scholarly journals Knee Muscle Strength Recovery in the Early Period After ACL Reconstruction

2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0014
Author(s):  
Gulcan Harput ◽  
Hasan Erkan Kılınc ◽  
Hamza Özer ◽  
Gül Baltacı ◽  
Carl G. Mattacola
Keyword(s):  
Acl Reconstruction ◽  
Early Period ◽  
Quadriceps Strength ◽  
Isometric Strength ◽  
Time Points ◽  
Hamstring Muscles ◽  
Significant Difference ◽  
Isometric Torque ◽  
Over Time ◽  
Time Point

Objectives: The aim of this study was to investigate quadriceps and hamstrings isometric strength at 4, 8 and 12 week time points following ACL Reconstruction (ACLR) and to document the strength changes of these muscles over time. The primary hypothesis was that there would be significant increases in quadriceps and hamstring muscle strengths between the 4th, 8th and 12th weeks following ACLR. The secondary hypothesis was that the quadriceps index would be higher than hamstring index at 12th week after ACLR. Methods: Thirty patients (Mean ± SD [age, 29.1±2.3yrs; weight, 77.3±13.2kg; height, 172.1±7.1cm; BMI, 21.2±3.5kg/m2, time to surgery: 7.1±7.2 months]) who underwent ACLR with Hamstring Tendon Autograft (HTG) were enrolled in this study. The isometric strength of quadriceps and hamstring muscles was measured on an isokinetic dynamometer at 60° knee flexion angle at 4th, 8th and 12th weeks after surgery. The recovery of quadriceps and hamstring muscles strength following rehabilitation was expressed as a Quadriceps Index (QI) and Hamstring Index (HI) and calculated with the following formula:[(maximum voluntary isometric torque of the involved limb / maximum voluntary isometric torque by uninvolved limb) × 100]. Torque output of the involved and uninvolved limbs and quadriceps and hamstring indexes were used for the statistical analysis. A repeated measures of ANOVA was used to determine the strength changes of quadriceps and hamstrings over time. Results: Quadriceps and Hamstrings strengths significantly increased over time for both involved (Quadriceps: F (2,46)=58.3, p<0.001, Hamstring: F (2,46)=35.7, p<0.001) and uninvolved limb (Quadriceps: F(2,46)=17.9, p<0.001, Hamstring: F(2,46)=56.9, p=0.001 ). Quadriceps strength was higher at 12th week when compared to the 8 and 4 week time points for the involved limb (p<0.001), and it was higher at 8th week when compared to 4 week time point for the involved limb (p<0.001). For the uninvolved limb, quadriceps strength was also higher at 12th week when compared to the 8 (p=0.02) and 4 week time point (p<0.001), and higher at 8 week when compared to the 4 week time point (p=0.02). Hamstring strength was higher at 12 week when compared to the 8 and 4 week time points (p<0.001) and it was higher at 8 week when compared to 4 week time point for the involved limb (p<0.001). For the uninvolved limb hamstring strength was also higher at 12 week when compared to 4 week time point (p=0.01). There was no significant difference between the 4 and 8 week time points (p>0.05) or between the 8 and 12 week time points (p=0.07). Quadriceps and hamstring indexes significantly changed from 4th weeks (QI:57.9, HI:54.4 ) to 8th weeks (QI:78.8, HI:69.9 ) and from 8th weeks to 12th weeks (QI:82, HI:75.7 ) (p<0.001); however, there was no difference between indexes at the 12-week time point (p=0.17). Conclusion: Isometric strength of quadriceps and hamstring muscles for the involved and uninvolved limb increased during the early period of ACLR. The results of this study could be a baseline for clinicians while prescribing a rehabilitation protocol for ACLR patients with HTG to better appreciate expected strength changes of the muscles in the early phase.

scholarly journals Cytotoxicity assessment of different doses of ozonated water on dental pulp cells

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ferdiye Küçük ◽  
Sibel Yıldırım ◽  
Serap Çetiner
Keyword(s):  
Cell Viability ◽  
Repeated Measures ◽  
Dental Pulp ◽  
Control Group ◽  
Dental Pulp Cells ◽  
Time Points ◽  
Significant Difference ◽  
Pulp Cells ◽  
Time Point ◽  
Ozonated Water

Abstract Background The purpose of this study was to assess the cytotoxicity of various concentrations of ozonated water (OW) on human primary dental pulp cells. Methods Human primary dental pulp cells were isolated from exfoliated primary canine teeth of an 11-year-old patient with good systemic and oral health. Afterwards, cells were divided into 6 experimental groups; four groups of OW in concentrations of 2 mg/L, 4 mg/L, 8 mg/L, and 16 mg/L, untreated control group, and cell culture without cells. Cytotoxicity was evaluated after exposure for 5-min exposure using Mosmann’s Tetrazolium Toxicity (MTT) assay at 0 h and 48 h time points. Data were analyzed using a repeated measures analysis of variance and Post-hoc tests were performed using Bonferroni correction for multiple comparisons. Results All experimental groups showed proliferation at 0 h time point. However, all groups also experienced a decrease in overtime at 48 h time point (p < 0.05). At both time points 2 mg/L OW showed the highest cell viability as well as proliferation. At 0 h time point, the increase in cell viability for all experimental groups was found statistically significant when compared to positive control group (p < 0.05). At 48 h time point, although 8 mg/L and 16 mg/L OW showed statistically significant reduction in compare to 0 h time point, 2 mg/L and 4 mg/L OW groups didn’t experience any statistically significant difference (p < 0.05). Conclusion Considering our findings, due to ozonated water's induced a higher proliferation rate of dental pulp cells, indicating their biocompatibility and a possible adjuvant on irrigating agent in regenerative endodontic procedures.

scholarly journals Levels of physical activity in four domains and affective wellbeing before and during the Covid-19 pandemic

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Eliane S. Engels ◽  
Michael Mutz ◽  
Yolanda Demetriou ◽  
Anne K. Reimers
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Protective Factor ◽  
Total Sample ◽  
Poor Mental Health ◽  
German Population ◽  
Time Points ◽  
Sport And Exercise ◽  
Over Time ◽  
Time Point

Abstract Background Latest studies indicated that the general mental health level is low during the pandemic. Probably, this deterioration of the mental health situation is partly due to declines in physical activity. The aim of this study was to investigate differences in and the association between affective wellbeing and levels of different domains of physical activity at three time points before and during the pandemic. Method We used a nationwide online panel with a trend data design encompassing a total sample of N = 3517, representing the German population (> 14 years). Four different activity domains (sport and exercise, light outdoor activity, housework/gardening, active travel) and affective wellbeing (positive and negative affect) were assessed at three time points before and during the Covid-19 pandemic (October 2019, March 2020, October 2020). Results Multivariate analyses of variance (MANOVA) indicate differences regarding affective wellbeing over the three time points with the lowest values at the second time point. Levels of activity in the four domains differed significantly over time with the strongest decrease for sport and exercise from the first to the second time point. Partial correlations indicated that the relationships between sport and exercise and positive affect were most consistent over time. Conclusions Overall, our findings suggest that physical activity plays a particularly important role in the pandemic period as a protective factor against poor mental health. Especially sports and exercise seem to be supportive and should be encouraged, e.g. by providing additional support in finding adequate outdoor, home-based or digital substitutes.

Effect of Analgesic Drugs on Tooth Sensitivity Induced by In-office Dental Bleaching: A Systematic Review and Meta-analysis

2020 ◽  
Vol 45 (2) ◽  
pp. E66-E76 ◽  
Author(s):  
RTF Costa ◽  
SLD Moraes ◽  
CAA Lemos ◽  
JR SoutoMaior ◽  
BC do E Vasconcelos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Drug Group ◽  
Preemptive Analgesia ◽  
Tooth Bleaching ◽  
Tooth Sensitivity ◽  
Time Points ◽  
Significant Difference ◽  
Anti Inflammatory ◽  
Time Point

SUMMARY Objective: This systematic review evaluates the effect of preemptive analgesia on tooth sensitivity induced by in-office tooth bleaching. Methods: The review was structured based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The methods were recorded at PROSPERO (CRD42018095440). Randomized clinical trials, studies published in English, and studies in which the efficacy of preemptive analgesia with analgesic and anti-inflammatory medications prior to in-office tooth bleaching was compared with that of placebo were included. PubMed/MEDLINE, Scopus, Web of Science, and Cochrane Library were used for searching. The electronic search provided 373 articles, and seven of them were selected based on the inclusion criteria. Results: Immediately after time point, a significant reduction of dental sensitivity was observed in the drug group compared to the control group (p=0.02; mean difference [MD]: −0.90; confidence interval [CI]: −1.63 to −0.16), while there was no significant difference at up to one-hour (p=0.22; MD: −0.42; CI: −1.09 to −0.25), at 1-24–hour (p=0.88; MD: −0.05; CI: −0.61 to 0.72), or 24-48–hour (p=0.69; MD: 0.05; CI: −0.21 to 0.32) time points. The incidence of sensitivity during the procedure was not statistically different between the groups (p=0.64; MD: 0.91; CI: 0.92 to 1.15). The nonsteroidal anti-inflammatory drug group showed a statistically significant reduction (p=0.04; MD: −0.69; CI: −1.36 to −0.03) in tooth sensitivity compared with the other groups. Conclusions: This systematic review and meta-analysis demonstrated that the medications analyzed did not interfere with the incidence of sensitivity symptoms. Regarding the intensity, no difference was observed between the drug and placebo groups at the up to one-hour, 1-24–hour, or 24-48–hour time points, and there was a statistically significant difference at the zero-hour time point in favor of the drug group. However, based on the variables that influenced this result, it should be considered with prudence because a small difference was observed.

scholarly journals Nonlinear Degradation of System Configuration During the Development of an Accident

2019 ◽  
Vol 273 ◽  
pp. 02003
Author(s):  
Maria Mikela Chatzimichailidou ◽  
Nektarios Karanikas
Keyword(s):  
Decision Making ◽  
Situation Awareness ◽  
End Users ◽  
System Configuration ◽  
Related System ◽  
Time Points ◽  
Risk Situation ◽  
Nonlinear Fluctuation ◽  
Over Time ◽  
Time Point

This paper utilises a methodology named “Risk SituatiOn Awareness Provision” (RiskSOAP). RiskSOAP expresses the capability of a system to meet its safety objectives by controlling its processes and communicating threats and vulnerabilities to increase the situation awareness of its end-users and support their decision-making. In reality safety-related system features might be partially available or unavailable due to design incompleteness or malfunctions. Therefore, respectively, the availability and capability of RiskSOAP mechanisms might fluctuate over time. To examine whether changes in RiskSOAP values correspond to a system degradation, we used the results of a previous study that applied the RiskSOAP methodology to the Überlingen mid-air collision accident. Complementary to the previous application where the RiskSOAP was calculated for four milestones of the specific event, in this study we divided the accident further into seventeen time-points and we calculated the RiskSOAP indicator per time-point. The results confirmed that the degradation of the RiskSOAP capability coincided with the milestones that were closer to the mid-air collision, while the plotting of the RiskSOAP indicator against time showed its nonlinear fluctuation alongside the accident development.

Quadriceps and Hamstring Strength Recovery During Early Neuromuscular Rehabilitation After ACL Hamstring-Tendon Autograft Reconstruction

2015 ◽  
Vol 24 (4) ◽  
pp. 398-404 ◽  
Author(s):  
Gulcan Harput ◽  
H. Erkan Kilinc ◽  
Hamza Ozer ◽  
Gul Baltaci ◽  
Carl G. Mattacola
Keyword(s):  
Outcome Measures ◽  
Cruciate Ligament ◽  
Early Period ◽  
Hamstring Tendon ◽  
Tendon Graft ◽  
Isometric Strength ◽  
Single Bundle ◽  
Strength Recovery ◽  
Gracilis Tendon Graft ◽  
Over Time

Context:There is lack of information related to quadriceps and hamstring strength recovery during the early period of rehabilitation after anterior cruciate ligament reconstruction (ACLR) using hamstring-tendon graft (HTG).Objective:To investigate quadriceps and hamstring isometric strength at 4-, 8-, and 12-wk time points after ACLR and to document the strength changes of these muscles over time.Design:Longitudinal study.Participants:24 patients (age 28.1 ± 8.1 y) who underwent unilateral single-bundle anatomic ACLR with 4-strand semitendinosus and gracilis tendon graft.Main Outcome Measures:The isometric strength of quadriceps and hamstring muscles was measured on an isokinetic dynamometer at a 60° knee-flexion angle 4, 8, and 12 wk after surgery.Results:Quadriceps and hamstring strength significantly increased over time for both the involved limb (quadriceps F2,46 = 58.3, P < .001; hamstring F2,46 = 35.7, P < .001) and uninvolved limb (quadriceps F2,46 = 17.9, P < .001; hamstring F2,46 = 56.9, P = .001). Quadriceps and hamstring indexes significantly changed from 4 wk (QI 57.9, HI 54.4) to 8 wk (QI 78.8, HI 69.9) and from 8 wk to 12 wk (QI 82, HI 75.7) (P < .001); however, there was no difference between indexes at the 12-wk time point (P = .17).Conclusions:The results of this study serve as a reference for clinicians while directing a rehabilitation protocol for HTG ACLR patients to better appreciate expected strength changes of the muscles in the early phase of recovery.

scholarly journals The impact of a dedicated physiotherapist clinic for children with dysfunctional breathing

2016 ◽  
Vol 2 (3) ◽  
pp. 00103-2015 ◽  
Author(s):  
Nicola J. Barker ◽  
Heather Elphick ◽  
Mark L. Everard
Keyword(s):  
Quality Of Life ◽  
Long Term Effects ◽  
Time Points ◽  
Significant Difference ◽  
Breathing Retraining ◽  
Dysfunctional Breathing ◽  
The Uk ◽  
The Impact ◽  
Time Point

Dysfunctional breathing is a significant cause of morbidity, adversely affecting an individual's quality of life. There is currently no data from paediatric centres on the impact of breathing retraining for dysfunctional breathing.Symptoms and quality of life were measured in 34 subjects referred sequentially for breathing retraining to the first dedicated paediatric dysfunctional breathing clinic in the UK. Data were obtained prior to the first intervention (time point 1), at discharge (time point 2) and by post 6 months later (time point 3).The mean (interquartile range) age of participants was 13.3 (9.1–16.3) years, with 52% female. Data were obtained at time points 2 and 3 in 23 and 13 subjects, respectively.Statistically significant improvements were observed in symptom scores, child quality of life and parental proxy quality of life between time points 1 and 2 (p<0.0001), while there was no significant difference in the data at time point 3 as compared with time point 2.This study suggests that physiotherapist-led breathing retraining offers significant benefit to young people with dysfunctional breathing which is maintained for at least 6 months after treatment is completed. Future studies will provide more information on the long-term effects of interventions for dysfunctional breathing.

scholarly journals Hockey Concussion Education Project, Part 1. Susceptibility-weighted imaging study in male and female ice hockey players over a single season

2014 ◽  
Vol 120 (4) ◽  
pp. 864-872 ◽  
Author(s):  
Karl G. Helmer ◽  
Ofer Pasternak ◽  
Eli Fredman ◽  
Ronny I. Preciado ◽  
Inga K. Koerte ◽  
...  
Keyword(s):  
Ice Hockey ◽  
Susceptibility Weighted Imaging ◽  
Male And Female ◽  
Time Points ◽  
Significant Difference ◽  
Hockey Players ◽  
Changes Over Time ◽  
Male Subjects ◽  
Over Time ◽  
Female Subjects

Object Concussion, or mild traumatic brain injury (mTBI), is a commonly occurring sports-related injury, especially in contact sports such as hockey. Cerebral microbleeds (CMBs), which appear as small, hypointense lesions on T2*-weighted images, can result from TBI. The authors use susceptibility-weighted imaging (SWI) to automatically detect small hypointensities that may be subtle signs of chronic and acute damage due to both subconcussive and concussive injury. The goal was to investigate how the burden of these hypointensities changes over time, over a playing season, and postconcussion, in comparison with subjects who did not suffer a medically observed and diagnosed concussion. Methods Images were obtained in 45 university-level adult male and female ice hockey players before and after a single Canadian Interuniversity Sports season. In addition, 11 subjects (5 men and 6 women) underwent imaging at 72 hours, 2 weeks, and 2 months after concussion. To identify subtle changes in brain tissue and potential CMBs, nonvessel clusters of hypointensities on SWI were automatically identified, and a hypointensity burden index was calculated for all subjects at the beginning of the season (BOS), the end of the season (EOS), and at postconcussion time points (where applicable). Results A statistically significant increase in the hypointensity burden, relative to the BOS, was observed for male subjects with concussions at the 2-week postconcussion time point. A smaller, nonsignificant rise in the burden for female subjects with concussions was also observed within the same time period. There were no significant changes in burden for nonconcussed subjects of either sex between the BOS and EOS time points. However, there was a statistically significant difference in the burden between male and female subjects in the nonconcussed group at both the BOS and EOS time points, with males having a higher burden. Conclusions This method extends the utility of SWI from the enhancement and detection of larger (> 5 mm) CMBs, which are often observed in more severe cases of TBI, to cases involving smaller lesions in which visual detection of injury is difficult. The hypointensity burden metric proposed here shows statistically significant changes over time in the male subjects. A smaller, nonsignificant increase in the burden metric was observed in the female subjects.

scholarly journals The Effects of Anti-retroviral Therapy on Epigenetic Age Acceleration Observed in HIV-1-infected Adults

2020 ◽  
Vol 5 (1) ◽  
pp. 291-311
Author(s):  
Mary E. Sehl ◽  
Tammy M. Rickabaugh ◽  
Roger Shih ◽  
Otoniel Martinez-Maza ◽  
Steve Horvath ◽  
...  
Keyword(s):  
Peripheral Blood ◽  
Epigenetic Clock ◽  
Time Points ◽  
Art Initiation ◽  
Age Related ◽  
Epigenetic Age ◽  
Significant Difference ◽  
Epigenetic Age Acceleration ◽  
Hiv 1 ◽  
Time Point

Background: HIV-1 infection is associated with acceleration of age-related methylation patterns in peripheral blood and brain of infected individuals although the relative contributions of HIV-1 infection versus its treatment to the observed accelerations in biological aging have not yet been investigated.Methods: In this longitudinal study of the effects of antiretroviral therapy (ART) on epigenetic aging patterns, we extracted DNA from peripheral blood mononuclear cells from 15 HIV-1-infected individuals infected at three time points: 6 months-1year pre-ART, 6-12 months post-initiation of ART, and 18-24 months after initiating ART. We compared these trajectories with those of 15 age-matched uninfected control participants at three time points with similar intervals. Methylation studies were performed using the Infinium methylation 450 arrays. We examined four epigenetic clock measurements: Age acceleration residual (AAR), Extrinsic (EEAA), Phenotypic (PEAA), and Grim (GEAA) epigenetic age acceleration. Weighted correlation network (WGCNA) analysis was used to identify clusters of highly co-methylated CpGs.Results: We found that prior to the initiation of ART all four epigenetic measures were significantly higher in HIV-1-infected individuals compared with uninfected individuals (P<0.001 for AAR, P=0.008 for EEAA, P=0.012 for GEAA, P<0.001 for PEAA using Wilcoxon rank sum tests between serostatus groups). These effects persisted after the initiation of ART, although the magnitude of these differences diminished. At 18-24 months post-ART initiation (time point 3), PEAA and GEAA were no longer significantly different between HIV-1-infected and uninfected individuals (P=0.059 for PEAA, P=0.11 for GEAA), while AAR and EEAA remained significantly higher in HIV-1-infected individuals compared with uninfected individuals. We further examined for global patterns of methylation differences between HIV-1-infected and uninfected at each time point, and found 14 groups of co-methylated CpGs that were significantly different between groups at baseline, and remained different after the initiation of ART.Conclusion: We confirm that epigenetic age acceleration associated with HIV-1 infection is most dramatic before ART initiation, and this observation is consistent across four epigenetic clock measurements, as well as in additional groups of co-methylated CpGs identified using WGCNA. Following initiation of ART, there is a partial reduction in age acceleration in all measures, with loss of any significant difference in PEAA and GEAA between serostatus groups. Our findings support the need for future studies examining for a link between epigenetic age acceleration and clinical outcomes in HIV-1-infected individuals.

scholarly journals Testing the waters: An investigation of the impact of hot tubbing on experts from referral through testimony

2020 ◽  
Author(s):  
Jennifer Torkildson Perillo ◽  
Anthony Perillo ◽  
Nikoleta M Despodova ◽  
Margaret Bull Kovera
Keyword(s):  
Doctoral Students ◽  
Cognitive Dissonance ◽  
Expert Testimony ◽  
Criminal Responsibility ◽  
Time Points ◽  
Expert Report ◽  
Significant Difference ◽  
Evidence Review ◽  
The Impact ◽  
Over Time

Objective: The present research examined whether concurrent expert testimony, or hot tubbing, is able to reduce adversarial allegiance compared to traditional adversarial expert testimony. Hypotheses: We expected concurrent experts would display less adversarial allegiance over the course of a mock criminal responsibility evaluation, with case opinions converging between prosecution and defense witnesses. We expected adversarial experts would display escalating adversarial allegiance with increasingly divergent case opinions and that court-appointed experts’ opinions would remain stable over the evaluation. We also expected concurrent expert witnesses would produce more balanced expert reports and testimony than would adversarial experts. Method: Clinicians and advanced clinical doctoral students (N = 103) completed criminal responsibility evaluation training before conducting a mock criminal responsibility evaluation for the prosecution, defense, or the court. Half of the partisan experts followed traditional adversarial procedures and half followed a concurrent testimony process. Participants provided case perceptions at three time points: after initial evidence review, after completing expert report(s), and after testifying. Case perceptions included a dichotomous responsibility judgment, strength of responsibility ratings, and a cognitive dissonance measure. Results: Concurrent testimony did not eliminate adversarial allegiance. For perceptions of responsibility, there was no significant difference between adversarial and concurrent experts (ηp2 = .001), nor any change in participants’ ratings over time (ηp2 = .03); however, prosecution experts – across testimony types – rated the defendant as significantly more responsible compared to defense experts (ηp2 = .80). Concurrent and adversarial experts did not differ in the information provided in their expert reports and minimally differed in testimony content.Conclusions: Partisan experts showed adversarial allegiance regardless of expert testimony method, and we observed no attenuation of this bias over the course of the evaluation.

scholarly journals The Effect of TRX vs. Aquatic Exercises on Self-Reported Knee Instability and Affected Factors in Women with Knee Osteoarthritis: A Randomized Controlled Trial

2019 ◽  
Author(s):  
Shirin Asar ◽  
Farzaneh Gandomi ◽  
Mahsa Mozafari ◽  
Freshteh Sohaili
Keyword(s):  
Knee Osteoarthritis ◽  
Knee Flexion ◽  
Controlled Trial ◽  
Weight Bearing ◽  
Quadriceps Strength ◽  
Knee Instability ◽  
Control Groups ◽  
Significant Difference ◽  
And Control ◽  
Over Time

Abstract Background: Knee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities. High prevalence (60-80%) has been reported for KI amongst the patients with knee osteoarthritis (KOA). In this line, the present study targeted the effect of two interventions on self-reported KI and affected factors. Methods: In this single blind, randomized, and controlled trial, 36 patients with radiographic grading (Kellgren–Lawrence > II) of KOA were selected. Patients were divided into three groups namely, aquatic (n=12), Total Resistance exercises (TRX) (n=12) and control (n=12) by random. Then both 8-week TRX and aquatic exercises were carried out by experimental groups. The following measure were taken before and after interventions: Pain by visual analog scale (VAS), balance by Berg Balance Scale (BBS), quadriceps strength by dynamometer, knee flexion range of motion (ROM) by inclinometer, knee stiffness with Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and self-reported KI with Felson's questionnaire. Results: The results demonstrated that KI, VAS, BBS improved over time both in TRX and aquatic groups significantly (p<0.05), but WOMAC(stiffness), knee flexion ROM, and quadriceps strength were significantly improved over time only for TRX (p<0.05). Post hoc test, also, showed that there were significant differences between interventions and control groups (p<0.05) for the VAS, KI, BBS, but for WOMAC(stiffness), a significant difference was observed only between TRX and control groups (p=0.05). Conclusions: Although TRX and aquatic interventions had a similar effect on the patients’ balance, pain and KI, TRX had more effect on WOMAC(stiffness), quadriceps strength, and knee flexion ROM than aquatic exercises.

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