The Efficacy of Backward Walking on Static Stability, Proprioception, Pain, and Physical Function of Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Objective. Impaired static stability and proprioception have been observed in individuals with knee osteoarthritis (KOA), which serves as a major factor increasing risk of fall. This study aimed to investigate the effects of backward walking (BW) on static stability, proprioception, pain, and physical function in KOA patients. Methods. Thirty-two subjects with knee osteoarthritis were randomly assigned to either an BW group (BG, n = 16) or a control group (CG, n = 16). The participants in the BG received combination treatment of a 4-week BW training and conventional treatments, while those in the CG was treated with conventional treatments alone. All the participants were tested for the assessment of static stability [center of pressure (COP) sway, including sway length (SL, mm) and sway area (SA, mm2)] and proprioception [average trajectory error (ATE, %) and completion time (CT, second)]. Additionally, pain and knee function scores were measured by the numerical rating scale (NRS) and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, respectively. The assessments were conducted before and after intervention. Results. The COP sway (SA and SL), ATE, NRS, and WOMAC showed a significant decline at week 4 in the two groups in contrast to their baseline ( P < 0.05 ). Moreover, after 4-week intervention, the SA [(610.50 ± 464.26) mm2 vs. (538.69 ± 420.52) mm2], NRS [(1.56 ± 0.63) vs. (2.25 ± 0.86)], and WOMAC [(11.69 ± 2.50) vs. (16.19 ± 3.94)] showed a significantly greater decrease in the BG compared to the CG ( P < 0.05 , respectively). However, the proprioception (ATE and CT) was closely similar between both groups at week 4 ( P > 0.05 ). Conclusion. BW is an effective adjunct to conventional treatment in reducing pain, improving physical function and static stability for KOA patients. It should be taken into consideration when developing rehabilitation programs for people with KOA.

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A Randomized Placebo-Controlled Trial of Efficacy and Safety: Drug-Free Gel Containing Ultra-Deformable Phospholipid Vesicles (TDT 064) in Osteoarthritic Knees

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.1177/11795441211031338 ◽

2021 ◽

Vol 14 ◽

pp. 117954412110313

Author(s):

Varah Yuenyongviwat ◽

Khanin Iamthanaporn ◽

Pakjai Tuntarattanapong ◽

Theerawit Hongnaparak ◽

Boonsin Tangtrakulwanich

Keyword(s):

Knee Osteoarthritis ◽

Rescue Medication ◽

Rating Scale ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Topical Therapy ◽

Phospholipid Vesicles ◽

Control Group ◽

Drug Free

Background: There are a number of topical agents that are used for treatment of knee osteoarthritis. Drug-free gels, containing ultra-deformable phospholipid vesicles (TDT 064) are one such topical therapy, which have been stated to act as a bio lubricant. However, the evidence of TDT 064 in treatment of knee osteoarthritis is limited. Hence, the aim of this study was to evaluate the efficacy of pain control as a primary outcome and safety of TDT 064 compared with a topical placebo. Methods: Sixty-four patients with primary osteoarthritis, with radiographic showing Kellgren and Lawrence classification grade II to III, were randomized into 2 groups. In the first group of 32 patients TDT 064 was used as topical agent, whilst in the second group of 32 patients a placebo identical in appearance was used instead. The verbal numerical rating scale (VNRS) was used for recording pain levels, Self-reported Knee Injury and Osteoarthritis Outcome Scores (KOOS) as well as amounts of rescue medication were also recorded. The data were recorded at the start of the study, and then at follow-up appointments of 14 days, 6 weeks, and 3 months. Results: The mean VNRS for pain in both groups were significantly improved, when compared to the start of treatment ( P < .0001); however, there were no differences between groups at any follow up visit. KOOS in all subscales were not significantly different between both groups at baseline and at the end of treatment. However, the average amount of NSAIDs in the TDT 064 group was 26.39 ± 22.11 tabs, which was significantly lower than the control group; which used an average 37.03 ± 19.22 tabs in 3 months ( P = .047). Conclusions: There were no differences in the VNRS for pain and KOOS scores between the active and placebo groups. Although, TDT 064 could decrease usage of rescue medication the difference with use of a placebo was minimal. Further, larger trials would also be beneficial to demonstrate any differences between TDT 064 and a placebo. Trial Registration: TCTR, TCTR 20190302001. Registered 1 March, 2019: http://www.clinicaltrials.in.th

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Ultrasound-guided superficial cervical plexus block for analgesia in patients undergoing craniotomy via suboccipital retrosigmoid approach: study protocol of a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-034003 ◽

2020 ◽

Vol 10 (2) ◽

pp. e034003

Author(s):

Kun Peng ◽

Min Zeng ◽

Jia Dong ◽

Xiang Yan ◽

Dexiang Wang ◽

...

Keyword(s):

Nerve Block ◽

Rating Scale ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Control Group ◽

Cervical Plexus ◽

Ethics Review ◽

Superficial Cervical Plexus Block ◽

Cervical Plexus Block ◽

Plexus Block

IntroductionScalp nerve block has been proven to be an alternative choice to opioids in multimodal analgesia. However, for the infratentorial space-occupying craniotomy, especially the suboccipital retrosigmoid craniotomy, scalp nerve block is insufficient.Methods and analysisThe study is a prospective, single-centre, randomised, paralleled-group controlled trial. Patients scheduled to receive elective suboccipital retrosigmoid craniotomy will be randomly assigned to the superficial cervical plexus block group or the control group. After anaesthesia induction, superficial cervical plexus nerve block will be performed under the guidance of ultrasound. The primary outcome is the cumulative consumption of sufentanil by the patient-controlled intravenous analgesia pump within 24 hours after surgery. Secondary outcomes include the cumulative consumption of sufentanil at other four time points and numerical rating scale pain severity score.Ethics and disseminationThe protocol (version number: 2.0, 10 April 2019) has been approved by the Ethics Review Committee of China Registered Clinical Trials (Ethics Review No. ChiECRCT-20190047). The findings of this study will be disseminated in peer-reviewed journals and at scientific conferences.Trial registration numberNCT04036812

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Efficacy of EMDR Therapy on the Pain Intensity and Subjective Distress of Cancer Patients

Journal of EMDR Practice and Research ◽

10.1891/emdr-d-20-00036 ◽

2021 ◽

Vol 15 (1) ◽

pp. 18-28

Author(s):

Naeem Abdi ◽

Mohammad Malekzadeh ◽

Zhila Fereidouni ◽

Mohammad Behnammoghadam ◽

Parisa Zaj ◽

...

Keyword(s):

Pain Intensity ◽

Rating Scale ◽

Therapeutic Option ◽

Controlled Trial ◽

Sampling Technique ◽

Control Group ◽

Subjective Distress ◽

Patients With Cancer ◽

Before And After ◽

Emdr Therapy

The present study was carried out to investigate the efficacy of eye movement desensitization and reprocessing (EMDR) therapy in treating pain and subjective distress of patients with cancer. A randomized controlled trial was performed on patients with cancer suffering from moderate to severe cancer pain in Yasuj, Iran, in 2019 and 2020. Sixty patients aged 30–60 years who fulfilled the inclusion criteria were selected using a consensus sampling technique. Patients were randomly assigned to EMDR therapy or control groups based on random block allocation. EMDR therapy was administered in six to eight daily 1-hour sessions. The control group received the standard treatment provided by the hospital. A Numeric Pain-Rating Scale (NRS) and the Subjective Units of Disturbance Scale (SUDS) were used to assess pain and subjective distress before and after the intervention in each session. The collected data were analyzed by descriptive statistics, chi-square test, and independent t test using Statistical Package for the Social Sciences (SPSS) version 24. The mean pain intensity and subjective distress score in the experimental group before and after the EMDR intervention were significantly reduced (p < .001). In the control group, no decreases in NRS and SUDS scores occurred at any time (p > .05). Differences in pain scores between the groups were statistically significant (p < .001). EMDR can effectively and sustainably reduce the pain and subjective distress experienced by patients with cancer. Thus, EMDR is a recommended therapeutic option to mitigate pain and subjective distress among patients with cancer.

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Electroacupuncture to alleviate postoperative pain after a laparoscopic appendectomy: study protocol for a three-arm, randomised, controlled trial

BMJ Open ◽

10.1136/bmjopen-2016-015286 ◽

2017 ◽

Vol 7 (8) ◽

pp. e015286 ◽

Cited By ~ 3

Author(s):

Seunghoon Lee ◽

Dongwoo Nam ◽

Minsoo Kwon ◽

Won Seo Park ◽

Sun Jin Park

Keyword(s):

Postoperative Pain ◽

Laparoscopic Appendectomy ◽

Pain Control ◽

Rating Scale ◽

Acupuncture Treatment ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Control Group ◽

Acupuncture Points ◽

Postoperative Pain Control

BackgroundThe purpose of this study is to evaluate the efficacy and safety of electroacupuncture (EA) for postoperative pain after laparoscopic appendectomy compared with sham electroacupuncture (SEA) and no acupuncture treatment.Methods and analysisThis study is a protocol for a three-arm, randomised, patient-assessor-blinded (to the type of acupuncture treatment), controlled, parallel trial. 138 participants diagnosed with appendicitis and scheduled for laparoscopic appendectomy will be randomly assigned to the EA group (n=46), SEA group (n=46) or control group (n=46). The EA group will receive acupuncture treatment at both regional and distal acupuncture points with electrostimulation. The SEA group will receive sham acupuncture treatment with mock electrostimulation. Both EA and SEA groups will receive a total of four treatments 1 hour preoperative, 1 hour postoperative and during the morning and afternoon the day after surgery with the same routine postoperative pain control. The control group will receive only routine postoperative pain control. The primary outcome is the 11-point Pain Intensity Numerical Rating Scale (PI-NRS) at 24 hours after surgery. The secondary outcomes are the PI-NRS, analgesic consumption, opioid-related side effects, time to first passing flatus, quality of life and adverse events evaluated 6, 12, 24 and 36 hours and 7 days after surgery.Ethics and disseminationThe study was planned in accordance with the Helsinki Declaration and the Korean Good Clinical Practice Guidelines to protect the participants and was approved by the institutional review board (IRB) of Kyung Hee University Medical Center (KMC IRB-1427–02). The results will be disseminated in peer-reviewed journals and presented at international conferences.Trial registration numberClinical Research Information Service (KCT0001328).

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The Effect of Using an Electric Fan on Dyspnea in Chinese Patients With Terminal Cancer

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909115615127 ◽

2016 ◽

Vol 34 (1) ◽

pp. 42-46 ◽

Cited By ~ 18

Author(s):

Sio Leng Wong ◽

Sok Man Leong ◽

Cheng Man Chan ◽

Sut Peng Kan ◽

Hon Wai Benjamin Cheng

Keyword(s):

Advanced Cancer ◽

Large Scale ◽

Rating Scale ◽

Numerical Rating Scale ◽

Relevant Literature ◽

Chinese Patients ◽

Control Group ◽

Significant Difference ◽

Before And After ◽

Experimental Group

Background: Fan therapy is often suggested for relieving the symptom of dyspnea in patients with advanced cancer, but relevant literature among Asians is limited. Objective: Phase 2 clinical trial to assess the clinical feasibility and outcome of using an electric fan to alleviate the symptom of dyspnea in Chinese patients with advanced cancer. Methods: Thirty patients with advanced cancer having unresolved breathlessness were recruited from Hospice and Palliative Care Centre of Kiang Wu Hospital in Macau. Participants were randomly and equally allocated to the experimental group and the control group, respectively. Outcome Measures: Verbal numerical rating scale (NRS) of breathlessness, respiratory rate (RR), and saturation of peripheral oxygen (SpO2) was collected before and after the intervention. Results: T test was used to analyze the data collected. There was a significant difference in the NRS scores of the experimental group ( P < .01), indicating a significant reduction in the patients’ sensation of breathlessness after fan therapy, whereas no significant difference was found in the objective statistic results of RR and SpO2. No significant difference ( P > .05) was found in the control group for all the 3 variables before and after routine treatment. Conclusion: The results of the study suggested that fan therapy could be effective in alleviating dyspnea in Chinese patients with advanced cancer. It should be considered as one of the nonpharmacological treatment option. Future large-scale phase 3 clinical trials are warranted.

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Effectiveness of the quadriceps strengthening exercise on pain and functional ability of the women with Osteoarthritis (OA)

International Journal of Current Research in Chemistry and Pharmaceutical Sciences ◽

10.22192/ijcrcps.2021.08.09.001 ◽

2021 ◽

Vol 8 (9) ◽

pp. 1-6

Author(s):

Absar Ahmed Qureshi ◽

◽

Shadia Hamoud Alshahrani ◽

Premalatha Paulsamy ◽

Krishnaraju Venkatesan ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Functional Ability ◽

Rating Scale ◽

Numerical Rating Scale ◽

Exercise Group ◽

Control Group ◽

Timed Up And Go ◽

Strengthening Exercise ◽

Study Results ◽

Numerical Rating

A Quasi experimental design was adopted for this study to find out the effectiveness of quadriceps strengthening exercise program on pain and functional ability of women with knee osteoarthritis (OA). Fifty women with OA were selected in which first 25 women were enrolled in the control group and second 25 women were allotted in the exercise group. Assessments were performed at baseline and at 8 weeks. The functional ability was assessed using the Timed Up and Go (TUG) test and Numerical Rating Scale (NRS) was used to assess the pain level .For the exercise group, quadriceps strengthening exercises were taught and asked the patients to follow the exercise schedule for 8 weeks. The study results show that the pain and functional abilty scores were improved in the exercise group and the difference was statistically significant (p<0.001). The study concluded that a simple quadriceps strengthening exercise programme can significantly improve self reported knee pain and functional ability among women with Knee osteoarthritis. Keywords: Osteoarthritis, Pain, Functional Ability, Exercise, Quadriceps strengthening, Timed Up and Go (TUG) test, Numerical Rating Scale (NRS)

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Evaluating the efficacy of Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis (iBEAT-OA) in the community: a study protocol for a randomised controlled trial

BMJ Open ◽

10.1136/bmjopen-2019-030564 ◽

2019 ◽

Vol 9 (10) ◽

pp. e030564

Author(s):

Sameer Akram Gohir ◽

Paul Greenhaff ◽

Abhishek Abhishek ◽

Ana M. Valdes

Keyword(s):

Randomised Controlled Trial ◽

Knee Osteoarthritis ◽

Rating Scale ◽

Controlled Trial ◽

Maximum Voluntary Contraction ◽

Intervention Group ◽

Exercise Programme ◽

Control Group ◽

Knee Oa ◽

Randomised Controlled

IntroductionKnee osteoarthritis (OA) is the most common joint disease worldwide. As of today, there are no disease-modifying drugs, but there is evidence that muscle strengthening exercises can substantially reduce pain and improve function in this disorder, and one very well tested physiotherapy protocol is the ‘Better Management of Patients with Osteoarthritis’ developed in Sweden. Given the high prevalence of knee OA, a potentially cost-effective, digitally delivered approach to treat knee OA should be trialled. This study aims to explore the benefits of iBEAT-OA (Internet-Based Exercise programme Aimed at Treating knee Osteoarthritis) in modulating pain, function and other health-related outcomes in individuals with knee OA.Methods and analysisA randomised controlled trial was designed to evaluate the efficacy of a web-based exercise programme in a population with knee OA compared with standard community care provided by general practitioners (GPs) in the UK. We anticipate recruiting participants into equal groups. The intervention group (n=67) will exercise for 20–30 min daily for six consecutive weeks, whereas the control group (n=67) will follow GP-recommended routine care. The participants will be assessed using a Numerical Rating Scale, the Western Ontario and McMaster Universities Osteoarthritis Index, the Arthritis Research UK Musculoskeletal Health Questionnaire, the Pittsburgh Sleep Quality Index, 30 s sit to stand test, timed up and go test, quantitative sensory testing, musculoskeletal ultrasound scan, muscle thickness assessment of the vastus lateralis, and quadriceps muscles force generation during an isokinetic maximum voluntary contraction (MVC). Samples of urine, blood, faeces and synovial fluid will be collected to establish biomarkers associated with changes in pain and sleep patterns in individuals affected with knee OA. Standard parametric regression methods will be used for statistical analysis.Ethics and disseminationEthical approval was obtained from the Research Ethics Committee (ref: 18/EM/0154) and the Health Research Authority (protocol no: 18021). The study was registered in June 2018. The results of the trial will be submitted for publication in a peer-reviewed journal.Trial registration numberNCT03545048

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Evaluation of teaching an integrated case formulation approach on the quality of case formulations: randomised controlled trial

The Psychiatrist ◽

10.1192/pb.bp.110.033746 ◽

2012 ◽

Vol 36 (4) ◽

pp. 140-145 ◽

Cited By ~ 3

Author(s):

Mohammed Abbas ◽

Ruth Walton ◽

Allan Johnston ◽

Millicent Chikoore

Keyword(s):

Randomised Controlled Trial ◽

Rating Scale ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Case Formulation ◽

New Approach ◽

Before And After ◽

Randomised Controlled

Aims and methodThis paper introduces a new approach to producing case formulations, the integrated case formulation (ICF) approach, and a rating scale, the Case Formulation Scale (CFS). Twenty-four psychiatrists participated in a single-blind randomised controlled trial to evaluate the effectiveness of teaching using this new approach. The intervention group (n = 12) received teaching about using ICF, whereas the control group (n = 12) received teaching as usual. The scores on the CFS were compared before and after teaching.ResultsPrior to teaching, psychiatric trainees had poor scores on the CFS. The CFS score for the group taught the ICF approach improved five times more than the control group.Clinical implicationsThis study demonstrates that case formulation skills can be taught. With further improvements, the ICF approach might be useful in the teaching of case formulation.

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Laughter and Stress Relief in Cancer Patients: A Pilot Study

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2015/864739 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

S. H. Kim ◽

Y. H. Kim ◽

H. J. Kim

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Rating Scale ◽

Numerical Rating Scale ◽

Controlled Trial ◽

Alternative Therapy ◽

Control Group ◽

Breast Cancer Patients ◽

Numerical Rating ◽

Anxiety Depression

The purpose of this study was to examine the effect of a therapeutic laughter program and the number of program sessions on anxiety, depression, and stress in breast cancer patients. A randomized controlled trial was conducted involving 31 patients who received four sessions of therapeutic laughter program comprised and 29 who were assigned to the no-program control group. Scores for anxiety, depression, and stress were measured using an 11-point numerical rating scale. While no change was detected in the control group, the program group reported reductions of 1.94, 1.84, and 2.06 points for anxiety, depression, and stress, respectively (p<0.01,p<0.01, andp<0.01). Scores decreased significantly after the first therapeutic laughter session (p<0.05,p<0.01, andp<0.01). As the therapeutic laughter program was effective after only a single session in reducing anxiety, depression, and stress in breast cancer patients, it could be recommended as a first-line complementary/alternative therapy.

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Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial (Preprint)

10.2196/preprints.10021 ◽

2018 ◽

Author(s):

Belinda J Lawford ◽

Rana S Hinman ◽

Jessica Kasza ◽

Rachel Nelligan ◽

Francis Keefe ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Self Efficacy ◽

Rating Scale ◽

Coping Skills ◽

Numerical Rating Scale ◽

Skills Training ◽

Control Group ◽

Pain Coping ◽

Coping Skills Training ◽

Numerical Rating

BACKGROUND Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. OBJECTIVE The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. METHODS Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. RESULTS Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI –0.13 to 0.35; interaction P=.02) for the control group. CONCLUSIONS People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs)

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