scholarly journals An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Indiana Cooper ◽  
Peter Brukner ◽  
Brooke L. Devlin ◽  
Anjana J. Reddy ◽  
Melanie Fulton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Confidence Interval ◽  
Knee Osteoarthritis ◽  
Drop Out ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee ◽  
Anti Inflammatory ◽  
Dietary Education

Abstract Background Knee osteoarthritis has an inflammatory component that is linked to pain and joint pathology, yet common non-surgical and non-pharmacological interventions (e.g., exercise, calorie restricting diets) do not typically target inflammation. We aimed to evaluate the feasibility of a telehealth delivered anti-inflammatory diet intervention for knee osteoarthritis. Methods This 9-week single-arm feasibility study recruited participants aged 40–85 years with symptomatic knee osteoarthritis (inclusion criteria: average pain ≥4/10 or maximal pain ≥5/10 during past week). All participants received a telehealth-delivered anti-inflammatory dietary education intervention involving 1:1 consultations at baseline, 3- and 6-week follow-up. The diet emphasised nutrient-dense wholefoods and minimally processed anti-inflammatory foods and discouraged processed foods considered to be pro-inflammatory. The primary outcome of feasibility was assessed via: i) eligibility, recruitment and retention rates; ii) self-reported dietary adherence; iii) adverse events; and iv) treatment satisfaction. Post-intervention interviews evaluated the acceptability of the dietary intervention delivered via telehealth. Secondary outcomes included changes in self-reported body mass, Knee injury and Osteoarthritis Outcome Score (KOOS), health-related quality of life (EuroQoL-5D), analgesic use and global rating of change. Worthwhile effects were determined by the minimal detectable change (MDC) for all five KOOS-subscales (pain, symptoms, activities of daily living, sport/recreation, quality of life) being contained within the 95% confidence interval. Results Forty-eight of seventy-three (66%) individuals screened were eligible and 28 enrolled over 2 months (82% female, mean age 66 ± 8 years, body mass index 30.7 ± 4.8 kg.m−2). Six participants withdrew prior to final follow-up (21% drop-out). Of those with final follow-up data, attendance at scheduled telehealth consultations was 99%. Self-reported adherence to diet during the 9-week intervention period: everyday = 27%, most of time = 68% and some of time = 5%. Two minor adverse events were reported. Change scores contained the MDC within the 95% confidence interval for all five KOOS subscales. Suggestions to improve study design and limit drop-out included an initial face-to-face consultation and more comprehensive habitual dietary intake data collection. Conclusion This study supports the feasibility of a full-scale randomised controlled trial to determine the efficacy of a primarily telehealth-delivered anti-inflammatory dietary education intervention in adults with symptomatic knee osteoarthritis. Trial registration ACTRN12620000229976 prospectively on 25/2/2020.

scholarly journals Response of osteoarthritis biomarkers after a rehabilitation program: study protocol

2020 ◽  
Vol 7 (1) ◽  
pp. 35
Author(s):  
Eliane Antonioli ◽  
Felipe B. D. Oliveira ◽  
Rosana R. Campedelli ◽  
Alessandro R. Zorzi ◽  
Danielli Specialli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
High Mobility ◽  
Rehabilitation Program ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Functional Evaluation ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

<p class="abstract"><strong>Background:</strong> Knee osteoarthritis is a progressive degenerative joint disease and remains a leading cause of pain, physical impairment and decline in health-related quality of life in adults.   Despite its incidence being amongst the highest in chronic diseases, effective biomarkers are not available to assist in its management. The main goal of this study is to identify mediators that serve as biomarkers and investigate if the levels of these biomarkers will be correlated to the efficacy of a rehabilitation program.</p><p class="abstract"><strong>Methods:</strong> This is a prospective cohort study with 65 participants. Patients with mild-to-moderate symptomatic knee osteoarthritis will be recruited. The Rehabilitation Program will consist of three session/week during eight weeks. Assessment about functional evaluation will be performed before and after treatment, using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and EuroQOL-5D (Euro quality of life - five dimension) scales, Visual Analog Scale (VAS), and physical function tests (time up and go, isometric strength testing and kinematic gait analysis). Serum levels of classical pro-inflammatory cytokines, hyaluronan and high mobility group box 1 protein (HMGB-1) will be evaluated. The primary outcome is the change in WOMAC scale from baseline to end. Statistical analyses will be used to determine correlation of physical improvement and serum biomarkers. Adverse events will be monitored throughout the study.</p><p class="abstract"><strong>Conclusions: </strong>This trial expect to study the correlation between the anti-inflammatory effects of rehabilitation program derived factors that may be involved in suppressing cytokine induction via suppressing HMGB-1.</p><p class="abstract"><strong>Trial registration:</strong> Clinicaltrials.gov - NCT02964624.</p>

Long term efficacy of mobilisation with movement on pain and functional status in patients with knee osteoarthritis: a randomised clinical trial

2020 ◽  
pp. 026921552094693
Author(s):  
Aishwarya Nigam ◽  
Kiran H Satpute ◽  
Toby M Hall
Keyword(s):  
Patient Satisfaction ◽  
Confidence Interval ◽  
Knee Osteoarthritis ◽  
Usual Care ◽  
Primary Outcome ◽  
Mean Difference ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

Objectives: To evaluate the long term effect of mobilisation with movement on disability, pain and function in subjects with symptomatic knee osteoarthritis Design: A randomised controlled trial. Setting: A general hospital Subjects: Forty adults with knee osteoarthritis (grade 1–3 Kellgren–Lawrence scale). Interventions: The experimental group received mobilisation with movement and usual care (exercise and moist heat) while the control group received usual care alone in six sessions over two weeks. Main Measures: The primary outcome was the Western Ontario McMaster University Osteoarthritis index, higher scores indicating greater disability. Pain intensity over 24 hours and during sit to stand were measured on a 10 centimetre visual analogue scale. Functional outcomes were the timed up and go test, the 12 step stair test, and knee range of motion. Patient satisfaction was measured on an 11 point numerical rating scale. Variables were evaluated blind pre- and post intervention, and at three and six months follow-up. Results: Thirty five participants completed the study. At each follow-up including six-months, significant differences were found between groups favouring those receiving mobilisation with movement for all variables except knee mobility. The primary outcome disability showed a mean difference of 7.4 points (95% confidence interval, 4.5 to 10.3) at six-months and a mean difference of 13.6 points (95% confidence interval, 9.3 to 17.9) at three-months follow-up. Conclusion: In patients with symptomatic knee osteoarthritis, the addition of mobilisation with movement provided clinically significant improvements in disability, pain, functional activities and patient satisfaction six months later.

scholarly journals Exercise-based cardiac rehabilitation in patients with reduced left ventricular ejection fraction: The Cardiac Rehabilitation Outcome Study in Heart Failure (CROS-HF): A systematic review and meta-analysis

2019 ◽  
Vol 27 (9) ◽  
pp. 929-952 ◽  
Author(s):  
Birna Bjarnason-Wehrens ◽  
R Nebel ◽  
K Jensen ◽  
M Hackbusch ◽  
M Grilli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Relative Risk ◽  
Left Ventricular Ejection Fraction ◽  
Confidence Interval ◽  
Cardiac Rehabilitation ◽  
Left Ventricular ◽  
Left Ventricular Ejection

Background In heart failure with reduced left ventricular ejection fraction (HFrEF) patients the effects of exercise-based cardiac rehabilitation on top of state-of-the-art pharmacological and device therapy on mortality, hospitalization, exercise capacity and quality-of-life are not well established. Design The design of this study involved a structured review and meta-analysis. Methods Evaluation of randomised controlled trials of exercise-based cardiac rehabilitation in HFrEF-patients with left ventricular ejection fraction ≤40% of any aetiology with a follow-up of ≥6 months published in 1999 or later. Results Out of 12,229 abstracts, 25 randomised controlled trials including 4481 HFrEF-patients were included in the final evaluation. Heterogeneity in study population, study design and exercise-based cardiac rehabilitation-intervention was evident. No significant difference in the effect of exercise-based cardiac rehabilitation on mortality compared to control-group was found (hazard ratio 0.75, 95% confidence interval 0.39–1.41, four studies; 12-months follow-up: relative risk 1.29, 95% confidence interval 0.66–2.49, eight studies; six-months follow-up: relative risk 0.91, 95% confidence interval 0.26–3.16, seven studies). In addition there was no significant difference between the groups with respect to ‘hospitalization-for-any-reason’ (12-months follow-up: relative risk 0.79, 95% confidence interval 0.41–1.53, four studies), or ‘hospitalization-due-to-heart-failure’ (12-months follow-up: relative risk 0.59, 95% confidence interval 0.12–2.91, four studies; six-months follow-up: relative risk 0.84, 95% confidence interval 0.07–9.71, three studies). All studies show improvement of exercise capacity. Participation in exercise-based cardiac rehabilitation significantly improved quality-of-life as evaluated with the Kansas City Cardiomyopathy Questionnaire: (six-months follow-up: mean difference 1.94, 95% confidence interval 0.35–3.56, two studies), but no significant results emerged for quality-of-life measured by the Minnesota Living with Heart Failure Questionnaire (nine-months or more follow-up: mean difference –4.19, 95% confidence interval –10.51–2.12, seven studies; six-months follow-up: mean difference –5.97, 95% confidence interval –16.17–4.23, four studies). Conclusion No association between exercise-based cardiac rehabilitation and mortality or hospitalisation could be observed in HFrEF patients but exercise-based cardiac rehabilitation is likely to improve exercise capacity and quality of life.

Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study

2013 ◽  
Vol 73 (7) ◽  
pp. 1369-1375 ◽  
Author(s):  
Jasmijn F M Holla ◽  
Marike van der Leeden ◽  
Martijn W Heymans ◽  
Leo D Roorda ◽  
Sita M A Bierma-Zeinstra ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activity Limitations ◽  
Follow Up Study ◽  
Symptomatic Knee Osteoarthritis ◽  
Symptomatic Knee

scholarly journals Effect of Nucart VG (Boswellia serrata in combination with veg glucosamine sulphate) in comparison with glucosamine sulphate to improve quality of life of knee osteoarthritis patients: a randomized controlled trial

2021 ◽  
Vol 7 (5) ◽  
pp. 976
Author(s):  
Vijay G. Goni ◽  
Mukesh Mishra ◽  
Sailee Kadam ◽  
Sharat S. Gandhi
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Open Label ◽  
Boswellia Serrata ◽  
Group Randomized Trial ◽  
Glucosamine Sulphate

<p class="abstract"><strong>Background:</strong> <em>Boswellia serrata</em> has been proved to be an effective and safe herb for the treatment of osteoarthritis (OA). This study aims at assessing the synergistic effect of this herb with vegetarian glucosamine sulphate, a nutritional supplement, on knee osteoarthritis using quality of life indicators.</p><p class="abstract"><strong>Methods:</strong> This<strong> </strong>was an open label, parallel group randomized trial of 12-week duration. Sixty-six subjects were equally randomized to two treatment arms: <em>Boswellia serrata</em> extract (600 mg) and glucosamine (750 mg) [Nucart VG]; and glucosamine sulphate (market comparator) 750 mg. Patients were administered 1 tablet twice-a-day post-meal for three months. Efficacy of treatment was measured on primary end-points like EuroQol-5D (EQ-5D) (health status indicator), visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale (pain indicators), while safety was measured in terms of vital parameters. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed for comparing scores between the two groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The baseline characteristics of patients between two groups were insignificantly different (p&gt;0.05). In ITT analysis, the health status (EQ-5D score) of patients in Nucart VG group improved significantly than the comparator group at follow up 2 (p=0.037) and showed further improvement at follow up 3 (p=0.012). The pain indicators i.e. VAS and WOMAC scores were significantly lower in Nucart VG group right from follow up 1 till follow up 3 (p&lt;0.05). Similar were the observations during PP analysis.</p><p class="abstract"><strong>Conclusions:</strong> Nucart VG is beneficial for the treatment of mild to moderate knee OA, as inferred from the functional and health status assessment.</p>

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