed: 11/30/2022] Open
Abstract
Proprioception is a major affection faced by individuals who undergo lower limb injuries. Especially in the elderly population, this places a major role in increasing the risk of fall. We are reporting a case of an elderly female having severe pain in her lower limb and difficulties in performing activities of daily living. Post clinical assessment, a functional diagnosis of osteoarthritic knee was made. The patient was managed with proprioception exercises (Otago exercises) and phonophoresis. These exercises were also beneficial in improving the apprehension of patient towards daily activities, walking, stair climbing, and fall risk. The technique of phonophoresis helped in alleviation of pain when given with a beneficial adjunct, like a medicinal gel.
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The Investigation of the Application Value of Musculoskeletal Ultrasound in the Diagnosis and Conservative Treatment of Knee Osteoarthritis. DISEASE MARKERS 2022; 2022:9660067. [PMID: 36016850 PMCID: PMC9398875 DOI: 10.1155/2022/9660067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/19/2022] [Accepted: 06/22/2022] [Indexed: 12/04/2022]
Abstract
Objective To explore the application value of musculoskeletal ultrasound in the diagnosis and conservative treatment of knee osteoarthritis. Methods Patients with knee osteoarthritis who were treated in our hospital from January 1, 2020 to August 31, 2021 were selected as the research subjects. The subjects underwent musculoskeletal ultrasonography to record the thickness of the lateral femoral malleolus cartilage, the thickness of the medial femoral malleolus cartilage, the depth of the suprapatellar bursa effusion, and the thickness of the suprapatellar bursa synovium. All patients in the study group received acupuncture treatment after musculoskeletal ultrasonography, and musculoskeletal ultrasonography was performed again after 2 weeks of treatment. The differences in musculoskeletal ultrasound-related parameters were compared between the two groups. Results The thickness of the lateral femoral malleolus cartilage and medial femoral malleolus cartilage in the study group was significantly smaller than those in the control group. The depth of the effusion in the suprapatellar bursa and the thickness of the synovial membrane in the suprapatellar bursa were significantly greater than those in the control group. Ultrasonography showed no significant difference in abnormal status compared with arthroscopy, and musculoskeletal ultrasonography revealed knee osteoarthritis, such as cruciate ligament injury, joint effusion, synovial hyperplasia, meniscus injury, and patellar ligament injury. The cartilage thickness of the lateral femoral malleolus and medial malleolus of femur after treatment were significantly greater than those before treatment. The depth of the deep suprapatellar bursa effusion and the thickness of the suprapatellar bursa synovium were significantly smaller than those before treatment. Conclusion Musculoskeletal ultrasound has high diagnostic value in knee osteoarthritis. It can detect the lesion as soon as possible and can be used to evaluate the effect of conservative treatment, so as to provide reference basis for clinical formulation or adjustment of further intervention plan.
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Oliveira S, Andrade R, Valente C, Espregueira-Mendes J, Silva F, Hinckel BB, Carvalho Ó, Leal A. Mechanical-based therapies may reduce pain and disability in some patients with knee osteoarthritis: A systematic review with meta-analysis. Knee 2022; 37:28-46. [PMID: 35660536 DOI: 10.1016/j.knee.2022.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/09/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Mechanical-based therapies are not yet recommended to manage osteoarthritis (OA). This systematic review and meta-analysis aim to assess the effects of passive mechanical-based therapies (isolated or combined with other therapies) on patients with knee OA compared to placebo, other isolated or combined interventions. METHODS Pubmed, Cochrane, Web of Science and EMBASE were searched up to December 2020. We included randomized and non-randomized trials using therapeutic ultrasound, phonophoresis, extracorporeal shockwave therapy (ESWT) and vibration (single or combined with other therapies) compared to placebo, and/or other physical therapies groups. Biochemical, patient-reported, physical and imaging outcome measures were retrieved. We judged risk of bias using the RoB2 tool for randomized studies, the ROBINS-I tool for non-randomized studies, and the GRADE to interpret certainty of results. RESULTS We included 77 clinical studies. Ultrasound and ESWT statistically improved pain and disability comparing to placebo (combined or not with other therapies), and when added to other therapies versus other therapies alone. Ultrasound was statistically inferior to phonophoresis (combined or not with other therapies) in reducing pain and disability for specific therapeutic gels and/or combined therapies. Vibration plus exercise statistically improved pain relief and function versus exercise alone. All meta-analyses showed very-low certainty of evidence, with 15 of 42 (38%) pooled comparisons being statistically significant (weak to large effect). CONCLUSIONS Despite the inconsistent evidence with very-low certainty, the potential benefits of passive mechanical-based therapies should not be disregard and cautiously recommended that clinicians might use them in some patients with knee OA.
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Affiliation(s)
- Sofia Oliveira
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Renato Andrade
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; Porto Biomechanics Laboratory (LABIOMEP), Faculty of Sports, University of Porto, Porto, Portugal.
| | - Cristina Valente
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal.
| | - João Espregueira-Mendes
- Clínica Espregueira - FIFA Medical Centre of Excellence, Porto, Portugal; Dom Henrique Research Centre, Porto, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; 3B's Research Group‑Biomaterials, Biodegradables and Biomimetics, Headquarters of the European Institute of Excellence on Tissue Engineering and Regenerative Medicine, University of Minho, AvePark, Parque de Ciência e Tecnologia, Zona Industrial da Gandra, Barco, 4805‑017 Guimarães, Portugal; School of Medicine, University of Minho, Braga, Portugal.
| | - Filipe Silva
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Betina B Hinckel
- Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI, USA.
| | - Óscar Carvalho
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal.
| | - Ana Leal
- Center for MicroElectroMechanical Systems (CMEMS‑UMINHO), University of Minho, Azurém Campus, 4800‑058 Guimarães, Portugal; LABBELS - Associate Laboratory, Braga, Guimarães, Portugal; Dom Henrique Research Centre, Porto, Portugal.
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10
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Jia L, Li D, Wei X, Chen J, Zuo D, Chen W. Efficacy and safety of focused low-intensity pulsed ultrasound versus pulsed shortwave diathermy on knee osteoarthritis: a randomized comparative trial. Sci Rep 2022; 12:12792. [PMID: 35896688 PMCID: PMC9329394 DOI: 10.1038/s41598-022-17291-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 07/22/2022] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to compare the efficacy and safety of focused low-intensity pulsed ultrasound (FLIPUS) with pulsed shortwave diathermy (PSWD) in subjects with painful knee osteoarthritis (OA). In a prospective randomized trial, 114 knee OA patients were randomly allocated to receive FLIPUS or PSWD therapy. The primary outcome was the change from baseline in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total scores. Secondary outcomes included the numerical rating scale (NRS) for pain assessment, time up and go (TUG) test, active joint range of motion (ROM) test, and Global Rating of Change (GRC) scale. Data were collected at baseline, 12 days, 12 weeks and 24 weeks. Patients receiving FLIPUS therapy experienced significantly greater improvements in the WOMAC total scores than patients receiving PSWD therapy at 12 days (mean difference, - 10.50; 95% CI - 13.54 to - 7.45; P = 0.000). The results of the NRS, TUG test, ROM test and GRC scale showed that participants treated with FLIPUS reported less pain and better physical function and health status than those treated with PSWD at 12 days (P = 0.011, P = 0.005, P = 0.025, P = 0.011, respectively). Furthermore, patients in the FLIPUS group showed significant improvements in the WOMAC total scores and NRS scores at 12 weeks (mean difference, - 7.57; 95% CI - 10.87 to - 4.26; P = 0.000 and - 1.79; 95% CI - 2.11 to - 1.47, respectively) and 24 weeks (mean difference, - 6.96; 95% CI - 10.22 to - 3.71; P = 0.000 and - 1.37; 95% CI - 1.64 to - 0.96; P = 0.000, respectively) of follow-up. There were no adverse events during or after the interventions in either group. This study concluded that both FLIPUS and pulsed SWD are safe modalities, and FLIPUS was more effective than PSWD in alleviating pain and in improving dysfunction and health status among subjects with knee OA in the short term.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000032735. Registered 08/05/2020, http://www.chictr.org.cn/showproj.aspx?proj=53413 .
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Affiliation(s)
- Lang Jia
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Dongqian Li
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xia Wei
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jinyun Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China
| | - Deyu Zuo
- Department of Rehabilitation, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Wenzhi Chen
- State Key Laboratory of Ultrasound in Medicine and Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing, China. .,Clinical Center for Tumor Therapy, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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11
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Chen H, Wang Z, Zhang X, Sun M. Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials. Clin Rehabil 2022; 36:1153-1169. [PMID: 35535403 PMCID: PMC9354068 DOI: 10.1177/02692155221097035] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA). Data sources PubMed, Web of Science, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were used from inception to 18 March 2022. Review Methods Meta-analysis was performed to evaluate pain and function recovery between control and LIPUS groups. Standardized mean difference (SMD) or mean difference (MD) and 95% confidence interval (CI) were calculated, and data were combined using the fixed or random-effect model. Results Thirteen studies involving 807 patients with KOA were included. Patients’ outcomes treated by LIPUS were improved significantly, including Visual analog scale (VAS) score (MD = −0.95, 95% CI: −1.43 to −0.48,P < 0.001), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score (MD = −4.35, 95% CI: −8.30 to −0.40, P = 0.0309), Lysholm score (SMD = 1.59, 95% CI: 1.29 to 1.90, P < 0.001), Lequesne index (MD = −1.33, 95% CI: −1.69 to −0.96, P < 0.001), Range of motion (ROM) (MD = 2.43, 95% CI: 0.39 to 4.46, P = 0.0197) and 50 meter walking time (SMD = 1.48, 95% CI: 0.46 to 2.49, P = 0.0044). Subgroup analyses showed monotherapy of LIPUS produced a better effect on reducing VAS score (P = 0.0213), and the shorter therapeutic period (≤4 weeks) produced a more significant effect on raising the WOMAC score (P = 0.0083). Conclusion LIPUS was beneficial for pain relief and functional knee recovery and maybe as an alternative therapy in KOA rehabilitation.
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Affiliation(s)
- Haoqian Chen
- Graduate Students' Affairs Department, 66444Shenyang Sport University, Shen-yang, China.,Sports Training College, 66444Shenyang Sport University, Shen-yang, China
| | - Zheng Wang
- College of Kinesiology, 66444Shenyang Sport University, Shen-yang, China
| | - Xinan Zhang
- College of Kinesiology, 66444Shenyang Sport University, Shen-yang, China
| | - Mingli Sun
- College of Kinesiology, 66444Shenyang Sport University, Shen-yang, China
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12
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Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci 2022; 14:854026. [PMID: 35592699 PMCID: PMC9110817 DOI: 10.3389/fnagi.2022.854026] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/11/2022] [Indexed: 12/14/2022] Open
Abstract
Osteoarthritis (OA) has a very high incidence worldwide and has become a very common joint disease in the elderly. Currently, the treatment methods for OA include surgery, drug therapy, and exercise therapy. In recent years, the treatment of certain diseases by exercise has received increasing research and attention. Proper exercise can improve the physiological function of various organs of the body. At present, the treatment of OA is usually symptomatic. Limited methods are available for the treatment of OA according to its pathogenesis, and effective intervention has not been developed to slow down the progress of OA from the molecular level. Only by clarifying the mechanism of exercise treatment of OA and the influence of different exercise intensities on OA patients can we choose the appropriate exercise prescription to prevent and treat OA. This review mainly expounds the mechanism that exercise alleviates the pathological changes of OA by affecting the degradation of the ECM, apoptosis, inflammatory response, autophagy, and changes of ncRNA, and summarizes the effects of different exercise types on OA patients. Finally, it is found that different exercise types, exercise intensity, exercise time and exercise frequency have different effects on OA patients. At the same time, suitable exercise prescriptions are recommended for OA patients.
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Affiliation(s)
- Hui Kong
- College of Kinesiology, Shenyang Sport University, Shenyang, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopedic Hospital, Shanghai, China
- *Correspondence: Xin-An Zhang,
| | - Xin-An Zhang
- College of Kinesiology, Shenyang Sport University, Shenyang, China
- Xue-Qiang Wang,
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13
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Chang TT, Zhu YC, Li Z, Li F, Li YP, Guo JY, Wang XQ, Zhang ZJ. Modulation in the Stiffness of Specific Muscles of the Quadriceps in Patients With Knee Osteoarthritis and Their Relationship With Functional Ability. Front Bioeng Biotechnol 2022; 9:781672. [PMID: 35223811 PMCID: PMC8870124 DOI: 10.3389/fbioe.2021.781672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
Deficits in the flexibility of the quadriceps are one of the risk factors for developing knee joint disorders. No studies have investigated the changes in the stiffness of the quadriceps muscle among patients with knee osteoarthritis (OA). Therefore, the purpose of this study was to investigate changes in the stiffness of specific-muscle of the quadriceps in patients with knee OA and their relationship with functional ability. Twenty-five patients with knee OA and 25 healthy, asymptomatic subjects were recruited in this study. The stiffness of the vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) in all participants was evaluated using MyotonPRO at 60° and 90° flexion of the knee joint. The results of this study showed a greater VL stiffness in patients with knee OA than in healthy subjects at both 60° and 90° of knee flexion (p < 0.05). Significant differences in VL, VM and RF stiffness were obtained at different knee joint angles in individuals with and without knee OA (p < 0.05). In addition, there was a positive correlation between VL stiffness and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in patients with Knee OA (60° of knee flexion: r = 0.508, p = 0.010; 90° of knee flexion: r = 0.456, p = 0.022). These results indicate that there is an increase in VL stiffness in patients with knee OA compared with healthy, asymptomatic subjects, and the quadriceps stiffness was increased with knee flexion in both healthy subjects and patients with knee OA. VL stiffness is associated with WOMAC scores in patients with knee OA.
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Affiliation(s)
- Tian-Tian Chang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Yuan-Chun Zhu
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Zhe Li
- The First Clinical Medical School, Shaanxi University of Chinese Medicine, Xi’an, China
| | - Feng Li
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Ya-Peng Li
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Jia-Yi Guo
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Zhi-Jie Zhang
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
- *Correspondence: Zhi-Jie Zhang,
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14
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Yaşar MF, Yakşi E, Kurul R, Balcı M. Comparison of outpatient and inpatient spa therapy in knee osteoarthritis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1675-1682. [PMID: 33851246 DOI: 10.1007/s00484-021-02122-z] [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: 11/14/2020] [Accepted: 03/25/2021] [Indexed: 06/12/2023]
Abstract
Osteoarthritis (OA) is a common condition that impacts many people worldwide and involves weight-bearing joints, resulting in chronic pain. In this study, we aimed to compare the effectiveness of inpatient and outpatient physical therapy modalities and spa combination treatments on pain and functional status in patients with knee osteoarthritis. Seventy-four patients diagnosed with primary knee osteoarthritis were included in this study. The patients were randomized into two groups, inpatient (n = 37) and outpatient (n = 37) physical therapy. All patients received a physical therapy program (superficial heater + deep heater + transcutaneous electrical nerve stimulation) for 2 weeks and spa therapy. All cases were evaluated clinically, laboratory, and radiographically. In order to evaluate pain and functional status, the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC), and Timed Up and Go (TUG) test were used before and after treatment. There was no significant difference between the two groups in the TUG test and WOMAC scores (p > 0.05). However, a significant difference was found in VAS scores in favor of the outpatient group (p < 0.05). As a result, although there was a significant improvement in pain scores in the outpatient group, multicenter studies with larger patient groups may provide more evidence.
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Affiliation(s)
- Mustafa Fatih Yaşar
- Medical Faculty, Department of Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University, 14020, Bolu, Turkey.
| | - Elif Yakşi
- Medical Faculty, Department of Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University, 14020, Bolu, Turkey
| | - Ramazan Kurul
- Department of Physical Therapy and Rehabilitation, Faculty of Health Sciences, Bolu Abant Izzet Baysal University, Bolu, Turkey
| | - Muhammed Balcı
- Medical Faculty, Department of Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University, 14020, Bolu, Turkey
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15
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Rabello R, Fröhlich M, Maffiuletti NA, Vaz MA. Influence of Pulse Waveform and Frequency on Evoked Torque, Stimulation Efficiency, and Discomfort in Healthy Subjects. Am J Phys Med Rehabil 2021; 100:161-167. [PMID: 32701636 DOI: 10.1097/phm.0000000000001541] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the study was to determine the influence of neuromuscular electrical stimulation pulse waveform and frequency on evoked torque, stimulation efficiency, and discomfort at two neuromuscular electrical stimulation levels. DESIGN This is a repeated measures study. The quadriceps muscle of 24 healthy men was stimulated at submaximal (neuromuscular electrical stimulationsub) and maximal (neuromuscular electrical stimulationmax) levels using two pulse waveforms (symmetrical, asymmetrical) and three pulse frequencies (60, 80, 100 Hz). Repeated measures analysis of variance and effect sizes were used to verify the effect of pulse waveform and pulse frequency on stimulation efficiency (evoked torque/current intensity) and discomfort and to assess the magnitude of the differences, respectively. RESULTS Stimulation efficiency was higher for symmetrical (neuromuscular electrical stimulationsub = 0.88 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.27 ± 0.46 Nm/mA) compared with asymmetrical (neuromuscular electrical stimulationsub = 0.77 ± 0.21 Nm/mA; neuromuscular electrical stimulationmax = 1.02 ± 0.34 Nm/mA; P ≤ 0.001; effect size = 0.56-0.66) but did not significantly differ between frequencies (P = 0.17). At both neuromuscular electrical stimulation levels, there were no statistically significant differences in discomfort between pulse waveforms or frequencies. CONCLUSIONS The higher stimulation efficiency of symmetrical pulses suggests that this waveform would be preferred to asymmetrical pulses in clinical practice. Stimulation frequencies between 60 and 100 Hz can be used interchangeably because of similar efficiency and discomfort.
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Affiliation(s)
- Rodrigo Rabello
- From the Laboratório de Pesquisa do Exercício, Escola de Educação Física, Fisioterapia e Dança, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil (RR, MF, MAV); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy (RR); and Human Performance Laboratory, Schulthess Clinic, Zurich, Switzerland (NAM)
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Soares ALC, Nogueira FDS, Gomes PSC. Assessment methods of vastus lateralis muscle architecture using panoramic ultrasound: a new approach, test-retest reliability and measurement error. REVISTA BRASILEIRA DE CINEANTROPOMETRIA E DESEMPENHO HUMANO 2021. [DOI: 10.1590/1980-0037.2021v23e76402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Extended-field-of-view ultrasonography is a valid alternative to determine the dimensions of the skeletal striated muscle; however, some factors may influence the final measurement. The aim of this study was to determine the test-retest reliability and measurement error of vastus lateralis muscle architecture variables through internal anatomical landmarks and to compare three fixed determined points using extended-field-of-view ultrasonography. Twelve young (24 ± 6 years) adult university male students participated in the study. Images were obtained through extended-field-of-view ultrasonography of the vastus lateralis muscle. Measurements were made for muscle thickness (MT), fascicle length (FL), and fascicle pennation angle (FA) using a method that identifies internal anatomical landmarks. MT was also measured at predetermined distances of 2 cm proximal, 6 cm proximal, and 2 cm distal. One-way ANOVA with repeated measures did not identify any test-retest significant differences for all variables measured. Typical measurement error in centimeters (cm) or degrees (º), coefficient of variation in percentage (%) and intraclass correlation coefficient were MT = 0.07 cm, 2.93%, 0.964; FL = 0.31 cm, 2.89%, 0.947; FA = 0.92°, 4.08%, 0.942; MT 2 cm proximal = 0.10 cm, 3.77%, 0.910; MT 6 cm proximal = 0.27 cm, 9.66%, 0.576; MT 2 cm distal = 0.35 cm, 19.76%, 0.564. MT, FL and FA showed high reliability and low measurement error. Internal anatomical landmarks proved to be more reliable and presented smaller measurement errors when compared to the predetermined distances method.
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Hawez SW, Hajee SI. Comparing the Effects of Ultrasound and Microwave Physiotherapy Treatments on Knee Osteoarthritis by Measuring Osteocalcin Level and Erythrocyte Sedimentation Rate in Blood. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2020. [DOI: 10.29333/ejgm/7810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Wu Y, Zhu S, Lv Z, Kan S, Wu Q, Song W, Ning G, Feng S. Effects of therapeutic ultrasound for knee osteoarthritis: a systematic review and meta-analysis. Clin Rehabil 2019; 33:1863-1875. [PMID: 31382781 DOI: 10.1177/0269215519866494] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Objective: To assess the effectiveness and safety of therapeutic ultrasound with sham ultrasound on pain relief and functional improvement in knee osteoarthritis patients. As phonophoresis is a unique therapeutic ultrasound, we also compared the effects of phonophoresis with conventional non-drug ultrasound. Data sources: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials from inception up to June 2019. Review methods: Randomized controlled trials comparing therapeutic ultrasound with sham ultrasound in knee osteoarthritis patients were included. Phonophoresis in the experimental and control groups were compared through conventional ultrasound, and corresponding trials were also included. Two reviewers independently identified eligible studies and extracted data. Risk of bias assessments and therapeutic ultrasound safety assessments were also performed. Results: Fifteen studies including three phonophoresis-related studies with 1074 patients were included. Meta-analyses demonstrated that therapeutic ultrasound significantly relieved pain ( P < 0.00001) and reduced the Western Ontario and McMaster Universities (WOMAC) physical function score ( P = 0.03). In addition, therapeutic ultrasound increased the active range of motion ( P < 0.00001) and reduced the Lequesne index ( P < 0.00001). Subgroup analysis of phonophoresis ultrasound illustrated significant differences on the visual analogue scale ( P = 0.009), but no significant differences on WOMAC pain subscales ( P = 0.10), and total WOMAC scores were observed ( P = 0.30). There was no evidence to suggest that ultrasound was unsafe treatment. Conclusions: Therapeutic ultrasound is a safe treatment to relieve pain and improve physical function in patients with knee osteoarthritis. However, phonophoresis does not produce additional benefits to functional improvement, but may relieve pain compared to conventional non-drug ultrasound.
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Affiliation(s)
- Yu Wu
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Shibo Zhu
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Zenghui Lv
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Shunli Kan
- Department of Spine Surgery, Tianjin Union Medical Center, Tianjin, P.R. China
| | - Qiuli Wu
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Wenye Song
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Guangzhi Ning
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
| | - Shiqing Feng
- Department of Orthopaedics, Tianjin Medical University General Hospital, Tianjin, P.R. China
- Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, P.R. China
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