Several scales are commonly used for assessing pain intensity. Among them, the numerical rating scale (NRS), visual analog scale (VAS), and verbal rating scale (VRS) are often used in clinical ...practice. However, no study has performed psychometric analyses of their reliability and validity in the measurement of osteoarthritic (OA) pain. Therefore, the present study examined the test-retest reliability, validity, and minimum detectable change (MDC) of the VAS, NRS, and VRS for the measurement of OA knee pain. In addition, the correlations of VAS, NRS, and VRS with demographic variables were evaluated.
The study included 121 subjects (65 women, 56 men; aged 40-80 years) with OA of the knee. Test-retest reliability of the VAS, NRS, and VRS was assessed during two consecutive visits in a 24 h interval. The validity was tested using Pearson's correlation coefficients between the baseline scores of VAS, NRS, and VRS and the demographic variables (age, body mass index BMI, sex, and OA grade). The standard error of measurement (SEM) and the MDC were calculated to assess statistically meaningful changes.
The intraclass correlation coefficients of the VAS, NRS, and VRS were 0.97, 0.95, and 0.93, respectively. VAS, NRS, and VRS were significantly related to demographic variables (age, BMI, sex, and OA grade). The SEM of VAS, NRS, and VRS was 0.03, 0.48, and 0.21, respectively. The MDC of VAS, NRS, and VRS was 0.08, 1.33, and 0.58, respectively.
All the three scales had excellent test-retest reliability. However, the VAS was the most reliable, with the smallest errors in the measurement of OA knee pain.
Vestibular rehabilitation (VR) has been shown to be effective for many vestibular disorders. This review focuses on the current evidence on the effects of physical therapy in the management of ...vestibular symptoms in individuals with a vestibular migraine (VM). The individuals with a history of a migraine tend to have a high incidence of vestibular symptoms with some or all of their headaches. A total of six included studies investigated the effects of VR in the management of VM. The critical review form for quantitative studies was used to appraise quality assessment and risk of bias in the selected studies. Previous studies validated the use of VR in the treatment of vestibular symptoms for individuals with a VM to include improved headache and migraine-related disability in patients with a VM. From the current evidence, it is difficult to provide conclusive evidence regarding the efficacy of VR to minimize vestibular symptoms in patients with VM. Therefore, more randomized controlled studies are required to make firm evidence on the effect of VR in reducing vestibular symptoms in patients with VM. The future prospective, blinded, randomized controlled studies may help to isolate possible therapeutic effects of VR and other general effects.
Background: The study aimed to investigate and compare the acute effects of 2 local vibration frequencies (63 Hz vs 42 Hz frequencies) applied to the biceps brachii muscles on the elbow joint ...position sense (JPS) in healthy young men. Methods: A 3-arm parallel-group design with randomization of participants was used. Forty-five healthy young men aged 19 to 30 years were randomly assigned to 3 groups: to receive 63 Hz (n = 15) in experimental group 1 (EG1) or 42 Hz (n = 15) in experimental group 2 (EG2) or sham vibration in the control group (n = 15). Participants in the EG1 and EG2 received 5 bouts of 1-minute vibration exposure to the biceps brachii muscle, with a 1-minute rest between the bouts. In control group, sham vibration was applied with the same duration and interval as in EG1 and EG2. The active elbow joint position error was selected as an outcome measure to assess elbow JPS. The target angle and the angle reproduced were measured using a Universal Goniometer. The difference between the target and the reproduced angles was calculated to determine active elbow joint position error. Measurements were made before the vibration application and right after it. Results: No statistically significant difference was observed in the JPS of the elbow joint over time in any group ( P = .625). No statistically significant differences were observed between the 33 groups in the JPS of the elbow ( P = .075). Conclusion: There was no acute effect of vibration of the biceps brachii muscle at 63 and 42 Hz on active elbow JPS in healthy adults.
Various outcome measures are used for the assessment of balance and mobility in patients with stroke. The purpose of the present study was to examine test-retest reliability, construct validity, and ...responsiveness of the Timed Up and Go Test (TUG), Berg Balance Scale (BBS), and Dynamic Gait Index (DGI) for measuring balance in patients with chronic stroke.
Fifty-six patients (39 male and 17 female) with chronic stroke participated in this study. A senior physical therapist assessed the test-retest reliability and validity of three scales, including the DGI, TUG, and BBS over two testing sessions. In addition, the third assessment of each scale was taken at the time of discharge to determine the responsiveness of the three outcome measures.
The reliability of the TUG (intraclass correlation coefficient ICC
= 0.98), DGI (ICC
= 0.98) and BBS (ICC
= 0.99) were excellent. The standard error of measurement (SEM) of the TUG, DGI, and BBS were 1.16, 0.71, and 0.98, respectively. The minimal detectable change (MDC) of the TUG, DGI, and BBS were 3.2, 1.9, and 2.7, respectively. There was a significant correlation found between the DGI and BBS (first reading r = 0.75; second reading r = 0.77), TUG and BBS (first reading r = -.52; second reading r = -.53), and the TUG and DGI (first reading r = 0.45; second reading r = 0.48), respectively.
The test-retest reliability of the TUG, BBS, and DGI was excellent. The DGI demonstrated slightly better responsiveness than TUG and BBS. However, the small sample size of this study limits the validity of the results.
Knee osteoarthritis (KOA) is more common as people age and have a higher body mass index (BMI). We must know the role of various factors in pain and physical functions in patients with KOA. ...Therefore, the present study sought to examine the factors associated with pain and physical functions in individuals with KOA. This cross-sectional observational study included patients with KOA (n = 125; 57 men, 68 women; mean age 52.9 years). Using the visual analogue scale and a reduced version of the Western Ontario McMaster Universities Osteoarthritis Index, pain severity and physical functions were assessed. Demographic factors such as age, BMI, sex, and Kellgren-Lawrence (K/L) radiographic grade of KOA were analyzed. Age (R = 0.263, P < .001), BMI (R = 0.379, P < .001), and K/L grade (R = 0.844, P < .001) were significantly associated with knee pain. Similarly, age (R = 0.310, P < .001), BMI (R = 0.374, P < .001), and K/L grade (R = 0.862, P < .001) were associated with physical functions. No significant association of sex with pain (R = 0.071, P = .440) and physical functions (R = 0.055, P = .545) was observed. Age, BMI, and K/L grade explained 71% and 74% of knee pain and physical functions, respectively. Age, BMI, and radiographic (K/L) grades were associated with pain and physical functions in patients with KOA. K/L grade was the most significant predictor of pain and physical functions in KOA.
Therapeutic strategies of plant origin are a better choice as both dietary plant products or its isolated active constituents against the development and progression of cancer. The present study aims ...to evaluate the anticancer activity of sumac (Rhus coriaria) against different human cancer MCF-7, PC-3, and SKOV3 cell lines. In addition, the study tries to explore a prospective mechanism of action, assessment of in vitro enzyme-inhibitory capacity of sumac extract against hCA I, II, IX, and XII. In the present study, the potential antitumor effects of sumac (Rhus coriaria) were explored in the human cancer cell lines; MCF-7, PC-3, and SKOV3 using in vitro assays. Apoptotic, cell survival, ELISA immunoassays were also conducted to reveal the inhibitory effects of sumac extract against hCA I, II, IX, and XII. In addition, both Clioquinol and Acetazolamide (AZM) were used as standards to explore the in vitro enzyme-inhibitory capacity of sumac extract against hCA I, II, IX, and XII. The hydro-alcoholic extract of R. coriaria (Sumac) was subjected to phytochemical analysis using GC/MS assays. Sumac at non-cytotoxic doses of 50 and 100 µM significantly modulates the growth of the MCF-7, PC-3, and SKOV3 cancer cells with a higher inhibitory effect and selectivity to carbonic anhydrase (CA) isoforms; hCA I, II, hCA IX, and XII. The data showed that sumac at doses of 50 and 100 µM significantly inhibited the growth, proliferation, and viability of cancer cells by activating the apoptotic process via caspase-3 overexpression and the regulation of Bcl-2 anti-apoptotic protein.
This study examined the associations between vitamin E, oxidative stress markers, total homocysteine levels, and physical activity or cognitive capacity in older adults. One hundred and six older ...adults (62 men, 44 women) within the age range of 56-81 years participated. The Global Physical Activity Questionnaire and the Loewenstein Occupational Therapy Cognitive Assessment were used to assess physical activity and cognitive function, respectively. Vitamin E (e.g., α-tocopherol and γ-tocopherol), oxidative stress markers (e.g., total antioxidant capacity and nitric oxide), and total homocysteine were estimated. There were significant associations between physical activity (high versus moderate versus poor) and all biomarkers (all p = 0.000, and p = 0.010 for γ-tocopherol). While total homocysteine and total antioxidant capacity were significantly associated with cognitive capacity (p = 0.000), vitamin E levels (e.g., α-tocopherol and γ-tocopherol) and nitric oxide (p = 0.354, 0.103 and 0.060, respectively) were not related to cognitive capacity in older adults. This study concludes that physical activity was associated with Vitamin E, oxidative stress markers, total homocysteine, and cognitive capacity in older adults. Although cognitive capacity was associated with total homocysteine and total antioxidant capacity, it was unrelated to vitamin E levels and nitric oxide in older adults.
Our aim was to evaluate the protective and antioxidant effects of ginger extract against cadmium-induced renal toxicity in animal models and to support the use of ginger as anti-renal failure natural ...remedy. Seventy rats were examined in a 4-week experiment to evaluate the effect of Ginger (Zingiber officinale) at doses of 100 and 200mg/kg body weight on molecular DNA content, antioxidant status, and renal function in rats intoxicated with cadmium at dose of (5mg/kg) using biochemical and histological analysis. Renal dysfunction, kidney tissue damage, and oxidative effect were evident in cadmium intoxicated rats as estimated by significant increase in (creatinine, urea), decrease in (creatinine clearance and reabsorption rate of urine albumin), increase in MDA, decrease in total antioxidant status (TAC), reduction in DNA content, and histopathological changes of kidneys’ tissues compared to control rats. Treatment with ginger resulted in significant restoring of renal function biomarkers, TAC, molecular DNA, and histological improvements which occurs via free radical scavenging and regenerative mechanisms. The activity of ginger was supported by estimation of bioactive phenolic and falvinods constituents. Twenty-eight polyphenolic compounds were estimated in ginger extract; 6-gingerol, 6-shogaol, citral and pyrogallol were the highest amounts in ginger, and supposed to be responsible for its major antioxidant and free radical scavenging activity as shown by In vitro DPPH/β-carotene-linolic acid assay tests. Consequently, ginger extracts could have a potent protective effects against nephrotoxicity induced by various toxicants.
Background: Fall occurrences and the associated risk of injury are debilitating and major health concerns in the older population. Several interventions have been investigated and implemented to ...address the needs of balance impairments and to reduce the increased risk of falls. This study aimed to compare the effectiveness of the Otago exercise program (OEP) and gaze stability exercises (GSE) on balance and the risk of falls in older adults residing at an old age home facility. Methods: Thirty elderly participants were equally and randomly divided into 2 groups: Group OEP received the OEP, and group GSE received GSE for 8 weeks (thrice a week). In addition, both groups also performed core muscle-strengthening exercises. The outcome measures were the Berg balance scale (BBS) and the Fall efficacy scale-International (FES-I). Results: The interventions resulted in significant improvements ( P < .001) in both outcome measures in both groups. The mean pretest BBS scores of groups OEP and GSE increased from 40.4 and 39.2 to the mean post-test scores of 48 and 45.2, respectively. Similarly, the mean pretest FES-I scores of groups OEP and GSE also improved from 39.47 and 40.4 to the mean post-test scores of 32.73 and 36.07. The between-group comparison showed greater improvement ( P < .05) in OEP group in both variables. Conclusions: OEP and GSE were found to be beneficial rehabilitation programs in improving balance and fear of falls in healthy older adults. However, the OEP was found to be a more effective intervention and may allow better balance and fall prevention improvements. Trial Registration: The study has been registered in clinicaltrials.gov (ID: NCT05781776; on 23/03/2023).
Abstract
This study aimed to compare the effects of knee strengthening exercises to those of polyvagal theory–based exercises combined with knee strengthening exercises on selected outcomes in women ...with grade II knee osteoarthritis (OA). A randomized controlled trial was conducted, in which 60 female participants diagnosed with grade II knee OA, with a mean age of 57.27 ± 7.81 years and knee pain rated between 4 and 7 on the visual analog scale (VAS), were assigned to either the knee strengthening exercise group (Group 1, n = 30) or the polyvagal theory–based exercise plus knee strengthening exercise group (Group 2, n = 30). Pre- and posttreatment assessment of outcome variables, including WOMAC scores (joint pain, joint stiffness, functional limitations, and the overall index), WHOQOL scores (overall quality of life, general health, physical, psychological, social, and environmental domains), and heart rate variability (HRV, time and frequency domains), were analyzed. Group 2 demonstrated significantly greater reductions in joint pain, stiffness, and functional limitations than Group 1 after the intervention. Group 2 presented with significantly improved WOMAC scores, indicating better overall outcomes. Group 2 showed significant improvements in the psychological and social domains regarding quality of life. There were no significant differences in the physical domain or the environmental domain. Group 2 showed a significant increase in high-frequency power (HF) and a significant decrease in the LF/HF ratio, suggesting improved autonomic regulation. A combination of polyvagal exercise and knee strengthening training resulted in superior outcomes compared to knee strengthening exercises alone in women with grade II knee OA. These findings support the potential effectiveness of incorporating polyvagal exercises as an adjunctive intervention for osteoarthritis management.
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