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Rostron ZPJ, Zacharias A, Semciw AI, Kingsley M, Pizzari T, Woodley SJ, Green R. Comparison between a targeted exercise program and a sham intervention on gluteal muscle activity in people with hip osteoarthritis: Analysis of secondary outcomes from a randomised clinical trial. Gait Posture 2023; 100:33-40. [PMID: 36469965 DOI: 10.1016/j.gaitpost.2022.11.016] [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: 06/29/2022] [Revised: 10/23/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND People with hip osteoarthritis (OA) typically display altered gluteus minimus (GMin) and gluteus medius (GMed) activity during gait, in addition to reduced walking speed and stride length. It is unknown if current rehabilitation programs address changes in gluteal muscle activity in people with hip OA. RESEARCH QUESTION Can a targeted gluteal intervention restore normal gluteal muscle segment activity during gait in people with hip OA? METHODS This study presents secondary outcomes from a multi-site, double-blinded clinical trial in which participants with radiologically confirmed mild-moderate hip OA were randomised into a targeted gluteal or sham intervention for 12-weeks following baseline testing. Electromyography (EMG) outcomes were only conducted at a single site and data were collected from 22 participants. Intramuscular electrodes were inserted into two segments of GMin (anterior, posterior) and three segments of GMed (anterior, middle, posterior) to record average amplitude, peak amplitude and time to peak (TTP) during the first 60 % of the gait cycle (stance phase) at baseline and post-intervention. RESULTS Following the targeted gluteal intervention, posterior GMin displayed a decrease in average (P = 0.032, ES=1.04) and peak (P = 0.017, ES=1.17) muscle activity during late stance phase with a shift to an earlier TTP (P = 0.034, ES=1.02). There were no further significant changes between groups for other outcome measures. Similar trends for an earlier TTP were observed for the posterior segment of GMed following the targeted intervention (P = 0.095, ES=0.87). The earlier TTP in the posterior segments of both GMin and GMed post-intervention resembled patterns observed in a healthy young population. SIGNIFICANCE A targeted gluteal intervention can positively impact activity in posterior GMin during gait in people with hip OA when compared to a sham intervention.
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Affiliation(s)
- Zachary P J Rostron
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia.
| | - Anita Zacharias
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Adam I Semciw
- Department of Physiotherapy, Podiatry, and Pr osthetics and Orthotics, School of Allied Health La Trobe University, Bundoora, VIC, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD, Australia
| | - Michael Kingsley
- Department of Exercise Sciences, Faculty of Science, University of Auckland, Auckland, New Zealand; Holsworth Research Initiative, College of Science, Health & Engineering, La Trobe University, Bendigo, VIC, Australia
| | - Tania Pizzari
- Department of Physiotherapy, Podiatry, and Pr osthetics and Orthotics, School of Allied Health La Trobe University, Bundoora, VIC, Australia
| | - Stephanie J Woodley
- Department of Anatomy, School of Biomedical Sciences, University of Otago, Dunedin, New Zealand
| | - Rodney Green
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
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Rostron ZPJ, Zacharias A, Semciw AI, Kingsley M, Pizzari T, Woodley SJ, Green R. Effects of a targeted resistance intervention compared to a sham intervention on gluteal muscle hypertrophy, fatty infiltration and strength in people with hip osteoarthritis: analysis of secondary outcomes from a randomised clinical trial. BMC Musculoskelet Disord 2022; 23:944. [PMID: 36309690 PMCID: PMC9617418 DOI: 10.1186/s12891-022-05907-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Background People with hip osteoarthritis are typically offered a combination of education and exercise to address muscle atrophy and weakness. Limited evidence exists to assess the efficacy of exercise programs on muscle structure or function in this population. The aim of this study was to evaluate the effects of targeted resistance exercise on gluteal muscle hypertrophy and strength in people with mild-to-moderate hip osteoarthritis. Methods Twenty-seven participants with radiologically confirmed hip osteoarthritis recruited from a single site of a multi-site, double-blind clinical trial were randomly allocated to receive a 12-week targeted gluteal intervention or sham intervention. Magnetic resonance imaging and hand-held dynamometry were used to determine change in gluteal muscle volume, fatty infiltration and hip muscle strength. For gluteal muscle volume and strength outcomes mixed model analyses of variance (ANOVA) were conducted. A general linear model (ANOVA) analysis with fixed effects parameter estimates was used to assess the impact of sex on gluteal muscle size and strength of the affected limb only. For muscle fat index a mixed method ANOVA was used to assess the differences between groups and over time. Results In the targeted intervention group, gluteus minimus volume increased from baseline to post-intervention in both limbs (pooled mean difference: 0.06 cm3/kg, 95% confidence interval: 0.01 to 0.11) while no change occurred in the sham group (time x group effect: P = 0.025). Gluteus medius, gluteus maximus and tensor fascia lata volume did not change significantly over time. Hip strength (abduction, adduction, flexion, extension, external and internal rotation) improved similarly in both groups (time main effect: P ≤ 0.042). There was a consistent, albeit non-significant, pattern of reduced fatty infiltration after the targeted intervention. Conclusion Targeted resistance exercise resulted in gluteus minimus hypertrophy, but improvements in hip strength occurred in both groups. Clinicians delivering hip osteoarthritis rehabilitation programs might consider implementing a targeted exercise program to attenuate disease associated changes within gluteal muscles. Trial registration Australian New Zealand Clinical Trials Registry, ID: ACTRN12617000970347. Registered prospectively on 5 July 2017. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05907-4.
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King MG, Kemp JL, Hon R, Pizzari T, Wong J, Menz H, Taylor NF, Harms A, McClelland JA, Semciw AI. Prefabricated contoured foot orthoses to reduce pain and increase physical activity in people with hip osteoarthritis: protocol for a randomised feasibility trial. BMJ Open 2022; 12:e062954. [PMID: 36691129 PMCID: PMC9453946 DOI: 10.1136/bmjopen-2022-062954] [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] [Received: 03/16/2022] [Accepted: 08/09/2022] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION The aim of this randomised feasibility trial is to determine the feasibility of conducting an adequately powered randomised controlled trial (RCT) investigating the efficacy of prefabricated contoured foot orthoses in people with hip osteoarthritis (OA). The secondary aims of the trial are to compare the effect of prefabricated contoured foot orthoses to a flat shoe insert comparator on outcomes of hip-related pain, physical activity and quality of life. We hypothesise that the demand, implementation, acceptability and practicality of foot orthoses as a treatment option for people with hip OA will be deemed feasible, informing the development of an adequately powered RCT to evaluate the efficacy and long term outcomes. METHODS AND ANALYSIS We will recruit 28 people with hip OA who will be randomised to receive either prefabricated contoured foot orthoses or flat shoe inserts to use for a 6-week period. Both groups will receive standardised education on hip OA and physical activity. The study's primary outcome is the feasibility domains of demand, implementation, acceptability and practicality. The secondary outcomes include the change in Hip Osteoarthritis Outcome Score-12, Patient Health Questionnaire-9, Brief Fear of Movement Scale for OA, Physical activity accelerometry and the Physical Activity Questionnaire-short form. Descriptive statistics will be used to describe feasibility outcomes with limited efficacy analysis used for the secondary outcomes. Linear mixed models will be used to analyse between-group differences at 6 weeks, with baseline values used as covariates, treatment allocation as a fixed factor and participant as a random factor. ETHICS AND DISSEMINATION This trial has been approved by the La Trobe University Human Research Ethics Committee (HEC20427), St. Vincent's Hospital Melbourne, Human Research Ethics Committee (HREC 266/20) and Northern Health Research Governance (NH-2021-292862). The results will be disseminated via a peer-reviewed journal and presented at international conferences. TRIAL REGISTRATION NUMBER NCT05138380.
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Affiliation(s)
- Matthew G King
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
| | - Joanne L Kemp
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
| | - Ryan Hon
- Northern Health, Epping, Victoria, Australia
| | - Tania Pizzari
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
| | - Justin Wong
- Northern Health, Epping, Victoria, Australia
| | - Hylton Menz
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Podiatry, La Trobe University, Melbourne, Victoria, Australia, LaTrobe University, Melbourne, Victoria, Australia
| | - Nicholas F Taylor
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
- Allied Health Clinical Research Office, Eastern Health, Box Hill, Victoria, Australia
| | - Anton Harms
- Northern Health, Epping, Victoria, Australia
| | - Jodie A McClelland
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
| | - Adam Ivan Semciw
- La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Melbourne, Victoria, Australia
- Discipline of Physiotherapy, LaTrobe University, Melbourne, Victoria, Australia, La Trobe University, Bundoora, Victoria, Australia
- Northern Health, Epping, Victoria, Australia
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Systematic evaluation of sample preparation strategy for GC-MS-based plasma metabolomics and its application in osteoarthritis. Anal Biochem 2021; 621:114153. [PMID: 33684344 DOI: 10.1016/j.ab.2021.114153] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/09/2021] [Accepted: 02/24/2021] [Indexed: 12/20/2022]
Abstract
Sample preparation plays a crucial part in plasma metabolomics. In order to obtain an optimal sample extraction method for gas chromatography mass spectrometry (GC-MS)-based plasma metabolomics, five different extraction strategies including protein precipitation, liquid-liquid extraction and solid-phase extraction were evaluated systematically for both plasma untargeted- and targeted-metabolomics. The comprehensive evaluation revealed that the all-in-one sample preparation method, MeOH-MTBE-H2O (1:5:1.5, v/v/v), was the optimal extraction method for both untargeted- and targeted-metabolomics. Next, the optimal sample preparation protocol was applied in plasma metabolomics of osteoarthritis (OA). A panel containing cholesterol, lactic acid, stearic acid, alpha-tocopherol and oxalic acid was selected as candidate biomarker to distinguish OA patients from healthy controls (HC) based on the support vector machine (SVM) classification model. The discriminating capability of the candidate biomarker panel was further validated successfully with logistic regression and principal components analysis (PCA) analysis. Therefore, the panel could potentially act as diagnostic biomarker for osteoarthritis.
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Coleman G, Dobson F, Hinman RS, Bennell K, White DK. Measures of Physical Performance. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:452-485. [PMID: 33091270 DOI: 10.1002/acr.24373] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 12/11/2022]
Affiliation(s)
| | - Fiona Dobson
- University of Melbourne, Melbourne, Victoria, Australia
| | - Rana S Hinman
- University of Melbourne, Melbourne, Victoria, Australia
| | - Kim Bennell
- University of Melbourne, Melbourne, Victoria, Australia
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Homma D, Minato I, Imai N, Miyasaka D, Sakai Y, Horigome Y, Suzuki H, Shimada H, Dohmae Y, Endo N. Appropriate sites for the measurement of the cross-sectional area of the gluteus maximus and the gluteus medius muscles in patients with hip osteoarthritis. Surg Radiol Anat 2020; 43:45-52. [PMID: 32681225 DOI: 10.1007/s00276-020-02535-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the relationship between the volume, cross-sectional area, and peak isometric muscle strength of the gluteus maximus and gluteus medius muscles in patients with hip osteoarthritis, and to use this information to identify effective sites for measurement of the cross-sectional area of these muscles. METHODS Twenty-four patients with hip osteoarthritis were included. The muscle cross-sectional area and volume were calculated from magnetic resonance images. The cross-sectional area was calculated at three levels: the inferior point of the sacroiliac joint, just above the femoral head, and at the greatest muscle diameter. Peak isometric strength was assessed using hand-held dynamometry, using the extension and external rotation for the gluteus maximus and abduction and internal rotation for the gluteus medius. Measured outcomes were compared between the two muscles, and the association between muscle volume, cross-sectional area, and peak isometric muscle strength was evaluated using Pearson's correlation. RESULTS Volume was correlated with the cross-sectional area in the gluteus maximus (r ≥ 0.707) and with the cross-sectional area (r ≥ 0.637) and peak isometric strength (r ≥ 0.477) in the gluteus medius. There was no difference between the cross-sectional area measured at the greatest muscle diameter and just above the femoral head (p = 0.503) for the gluteus maximus and at the inferior point of the sacroiliac joint (p = 0.651) for the gluteus medius. CONCLUSION The cross-sectional area, when used to calculate the muscle volume, should be evaluated just above the femoral head for the gluteus maximus and at the inferior point of the sacroiliac joint for the gluteus medius.
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Affiliation(s)
- Daisuke Homma
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan. .,Division of Rehabilitation, Niigata Bandai Hospital, 2-2-8 Yachiyo, Chuou-ku, Niigata, Niigata, 950-8584, Japan.
| | - Izumi Minato
- Division of Orthopedic Surgery, Niigata Rinko Hospital, 1-114-3 Momoyama-cho, Higashi-ku, Niigata, Niigata, 950-0051, Japan
| | - Norio Imai
- Division of Comprehensive Geriatrics in Community, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Dai Miyasaka
- Division of Orthopedic Surgery, Niigata Bandai Hospital, 2-2-8 YachiyoChuou-ku, Niigata, Niigata, 950-8584, Japan
| | - Yoshinori Sakai
- Division of Orthopedic Surgery, Niigata General Hospital, 463 Kanege, Chuo-ku, Niigata, Niigata, 950-1197, Japan
| | - Yoji Horigome
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Hayato Suzuki
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
| | - Hayato Shimada
- Division of Orthopedic Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki, 311-4198, Japan
| | - Yoichiro Dohmae
- Division of Orthopedic Surgery, Niigata Bandai Hospital, 2-2-8 YachiyoChuou-ku, Niigata, Niigata, 950-8584, Japan
| | - Naoto Endo
- Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 757 Ichibancho, Asahimachidori, Chuou-ku, Niigata, Niigata, 951-8510, Japan
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O'Neill TW, McCabe PS, McBeth J. Update on the epidemiology, risk factors and disease outcomes of osteoarthritis. Best Pract Res Clin Rheumatol 2018; 32:312-326. [PMID: 30527434 DOI: 10.1016/j.berh.2018.10.007] [Citation(s) in RCA: 220] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 10/12/2018] [Accepted: 10/12/2018] [Indexed: 12/20/2022]
Abstract
Osteoarthritis (OA) is the most frequent form of arthritis and a leading cause of pain and disability worldwide. OA can affect any synovial joint, although the hip, knee, hand, foot and spine are the most commonly affected sites. Knowledge about the occurrence and risk factors for OA is important to define the clinical and public health burden of the disease to understand mechanisms of disease occurrence and may also help to inform the development of population-wide prevention strategies. In this article, we review the occurrence and risk factors for OA and also consider patient-reported outcome measures that have been used for the assessment of the disease.
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Affiliation(s)
- Terence W O'Neill
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Paul S McCabe
- Royal Oldham Hospital, Pennine Acute NHS Trust, Rochdale Rd, Oldham OL1 2JH, UK
| | - John McBeth
- Arthritis Research UK Centre for Epidemiology, The University of Manchester, Manchester, UK & NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
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