scholarly journals Hyperalgesia affects muscle activity and knee range of motion during a single-limb mini squat in individuals with knee osteoarthritis: a cross-sectional study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jéssica Garcia Jorge ◽  
Ana Luiza Costa e Silva Cabral ◽  
Vanessa Martins Pereira Silva Moreira ◽  
Wallisen Tadashi Hattori ◽  
Valdeci Carlos Dionisio

Abstract Background The effect of hyperalgesia on functionality remains uncertain for individuals with knee osteoarthritis (KOA). This study aimed examine the clinical measures and hyperalgesia’s effect on muscle activity, knee range of motion (ROM) and postural control during the single-leg mini squat (SLMS) in individuals with KOA, determining the correlation between variables. Methods In this cross-sectional study, 60 individuals, 30 healthy (HG, 57.4 ± 6.86 years), and 30 with mild to moderate KOA (KOAG, 59.4 ± 5.46 years) were evaluated by the visual analog scale (VAS), Western Ontario and McMaster Universities Index (WOMAC), and the pressure pain threshold (PPT) in subcutaneous, myotomal, and sclerotomal structures. Muscle activity, knee ROM and postural control were assessed during a SLMS. The analyses were performed in the two phases of the SLMS. Phase 1 - during descending movement (eccentric contraction), Phase 2 - during ascending movement (concentric contraction). Analysis of covariance was applied for each variable separately, using weight as a co-variable. We used Spearman’s test for determining the correlation. Results There was no difference between groups for age, height, and postural control (p > 0.059), but KOAG presented the highest values for VAS and WOMAC (p = 0.000). In addition, EMG activity was higher in KOAG for gastrocnemius medialis and tibialis anterior muscles during phase 1 (p < 0.027), and for gastrocnemius medialis and gluteus medius muscles during phase 2 (p < 0.007), and reduced values for PPT and knee ROM (p = 0.000). Also, the correlations between PPT with muscle activity and postural control were moderate (rho< 0.482), while strong relationships were observed between some PPT points with VAS and WOMAC (rho> 0.507). Conclusion Hyperalgesia affects the functionality during a single-limb mini squat. There is an important correlation between hyperalgesia and muscle activity, postural control, and clinical measures in individuals with KOA.


2020 ◽  
Author(s):  
Kathryn Lee Hopkins ◽  
Khuthadzo E Hlongwane ◽  
Kennedy Otwombe ◽  
Janan Dietrich ◽  
Mireille Cheyip ◽  
...  

Abstract Background: While HIV Testing Services (HTS) have increased, many South Africans have not been tested. Non-communicable diseases (NCDs) are the top cause of death worldwide. Integrated NCD-HTS could be a strategy to control both epidemics. Healthcare service strategies depends partially on positive user experience. We investigated client satisfaction of services and clinic flow time of an integrated NCD-HTS clinic. Methods: This prospective, cross-sectional study evaluated HTS client satisfaction with an HTS clinic at two phases. Phase 1 (February–June 2018) utilised standard HTS services: counsellor-led height/weight/BP measurements, HIV rapid testing, and symptoms screening for sexually transmitted infections/Tuberculosis. Phase 2 (June 2018–March 2019) further integrated counsellor-led obesity screening (BMI/abdominal measurements), rapid cholesterol/glucose testing; and nurse-led Chlamydia and HPV/cervical cancer screening. Socio-demographics, proportion of repeat clients, clinic flow time, and client survey data (open/closed-ended questions using five-point Likert scale) are reported. Fisher’s exact test, chi-square analysis, Kruskal Wallis test conducted comparisons. Multiple linear regression determined predictors associated with clinic time. Content thematic analysis was conducted for free response data. Results: 284 and 333 participants were from Phase 1 and 2, respectively (N=617). Phase 1 participants were significantly older (median age 36.5 (28.0–43.0) years vs. 31.0 (25.0–40.0) years; p=0.0003), divorced/widowed (6.7%, [n=19/282] vs. 2.4%, [n=8/332]; p=0.0091); had tertiary education (27.9%, [n=79/283] vs. 20.1%, [n=67/333]; p=0.0234); and were less female (53.9%, [n=153/284] vs 67.6%, [n=225/333]; p=0.0005), compared to Phase 2. Phase 2 had 10.2% repeat clients (n=34/333), and 97.9% (n=320/327) were ‘ very satisfied’ with integrated NCD-HTS, despite standard HTS having significantly shorter median time for counsellor-led HTS (36.5, interquartile range [IQR]: 31.0-45.0 vs. 41.5, IQR: 35.0-51.0; p<0.0001). Phase 2 associations with longer clinic time were clients living together/married (est=6.548; p=0.0467), more tests conducted (est=3.922; p<0.0001), higher overall satisfaction score (est=1.210; p=0.0201). Matriculated clients experienced less clinic time (est=-7.250; p=0.0253). Conclusions: It is possible to integrate counsellor-led NCD rapid testing into standard HTS within historical HTS timeframes, yielding client satisfaction. Rapid cholesterol/glucose testing should be integrated into standard HTS. Research is required on the impact of cervical cancer/HPV screenings to HTS clinic flow to determine if it could be scaled up within the public sector.





PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e76173 ◽  
Author(s):  
Thomas J. Hoogeboom ◽  
Nico L. U. van Meeteren ◽  
Raymond H. Kim ◽  
Jennifer E. Stevens-Lapsley


2021 ◽  
Author(s):  
Jaclyn B. Caccese ◽  
Fernando V. Santos ◽  
Felipe K. Yamaguchi ◽  
Thomas A. Buckley ◽  
John J. Jeka


Author(s):  
Praveen Kumar Kandakurti ◽  
Ravi Shankar Reddy ◽  
Venkata Nagaraj Kakarparthy ◽  
Kanagaraj Rengaramanujam ◽  
Jaya Shanker Tedla ◽  
...  

Abstract Purpose Neck extensor endurance (NEE) and position sense are vital for maintaining cervical spine function and defects in these processes may be associated with impaired postural control in chronic neck pain (CNP) subjects. The study’s objectives are 1) to compare the cervical extensor endurance capability and postural control of CNP subjects with those of asymptomatic controls; 2) to investigate the association between NEE and postural control. Materials and Methods Sixty-four participants (38 asymptomatic, 38 with CNP) participated in this cross-sectional study. NEE was assessed using a clinical extensor endurance test. Under open and closed eyes conditions, postural control measures were tested with the Good Balance system. The postural control parameters were AP-velocity (mm/s), ML-velocity (mm/s) and Velocity moment (mm2). NEE capacity and postural control parameters were compared and correlated between asymptomatic and CNP subjects. Results and Discussion CNP subjects showed lower NEE capacity (p<0.001) and significantly larger AP-velocity (p<0.001), ML-velocity (p<0.001) and Velocity moment (p<0.001) than asymptomatic participants. NEE negatively correlated with AP-velocity (r=−0.51, p=0.001), ML-velocity (r=0.46, p=0.003) and velocity moment (r=0.38, p=0.020) in asymptomatic subjects in eyes open condition and no correlations in subjects with CNP. CNP subjects showed increased postural sway velocities and lowered extensor endurance capacity compared to asymptomatic participants. No correlations existed between NEE and postural control parameters in CNP subjects.



2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Willemijn F. C. de Sonnaville ◽  
Caroline M. Speksnijder ◽  
Nicolaas P. A. Zuithoff ◽  
Daan R. C. Verkouteren ◽  
Nico W. Wulffraat ◽  
...  

Abstract Background Recognition of temporomandibular joint (TMJ) involvement in children with juvenile idiopathic arthritis (JIA) has gained increasing attention in the past decade. The clinical assessment of mandibular range of motion characteristics is part of the recommended variables to detect TMJ involvement in children with JIA. The aim of this study was to explore explanatory variables for mandibular range of motion outcomes in children with JIA, with and without clinically established TMJ involvement, and in healthy children. Methods This cross-sectional study included children with JIA and healthy children of age 6–18 years. Mandibular range of motion variables included active and passive maximum interincisal opening (AMIO and PMIO), protrusion, laterotrusion, dental midline shift in AMIO and in protrusion. Additionally, the TMJ screening protocol and palpation pain were assessed. Adjusted linear regression analyses of AMIO, PMIO, protrusion, and laterotrusion were performed to evaluate the explanatory factors. Two adjusted models were constructed: model 1 to compare children with JIA and healthy children, and model 2 to compare children with JIA with and without TMJ involvement. Results A total of 298 children with JIA and 169 healthy children were included. Length was an explanatory variable for the mandibular range of motion excursions. Each centimeter increase in length increased AMIO (0.14 mm), PMIO (0.14 mm), and protrusion (0.02 mm). Male gender increased AMIO by 1.35 mm. Having JIA negatively influenced AMIO (3.57 mm), PMIO (3.71 mm), and protrusion (1.03 mm) compared with healthy children, while the discrepancy between left and right laterotrusion raised 0.68 mm. Children with JIA and TMJ involvement had a 8.27 mm lower AMIO, 7.68 mm lower PMIO and 0.96 mm higher discrepancy in left and right laterotrusion compared to healthy children. Conclusion All mandibular range of motion items were restricted in children with JIA compared with healthy children. In children with JIA and TMJ involvement, AMIO, PMIO and the discrepancy between left and right laterotrusion were impaired more severely. The limitation in protrusion and laterotrusion was hardly clinically relevant. Overall, AMIO is the mandibular range of motion variable with the highest restriction (in millimeters) in children with JIA and clinically established TMJ involvement compared to healthy children.



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