To determine whether land-based therapeutic exercise is beneficial for people with knee osteoarthritis (OA) in terms of reduced joint pain or improved physical function and quality of life.
Five ...electronic databases were searched, up until May 2013. Randomised clinical trials comparing some form of land-based therapeutic exercise with a non-exercise control were selected. Three teams of two review authors independently extracted data and assessed risk of bias for each study. Standardised mean differences immediately after treatment and 2-6 months after cessation of formal treatment were separately pooled using a random effects model.
In total, 54 studies were identified. Overall, 19 (35%) studies reported adequate random sequence generation, allocation concealment and adequately accounted for incomplete outcome data. However, research results may be vulnerable to selection, attrition and detection bias. Pooled results from 44 trials indicated that exercise significantly reduced pain (12 points/100; 95% CI 10 to 15) and improved physical function (10 points/100; 95% CI 8 to 13) to a moderate degree immediately after treatment, while evidence from 13 studies revealed that exercise significantly improved quality of life immediately after treatment with small effect (4 points/100; 95% CI 2 to 5). In addition, 12 studies provided 2-month to 6-month post-treatment sustainability data which showed significantly reduced knee pain (6 points/100; 95% CI 3 to 9) and 10 studies which showed improved physical function (3 points/100; 95% CI 1 to 5).
Among people with knee osteoarthritis, land-based therapeutic exercise provides short-term benefit that is sustained for at least 2-6 months after cessation of formal treatment.
Background:
Anterior cruciate ligament (ACL) tear is a common injury in sports and often occurs during landing from a jump.
Purpose:
To synthesize the evidence on the effects of injury prevention ...programs (IPPs) on landing biomechanics as they relate to the ligament, quadriceps, trunk, and leg dominance theories associated with ACL injury risk.
Study Design:
Meta-analysis.
Methods:
Six electronic databases were searched for studies that investigated the effect of IPPs on landing task biomechanics. Prospective studies that reported landing biomechanics at baseline and post-IPP were included. Results from trunk, hip, and knee kinematics and kinetics related to the ACL injury theories were extracted, and meta-analyses were performed when possible.
Results:
The criteria were met by 28 studies with a total of 466 participants. Most studies evaluated young females, bilateral landing tasks, and recreational athletes, while most variables were related to the ligament and quadriceps dominance theories. An important predictor of ACL injury, peak knee abduction moment, decreased (P = .01) after the IPPs while other variables related to the ligament dominance theory did not change. Regarding the quadriceps dominance theory, after the IPPs, angles of hip flexion at initial contact (P = .009), peak hip flexion (P = .002), and peak knee flexion (P = .007) increased, while knee flexion at initial contact did not change (P = .18). Moreover, peak knee flexion moment decreased (P = .005) and peak vertical ground-reaction force did not change (P = .10).
Conclusion:
The exercises used in IPPs might have the potential to improve landing task biomechanics related to the quadriceps dominance theory, especially increasing peak knee and hip flexion angles. Importantly, peak knee abduction moment decreased, which indicates that IPPs influence a desired movement strategy to help athletes overcome dangerous ligament dominance loads arising from lack of frontal plane control during dynamic tasks. The lack of findings for some biomechanical variables suggests that future IPPs may be enhanced by targeting participants’ baseline profile deficits, highlighting the need to deliver an individualized and task-specific IPP.
Low back pain is one of the most prevalent musculoskeletal conditions and the highest contributor to disability in the world. It is characterized by frequent relapses leading to additional ...care-seeking. Engagement in leisure physical activity is associated with lower recurrences and better prognosis and potentially reduced care-seeking. Our aim was to investigate the feasibility and preliminary efficacy of a patient-centred physical activity intervention, supported by health coaching and mobile health, to reduce care-seeking, pain and disability in patients with chronic low back pain after treatment discharge.
We conducted a pilot randomised controlled trial with blinded outcome assessment. Sixty-eight participants were recruited from four public outpatient physiotherapy departments and the general community in Sydney. The intervention group received a physical activity information booklet, plus one face-to-face and 12 telephone-based health coaching sessions. The intervention was supported by an internet-based application and an activity tracker (Fitbit). Control group (standard care) received the physical activity information booklet and advice to stay active. Feasibility measures included recruitment rate, intervention compliance, data completeness, and participant satisfaction. Primary outcomes were care-seeking, pain levels and activity limitation. Outcomes were assessed at baseline, 6-month follow-up and weekly for 6 months.
Ninety potential participants were invited over 15 months, with 68 agreeing to take part (75%). Overall, 903 weekly questionnaires were answered by participants from a total of 1107 sent (89%). Participants were largely satisfied with the intervention (mean = 8.7 out of 10 on satisfaction scale). Intervention group participants had a 38% reduced rate of care-seeking (Incidence Rate Ratio (IRR): 0.62, 95% CI: 0.32 to 1.18, p = 0.14, using multilevel mixed-effects Poisson regression analysis) compared to standard care, although none of the estimates was statistically significant. No between groups differences were found for pain levels or activity limitation.
The health coaching physical activity approach trialed here is feasible and well accepted by participants and may reduce care-seeking in patients with low back pain after treatment discharge, although further evaluation with an adequately powered trial is needed.
Australian and New Zealand Trial Registry ACTRN12615000189527 . Registered prospectively on 26-02-2015.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Background Telehealth has emerged as a potential alternative to deliver interventions for low back pain (LBP), however its effectiveness has not been investigated. Purpose The aim of this ...review was to evaluate whether interventions delivered by telehealth improve pain, disability, function, and quality of life in non-specific LBP. Study Design Systematic review with meta-analysis Methods Seven databases were searched from the earliest records to August 2015. Eligible studies were randomized controlled trials that investigated the effectiveness of telehealth-based interventions, solo or in combination with other interventions, for non-specific LBP compared to a control group. Trials deemed clinically homogeneous were grouped in meta-analyses. Results Eleven studies were included (N = 2280). In chronic LBP, telehealth interventions had no significant effect on pain at short four trials; 1,089 participants; weighted mean difference (WMD) -2.61 points; 95% CI: -5.23 to 0.01 or medium-term follow-up (two trials; 441 participants; WMD: -0.94 points; 95% CI: -6.71 to 4.84) compared to a control group. Similarly, there was no significant effect for disability. Results from three individual trials showed that telehealth was superior to a control intervention for improving quality of life. Interventions combining telehealth and usual care were more beneficial than usual care alone in people with recent onset of LBP symptoms. Conclusion There is moderate-quality evidence that current telehealth interventions, alone, are not more effective than minimal interventions for reducing pain and disability in chronic LBP. To date, modern telehealth media (e.g. apps) and telehealth as an adjunct to usual care remain understudied.
OBJECTIVE:To establish reference values for isometric strength of 12 muscle groups and flexibility of 13 joint movements in 1,000 children and adults and investigate the influence of demographic and ...anthropometric factors.
METHODS:A standardized reliable protocol of hand-held and fixed dynamometry for isometric strength of ankle, knee, hip, elbow, and shoulder musculature as well as goniometry for flexibility of the ankle, knee, hip, elbow, shoulder, and cervical spine was performed in an observational study investigating 1,000 healthy male and female participants aged 3–101 years. Correlation and multiple regression analyses were performed to identify factors independently associated with strength and flexibility of children, adolescents, adults, and older adults.
RESULTS:Normative reference values of 25 strength and flexibility measures were generated. Strong linear correlations between age and strength were identified in the first 2 decades of life. Muscle strength significantly decreased with age in older adults. Regression modeling identified increasing height as the most significant predictor of strength in children, higher body mass in adolescents, and male sex in adults and older adults. Joint flexibility gradually decreased with age, with little sex difference. Waist circumference was a significant predictor of variability in joint flexibility in adolescents, adults, and older adults.
CONCLUSIONS:Reference values and associated age- and sex-stratified z scores generated from this study can be used to determine the presence and extent of impairments associated with neuromuscular and other neurologic disorders, monitor disease progression over time in natural history studies, and evaluate the effect of new treatments in clinical trials.
Objective
To evaluate the effect of gait modification strategies on the external knee adduction moment (KAM), a marker of medial knee joint load; determine potentially adverse effects; assess the ...methodologic quality; and identify areas of future research.
Methods
Five electronic databases were searched. Studies evaluating the effects of gait modifications on the KAM in either healthy individuals or those with knee osteoarthritis (OA) were included. Methodologic quality was evaluated by 2 reviewers using the Downs and Black checklist.
Results
Twenty‐four studies met the inclusion criteria, exploring 14 different gait modifications of varying sample sizes, age groups, and OA classifications. Contralateral cane use, increased step width, medial knee thrust, increased hip internal rotation, weight transfer to the medial foot, and increased lateral trunk lean demonstrated KAM reductions. Tai Chi gait, ipsilateral cane use, Nordic walking poles, and increased knee flexion exhibited increases in the KAM, demonstrating a potential detriment to their use. The effects of reduced stride length, as well as increases and reductions in either toe‐out or gait speed, were inconsistent across the studies and gait cycle.
Conclusion
This review demonstrates that some gait modifications have the ability to alter knee load. Future research is required to determine the magnitude of modification required to maximize beneficial effects, the best method of training, long‐term patient adherence, and if these biomechanical changes can translate into clinically relevant changes in symptoms or disease progression risk.
Cover crops play an important role in low-input cropping systems, increasing the use of agro-ecosystem services. Due to the lack of information about the impact of cover crops and bio-fertilizers on ...popcorn maize (
Sturt.) growth and yield quality, especially the popping volume and nutritive quality, such as concentrations of protein and mineral elements, this research aimed to provide essential information. The interrelation between popcorn maize productivity and quality with important groups of soil microorganisms presents additional novelty. The results demonstrated that field pea is a beneficial cover crop, especially when combined with a bio-fertilizer, supporting the accumulation of maize biomass, chlorophyll, yield potential, and the concentrations of protein, Ca, Mg, Fe, and Zn. In addition, field pea residues promoted N-fixing bacteria, and the number of total microorganisms, especially actinomycetes and decomposing bacteria, which could promote nutrient uptake and grain quality. Residues of cover crop mixtures, common vetch + winter oats and field pea + winter oats, promoted the total number of microorganisms in the soil, and up to the end of vegetation, a greater number of decomposition and ammonification microorganisms were found, especially when the bio-fertilizer was applied, which consequently could support greater maize biomass. Popping volume, as a main trait of popcorn maize, had the highest value in the common vetch + winter oats variant, supporting again the statement that quality traits could be enhanced in sustainable production. Unlike living cover crops, mulch mainly affected soil microbial communities and promoted the development of actinomycetes and cellulolytic microorganisms during the growing season. The results of this research could contribute to the development of sustainable popcorn maize production for improved grain quality. They could also serve as a basis for isolating beneficial soil microorganisms to develop new bio-fertilizers that could improve maize production in synergy with cover crops.
Popcorn is a specialty maize variety with popping abilities. Although considered a snack, popcorn flakes provide a variety of benefits for the human diet. To evaluate the change in content of ...bioactive compounds in response to microwave popping, the kernels and flakes of twelve popcorn hybrids were assayed. Accordingly, the content of phytic acid, glutathione, phenolic compounds, carotenoids, and tocopherols, as well as the antioxidant activity, were evaluated. In all evaluated popcorn hybrids, the most pronounced significant average decrease of 71.94% was observed for GSH content, followed by 57.72% and 16.12% decreases for lutein + zeaxanthin and phytic acid content, respectively. In response to popping, in the majority of the evaluated hybrids, the most pronounced significant average changes of a 63.42% increase and a 27.61% decrease were observed for DPPH, followed by a 51.52% increase and a 24.48% decrease for
-carotene, as well as, a 48.62% increase and a 16.71% decrease for α-Tocopherol content, respectively. The applied principal component and hierarchical cluster analyses revealed the distinct separation of popcorn hybrids' kernels and flakes, indicating the existence of a unique linkage of changes in bioactive compound content in response to popping.
Maize is an important staple crop and a significant source of various nutrients. We aimed to determine the macronutrients, antioxidants, and essential elements in maize genotypes (white, yellow, and ...red kernel) using three different fertilizers, which could be used as a basis to increase the nutrient density of maize. The fertilizer treatments used bio- and organic fertilizers as a sustainable approach, urea, as a commonly used mineral fertilizer, and the control (no fertilization). We evaluated the yield, concentration of macronutrient (protein, oil, and starch), nonenzymatic antioxidants (phenolics, yellow pigment, total glutathione (GSH), and phytic phosphorus), and reduction capacity of the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical, as well as essential elements that are commonly deficient in the diet (Mg, Ca, Fe, Mn, Zn, Cu, and S) and their relationships with phytic acid. The genotype expressed the strongest effect on the variability of grain yield and the analyzed grain constituents. The red-kernel hybrid showed the greatest accumulation of protein, oil, phenolics, and essential elements (Ca, Fe, Cu, and S) than a yellow and white hybrid, especially in the biofertilizer treatment. The yellow kernel had the highest concentrations of yellow pigment, GSH, phytic phosphorous, Mg, Mn, and Zn (19.61 µg g
, 1,134 nmol g
, 2.63 mg g
, 1,963 µg g
, 11.7 µg g
, and 33.9 µg g
, respectively). The white kernel had a greater starch concentration (2.5% higher than that in the red hybrid) and the potential bioavailability of essential metals, particularly under no fertilization. This supports the significance of white maize as a staple food in many traditional diets across the world. Urea was important for the enhancement of the antioxidant status (with 88.0% reduction capacity for the DPPH radical) and increased potential Zn bioavailability in the maize kernels (13.3% higher than that in the biofertilizer treatment). This study underlines the differences in the yield potential and chemical composition of red, yellow, and white-kernel maize and their importance as a necessary part of a sustainable human diet. This information can help determine the most appropriate genotype based on the antioxidants and/or essential elements targeted for kernel improvement.
Purpose The sagittal shape of the spine is associated with back-pain, balance and quality of life. We developed, evaluated and report the responses of a graphical tool to assess sagittal spine shape ...knowledge (literacy). Participants and Methods Two hundred and fifty adults were randomly assigned, in a cross-sectional crossover study, to free-hand draw and select the “ideal” sagittal spine shape. We evaluated the inter and intra-rater reliability and agreement between tests and the sagittal and lordotic spine literacy between the drawing and selection test versions. Results Drawing test inter- and intra-rater agreement was 79% and 80% respectively. Drawing vs. selection agreement was 43%. More participants drew than selected the correct spine (30% vs. 21%) (p<0.001) and lumbar lordosis shape (56% vs. 42%) (p<0.001). Test order did not affect spine shape literacy scores. A significantly poorer literacy trend was observed with spine pain presence (p=0.02). Conclusion We developed a reliable method to evaluate spine shape literacy and established that only 21% and 42% of our sample demonstrated correct sagittal spine and lordotic spine shape literacy, respectively. The low literacy scores suggests that consideration of including spine shape literacy in health literacy and self-management programs may be warranted, especially in ageing populations.
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