AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint condition...AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.展开更多
Objective: To study the clinical effect of rehabmtation treating combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to research the function, biomechanics of kn...Objective: To study the clinical effect of rehabmtation treating combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to research the function, biomechanics of knee joint, and inflammatory factor in articular cavity. Method:Selecting 120 patients with exercise induced knee osteoarthritis, then they were randomly divided into control group (n=60) and intervene group (n=60). The patients in the control group were given conventional rehabmtation treating, and the intervene group were given intra-articular injection of sodium hyaluronate on this basic, they were treated 4 weeks. Evaluating the function of knee joint;conduct isokinetic muscle strength test (determination of the angIllar velocity were 60°/S, 180°/S);test the ratio of muscle peak torque and four muscles centripetal centripetal peak torque and peak torque, work load of femoral knee joints after (simultaneous determination of the angular velocity were 60°/S);detect the inflammatory factor in the joint fluid. Results: After the treatment, clinical effect in intervene group was superior to that in control group,but had no statistical significance;after the treatment, the score of function of knee joint in the two groups were higher than before treatment, and had statistical significance, and the score of function of knee joint in the intervene group were higher than control group, and the difference had statistical significance;Angular velocity of 60°/S and 180°/S the two groups peak torque, work load and the H/Q values were significantly increased, the intervene group were higher than control group, and the difference had statistical significance;inflammatory factor in the two groups were significantly decreased, the intervene group were lower than control group, and the difference had statistical significance.Conclusions: On the basic of rehabmtation treating, the treatment of intra-articular injection of sodium hyaluronate can improve the function of knee joint through improving the knee muscle strength, the level of their participation in the activities of the biomechanics of knee joint, and the inflammatory factor in the joint fluid.展开更多
AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight datab...AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight databases(i.e.,Pub Med,Cochrane,CINHAL,MEDLINE,Sports Discus,EMBASE,APTA Hooked on Evidence,and PEDro).Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria:subjects had a primary diagnosis of patellofemoral pain syndrome(PFPS),intervention group included hip-strengthening exercises,control group included a traditional physical therapy intervention,study included outcome measures of pain and/or function,study used a randomized controlled trial design,PEDro score was ≥ 7,and study was published in a peer-reviewed journal.Primary outcome measures were subjective scales of pain and function.These measures were converted to standardized mean difference [effect size(ES)],and a random-effects model was used to calculate the overall ES.RESULTS:Two hundred eighty-three studies were screened for inclusion in our meta-analysis.Nine studies were deemed suitable for data extraction and analysis.A total of 426 subjects were used in the nine studies.Overall,there was a significant positive effect of hip-strengthening exercises on measures of pain and function in subjects with PFPS(ES = 0.94,P = 0.00004).None of the individual studies had a negative ES,with study ES ranging from 0.35 to 2.59.Because of the high degree of between-study variance(I2 = 76%;Q = 34.0,P < 0.001),subgroup meta-analyses and meta-regressions were performed.None of the potential moderator variables that were investigated(e.g.,outcome type,hip region targeted,duration of treatment) could explain a significant amount of the between-study variance in ES(P ≥ 0.23).CONCLUSION:Overall,the addition of hip-strengthening exercises to traditional physical therapy produced greater improvements in measures of pain and function.展开更多
Objective To evaluate the efficacy of Tuina(Chinese therapeutic massage)manipulation plus horse-riding squat exercise in treating knee osteoarthritis(KOA)and optimize the combining protocol.Methods Based on a 2×2...Objective To evaluate the efficacy of Tuina(Chinese therapeutic massage)manipulation plus horse-riding squat exercise in treating knee osteoarthritis(KOA)and optimize the combining protocol.Methods Based on a 2×2 factorial design,120 eligible KOA patients were randomized into a manipulation group(group A1B2),a manipulation plus horse-riding squat group(group A1B1),a sitting knee-adjustment group(group A2B2 group),and a sitting knee-adjustment plus horse-riding squat group(group A2B1),with 30 cases in each group.The intervention was conducted three times a week,lasting for four weeks.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was taken as the major measure for efficacy evaluation(including three component scores,pain,stiffness,and daily function,and total score).Results The three component scores(pain,stiffness,and daily function)and the total score of WOMAC showed significant differences after the intervention in the four groups(P<0.05).There were significant inter-group differences in the WOMAC stiffness score amongst the four groups after the intervention(P<0.05).In group A1B1,the step length,stride,walking speed,and knee joint flexion angle changed significantly after treatment(P<0.05).After the intervention,the step length changed significantly in group A1B2(P<0.05),and the walking speed changed significantly in group A2B1(P<0.05).There were no significant differences in the step length,stride,walking speed,or knee joint flexion angle among the four groups(P>0.05).The extensor peak torque at 180°/s changed significantly in group A1B2 after treatment(P<0.05).Neither the intra-group nor the inter-group comparisons of the four groups revealed significant differences in the other isokinetic muscle strength parameters(P>0.05).The main effect of manipulation showed significant in affecting the WOMAC pain and total scores(P<0.05).The main effect of horse-riding squat exercise showed significant in affecting the WOMAC pain and stiffness scores(P<0.05).Conclusion The four treatment protocols all can improve the symptoms of KOA,for instance,relieving pain and stiffness,and enhancing daily function.Group A2B1 produces the most eminent effect in relieving joint stiffness.The main effects of both manipulation and horse-riding squat exercise are significant in reducing pain.Besides,the main effect of horse-riding squat exercise is significant in relieving joint stiffness.展开更多
Objective:To observe the efficacy of electroacupuncture(EA)plus Yi Jin Jing(Sinew-transforming Qigong Exercises)for knee osteoarthritis(KOA).Methods:A total of 60 patients with KOA were divided into an observation gro...Objective:To observe the efficacy of electroacupuncture(EA)plus Yi Jin Jing(Sinew-transforming Qigong Exercises)for knee osteoarthritis(KOA).Methods:A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Patients in the observation group received the treatment of EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises),while patients in the control group only received EA treatment.Both groups were treated for 5 weeks.The changes of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and visual analog scale(VAS)scores in the two groups were observed after treatment.Results:After treatment,the total effective rate in the observation group(92.3%)was significantly higher than that in the control group(70.0%),(P<0.05);the WOMAC and VAS scores in both groups were significantly lower than those before treatment,showing statistical significance(all P<0.01);there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups(P<0.05,P<0.01).Conclusion:EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises)is clinically effective for KOA.This combined treatment can alleviate clinical symptoms.展开更多
OBJECTIVE: To verify the action of non-pharmacological interventions, whole body vibration exercise (WBVE) and auriculotherapy (AT) on the management of knee osteoarthritis (KOA) analyzing the handgrip strength (HS). ...OBJECTIVE: To verify the action of non-pharmacological interventions, whole body vibration exercise (WBVE) and auriculotherapy (AT) on the management of knee osteoarthritis (KOA) analyzing the handgrip strength (HS). METHODS: One hundred twelve participants with KOA were allocated in (a) WBVE group with peak-to-peak displacement of 2.5 to 7.5 mm, frequency from 5 up to 14 Hz, acceleration peak from 0.12 up to 2.95 g (2 d/weekly for 5 weeks),(b) AT group, points of both ears (Kidney, Knee-correspondent point and Shenmen) were stimulated with seeds,(c) WBVE + AT group and (d) respective control groups. HS was assessed in all the participants, in acute and cumulative responses. RESULTS: The intervention with WBVE alone and combined with AT improved (P < 0.05), in a cumulative response, the HS. CONCLUSION: WBVE alone or combined with AT might promote biological effects that interfere with the HS in individuals with KOA.展开更多
基金National Institute of Arthritis and Musculoskeletal and Skin Diseases of the National Institutes of Health,No.U01AR067138.
文摘AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.
基金National Natural Science Foundation Youth Project:81501857.
文摘Objective: To study the clinical effect of rehabmtation treating combined with intra-articular injection of sodium hyaluronate for exercise induced knee osteoarthritis, and to research the function, biomechanics of knee joint, and inflammatory factor in articular cavity. Method:Selecting 120 patients with exercise induced knee osteoarthritis, then they were randomly divided into control group (n=60) and intervene group (n=60). The patients in the control group were given conventional rehabmtation treating, and the intervene group were given intra-articular injection of sodium hyaluronate on this basic, they were treated 4 weeks. Evaluating the function of knee joint;conduct isokinetic muscle strength test (determination of the angIllar velocity were 60°/S, 180°/S);test the ratio of muscle peak torque and four muscles centripetal centripetal peak torque and peak torque, work load of femoral knee joints after (simultaneous determination of the angular velocity were 60°/S);detect the inflammatory factor in the joint fluid. Results: After the treatment, clinical effect in intervene group was superior to that in control group,but had no statistical significance;after the treatment, the score of function of knee joint in the two groups were higher than before treatment, and had statistical significance, and the score of function of knee joint in the intervene group were higher than control group, and the difference had statistical significance;Angular velocity of 60°/S and 180°/S the two groups peak torque, work load and the H/Q values were significantly increased, the intervene group were higher than control group, and the difference had statistical significance;inflammatory factor in the two groups were significantly decreased, the intervene group were lower than control group, and the difference had statistical significance.Conclusions: On the basic of rehabmtation treating, the treatment of intra-articular injection of sodium hyaluronate can improve the function of knee joint through improving the knee muscle strength, the level of their participation in the activities of the biomechanics of knee joint, and the inflammatory factor in the joint fluid.
文摘AIM:To determine if the addition of hip-strengthening exercises decreases pain and improves function in patients with patellofemoral pain syndrome.METHODS:The authors completed a systematic reviewsearching eight databases(i.e.,Pub Med,Cochrane,CINHAL,MEDLINE,Sports Discus,EMBASE,APTA Hooked on Evidence,and PEDro).Two independent reviewers screened and excluded studies if they did not meet the following inclusion criteria:subjects had a primary diagnosis of patellofemoral pain syndrome(PFPS),intervention group included hip-strengthening exercises,control group included a traditional physical therapy intervention,study included outcome measures of pain and/or function,study used a randomized controlled trial design,PEDro score was ≥ 7,and study was published in a peer-reviewed journal.Primary outcome measures were subjective scales of pain and function.These measures were converted to standardized mean difference [effect size(ES)],and a random-effects model was used to calculate the overall ES.RESULTS:Two hundred eighty-three studies were screened for inclusion in our meta-analysis.Nine studies were deemed suitable for data extraction and analysis.A total of 426 subjects were used in the nine studies.Overall,there was a significant positive effect of hip-strengthening exercises on measures of pain and function in subjects with PFPS(ES = 0.94,P = 0.00004).None of the individual studies had a negative ES,with study ES ranging from 0.35 to 2.59.Because of the high degree of between-study variance(I2 = 76%;Q = 34.0,P < 0.001),subgroup meta-analyses and meta-regressions were performed.None of the potential moderator variables that were investigated(e.g.,outcome type,hip region targeted,duration of treatment) could explain a significant amount of the between-study variance in ES(P ≥ 0.23).CONCLUSION:Overall,the addition of hip-strengthening exercises to traditional physical therapy produced greater improvements in measures of pain and function.
文摘Objective To evaluate the efficacy of Tuina(Chinese therapeutic massage)manipulation plus horse-riding squat exercise in treating knee osteoarthritis(KOA)and optimize the combining protocol.Methods Based on a 2×2 factorial design,120 eligible KOA patients were randomized into a manipulation group(group A1B2),a manipulation plus horse-riding squat group(group A1B1),a sitting knee-adjustment group(group A2B2 group),and a sitting knee-adjustment plus horse-riding squat group(group A2B1),with 30 cases in each group.The intervention was conducted three times a week,lasting for four weeks.The Western Ontario and McMaster Universities osteoarthritis index(WOMAC)was taken as the major measure for efficacy evaluation(including three component scores,pain,stiffness,and daily function,and total score).Results The three component scores(pain,stiffness,and daily function)and the total score of WOMAC showed significant differences after the intervention in the four groups(P<0.05).There were significant inter-group differences in the WOMAC stiffness score amongst the four groups after the intervention(P<0.05).In group A1B1,the step length,stride,walking speed,and knee joint flexion angle changed significantly after treatment(P<0.05).After the intervention,the step length changed significantly in group A1B2(P<0.05),and the walking speed changed significantly in group A2B1(P<0.05).There were no significant differences in the step length,stride,walking speed,or knee joint flexion angle among the four groups(P>0.05).The extensor peak torque at 180°/s changed significantly in group A1B2 after treatment(P<0.05).Neither the intra-group nor the inter-group comparisons of the four groups revealed significant differences in the other isokinetic muscle strength parameters(P>0.05).The main effect of manipulation showed significant in affecting the WOMAC pain and total scores(P<0.05).The main effect of horse-riding squat exercise showed significant in affecting the WOMAC pain and stiffness scores(P<0.05).Conclusion The four treatment protocols all can improve the symptoms of KOA,for instance,relieving pain and stiffness,and enhancing daily function.Group A2B1 produces the most eminent effect in relieving joint stiffness.The main effects of both manipulation and horse-riding squat exercise are significant in reducing pain.Besides,the main effect of horse-riding squat exercise is significant in relieving joint stiffness.
文摘Objective:To observe the efficacy of electroacupuncture(EA)plus Yi Jin Jing(Sinew-transforming Qigong Exercises)for knee osteoarthritis(KOA).Methods:A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method,with 30 cases in each group.Patients in the observation group received the treatment of EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises),while patients in the control group only received EA treatment.Both groups were treated for 5 weeks.The changes of Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)and visual analog scale(VAS)scores in the two groups were observed after treatment.Results:After treatment,the total effective rate in the observation group(92.3%)was significantly higher than that in the control group(70.0%),(P<0.05);the WOMAC and VAS scores in both groups were significantly lower than those before treatment,showing statistical significance(all P<0.01);there were significant differences in the post-treatment changes in the WOMAC and VAS scores between the two groups(P<0.05,P<0.01).Conclusion:EA plus Yi Jin Jing(Sinew-transforming Qigong Exercises)is clinically effective for KOA.This combined treatment can alleviate clinical symptoms.
基金Supported by Conselho Nacional de Desenvolvimento Cientifico e Tecnologico(CNPq)Fundacao de Amparo a Pesquisa do Estado do Rio de Janeiro(FAPERJ)
文摘OBJECTIVE: To verify the action of non-pharmacological interventions, whole body vibration exercise (WBVE) and auriculotherapy (AT) on the management of knee osteoarthritis (KOA) analyzing the handgrip strength (HS). METHODS: One hundred twelve participants with KOA were allocated in (a) WBVE group with peak-to-peak displacement of 2.5 to 7.5 mm, frequency from 5 up to 14 Hz, acceleration peak from 0.12 up to 2.95 g (2 d/weekly for 5 weeks),(b) AT group, points of both ears (Kidney, Knee-correspondent point and Shenmen) were stimulated with seeds,(c) WBVE + AT group and (d) respective control groups. HS was assessed in all the participants, in acute and cumulative responses. RESULTS: The intervention with WBVE alone and combined with AT improved (P < 0.05), in a cumulative response, the HS. CONCLUSION: WBVE alone or combined with AT might promote biological effects that interfere with the HS in individuals with KOA.
