scholarly journals TMS-guided physiotherapy reduces pain and induces plasticity in the motor cortex in Chronic Knee Osteoarthritis

2018 ◽  
Vol 8 (2) ◽  
pp. 269-278
Author(s):  
Lucy Chipchase ◽  
Abrahão Fontes Baptista ◽  
Maxine Te ◽  
Simon Summers
Keyword(s):  
Electrical Stimulation ◽  
Motor Cortex ◽  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Quadriceps Strength ◽  
Vastus Medialis ◽  
Intervention Period ◽  
Knee Oa ◽  
Peripheral Electrical Stimulation ◽  
Maladaptive Plasticity

BACKGROUND: Knee osteoarthritis (OA) is associated with chronic pain, impaired function and loss of quality of life.  Brain maladaptive plasticity may be involved and prevent beneficial effects of exercises and other interventions. Neuromodulation with peripheral electrical stimulation guided by TMS mapping may specifically influence those maladaptive modifications. OBJECTIVE: To compare the cortical organization and excitability of three muscles (straight femuris, vastus lateralis and vastus medialis) in a subject with OA knee.  METHODS: This single case ABA study involved a 66 yo woman with knee OA that was considering an arthroplasty.  She was assessed for pain (VAS), function (WOMAC, ICOAP), and quadriceps strength one time a week, for 10 weeks (A – four weeks assessment; B – two weeks assessment and intervention; A – four weeks assessment). TMS mapping was performed at baseline, after the two-week intervention period and at the end of the study.  This examination initially revealed a prominent decrease in the volume of vastus medialis portion of the quadriceps muscle over the primary motor cortex (M1), which determined a peripheral electrical stimulation protocol specifically designed to increase this muscle’s excitability.  During the intervention period the participant also carried over specific exercises daily.  RESULTS: WOMAC scores, and quadriceps strength were not changed during the study period.  Improvements were seen in the three subscales of the ICOAP following the intervention. This clinical change was associated with an increase in vastus medialis and also Vastus lateralis, and a decrease in rectus femuris TMS map volumes, which were maintained until the last evaluation. CONCLUSION:  TMS mapping may guide specific interventions to counteract motor cortex maladaptive plasticity and positively influence pain and function in knee OA.

scholarly journals Lower Extremity Muscle Strength and Risk of Self-Reported Hip or Knee Osteoarthritis

2004 ◽  
Vol 1 (4) ◽  
pp. 321-330 ◽  
Author(s):  
Jennifer M. Hootman ◽  
Shannon FitzGerald ◽  
Carol A. Macera ◽  
Steven N. Blair
Keyword(s):  
Lower Extremity ◽  
Knee Osteoarthritis ◽  
Knee Extension ◽  
Quadriceps Strength ◽  
Community Dwelling ◽  
Leg Press ◽  
Knee Oa ◽  
Lower Extremity Muscle ◽  
Longitudinal Association

Purpose:The purpose of this study was to investigate the gender-specific longitudinal association between quadriceps strength and self-reported, physician-diagnosed hip or knee osteoarthritis (OA).Methods:Subjects were 3081 community-dwelling adults who were free of OA, joint symptoms and injuries, completed a maximum treadmill exercise test, had isokinetic knee extension and flexion and isotonic leg press strength measurements taken at baseline and returned at least one written follow-up survey. Multivariate logistic regression was used to estimate odds ratios and 95% confidence intervals.Results:Women with moderate or high isokinetic quadriceps strength had a significantly reduced risk (55% to 64%) of hip or knee OA. A similar, nonsignificant trend was noted among men. Moderate isotonic leg press strength was protective for hip or knee osteoarthritis among men only.Conclusions:These results suggest that quadriceps weakness is an independent and modifiable risk factor for lower extremity OA, particularly among women.

scholarly journals Phisical modalities on the functional performance in knee osteoarthritis: a sytematic review

2017 ◽  
Vol 30 (3) ◽  
pp. 607-623 ◽  
Author(s):  
Letícia Ferronato ◽  
Hemily Marega Cunha ◽  
Pâmela Maiara Machado ◽  
Gabriela dos Santos de Souza ◽  
Mirieli Denardi Limana ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Life Quality ◽  
Low Level Laser Therapy ◽  
Ultrasound Therapy ◽  
Pulsed Ultrasound ◽  
Eligibility Criteria ◽  
Knee Oa ◽  
Physical Modalities

Abstract Introduction: Despite recent advances in the treatment of osteoarthritis (OA), few studies have evaluated the longitudinal effect of physical modalities in functional capacity in patients with knee OA. Thereby, since the physical components and pain can affect the functional performance of daily activities, the effect of these treatment’s form is still to be established. Objective: Evaluate the effectiveness of therapeutic ultrasound, electrical stimulation and phototherapy in the functional performance, in patients with knee osteoarthritis. Methods: Articles present in the PubMed, Lilacs, SciELO and PEDro’s databases were evaluated. The used keywords were “pulsed ultrasound therapy”, “ultrasound therapy”, “electric stimulation” and “low level laser therapy” in combination with “knee osteoarthritis”. Were included in this presented review, randomized clinical studies using ultrasound, electrical and laser stimulation in subjects with knee osteoarthritis. To evaluate the methodological quality of the selected studies, was used the PEDro’s scale. The dependent variables of the study were: pain, physical function, joint stiffness, life quality and functional performance. Results: 268 studies were found, of these, 41 studies met eligibility criteria and were classified for analysis in full. The used methodology in the studies varied widely, however, in most cases there was improvement in functional performance of individuals with knee OA, with the use of physical modalities, for the pulsed ultrasound, continuous ultrasound, electrical stimulation and laser resourses. Conclusion: The physical modalities used in the studies demonstrated improvement in functional performance of individuals with knee OA.

scholarly journals Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Pain and the Function in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Aline Mizusaki Imoto ◽  
Stella Peccin ◽  
Kelson Nonato Gomes da Silva ◽  
Lucas Emmanuel Pedro de Paiva Teixeira ◽  
Marcelo Ismael Abrahão ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Controlled Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Functional Improvement ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Significant Difference

Objectives. To investigate the effect of 8 weeks of NMES + Ex (neuromuscular electrical stimulation combined with exercises) on pain and functional improvement in patients with knee osteoarthritis (OA) compared to exercise (Ex) alone.Design. Randomized controlled trial.Setting. A specialty outpatient clinic.Participants. Patients (N=100; women = 86, men = 14; age range, 50–75 years) with knee OA.Interventions. Participants were randomly assigned to NMES + Ex or Ex group.Outcome Measures. Numerical Rating Scale 0 to 10 (NRS) and the Timed Up and Go (TUG) test were the primary outcomes. The secondary outcomes used were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results. Following the interventions, a statistically significant improvement in both groups was observed in all outcomes assessed. For the comparison between the groups, no statistically significant difference was found between the NMES + Ex and the Ex groups in NRS (P=0.52), TUG test (P=0.12), and aspects of WOMAC: pain (P=0.26), function (P=0.23), and stiffness (P=0.63).Conclusion. The addition of NMES to exercise did not improve the outcomes assessed in knee OA patients. This study was registered at the Australian Clinical Trials Registry (ACTRN012607000357459).

QUADRICEPS STRENGTH, KNEE PAIN AND FUNCTIONAL PERFORMANCE WITH PATELLAR TAPING IN KNEE OSTEOARTHRITIS

2014 ◽  
Vol 17 (03) ◽  
pp. 1450014 ◽  
Author(s):  
Abeer Farag Hanafy ◽  
Amira Abdallah Abd El Megeid Abdallah
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Performance ◽  
Quadriceps Muscle ◽  
Quadriceps Strength ◽  
Stair Climbing ◽  
Walking Distance ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Vas Scores ◽  
Patellar Taping

Background: Patellar taping has long been reported to be effective in relieving pain in patients with patello-femoral pain syndrome (PFPS). Yet, there is lack of knowledge that supports its use in knee osteoarthritis (OA) management. Purpose: This study examined the effect of therapeutic patellar taping on concentric and eccentric quadriceps muscle peak torques, VAS pain scores, 6-minute walking distance and stair climbing time in patients with knee OA. Methods: A total of 30 female patients with symptomatic knee OA with mean age 51.8 ± 6.3 years and BMI 32.56 ± 3.26 m2/kg participated in the study. They were tested under three taping conditions that were tested randomly; therapeutic, placebo and no-tape. Results: Repeated measure MANOVA revealed that the quadriceps muscle peak torques and 6-minute walking distance increased significantly (p < 0.05) and the VAS scores and stair climbing time decreased significantly with therapeutic tape use compared with the other two tapes. Moreover, the quadriceps muscle peak torques increased significantly and the VAS scores decreased significantly with placebo tape use compared with no-tape use, with no significant difference (p > 0.05) in between for the 6-minute walking distance and stair climbing time. Conclusion: The findings indicate that therapeutic patellar taping is effective in improving quadriceps strength and functional performance and reducing pain in patients with knee OA.

scholarly journals FRI0390 IMPACT OF ULTRASONOGRAPHY‑DETECTED QUADRICEPS CALCIFIC TENDONITIS ON PAIN AND FUNCTION IN PATIENTS WITH PRIMARY KNEE OSTEOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 793.3-793
Author(s):  
M. A. Mortada ◽  
Y. A. Amer
Keyword(s):  
Knee Osteoarthritis ◽  
Vastus Lateralis ◽  
Health Assessment ◽  
Quadriceps Tendon ◽  
Knee Joints ◽  
Knee Oa ◽  
Vastus Intermedius ◽  
Calcific Tendonitis ◽  
Advanced Stages ◽  
And Function

Background:Calcific tendonitis is most commonly seen around shoulder joint. Few cases of quadriceps calcific tendonitis (QCT) of were reported. Routine use of ultrasonography in diagnosis of knee osteoarthritis has resulted in detection of many cases of QCT.Up to the best of our knowledge, this is the first study to detect impact of QCT in knee osteoarthritis by ultrasonography.Objectives:To compare pain, function, and clinical and radiological findings among primary KOA patients with or without ultrasonography-detected QCT.Methods:A prospective, observational study study was conducted on 214 patients with knee OA in the period between february 2019 to july 2019. Ultrasonography of knee joints was done according to EULAR guidelines. Quadriceps calcific tendonitis is defined as hyperechoic mass within the quadriceps tendon with posterior shadowing. The patients were categorized into two groups according to the presence or absence of QCT.Radiological grades of Kellgren–Lawrence were recorded. Pain and functional status was assessed by visual analog scale (VAS), Health Assessment Questionnaire-II (HAQ-II), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)Results:QCT were detected in 25 (11.6%) patients. Most cases of QCT were detected in vastus lateralis 18 (72%), then in vastus intermedius 5 (20%) and only 2 cases were detected in vastus medialis.QCT were detected mainly in advanced stages of knee OA; 22 cases of QCT were found in patients with grade 4 KOA.The presence of QCT was statistically significant related (P< 0.05*) with age, VAS, HAQ-II, WOMAC subscales, synovitis and effusion.Conclusion:Quadriceps calcific tendonitis is not rare. Ultrasonography can detect QCT in many cases with advanced knee OA. QCT is associated with increased pain and dysfunction in knee OAReferences:NoneDisclosure of Interests:None declared

scholarly journals Comparative effects of burst mode alternating current and resisted exercise on physical function, pain intensity and quadriceps strength among patients with primary knee osteoarthritis

2017 ◽  
Vol 21 (2) ◽  
pp. 10-18
Author(s):  
John O. Omole ◽  
Michael O. Egwu ◽  
Chidozie E. Mbada ◽  
Taofeek O. Awotidebe ◽  
Ayodele T. Onigbinde
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Physical Function ◽  
Alternating Current ◽  
Quadriceps Strength ◽  
Burst Mode ◽  
Knee Oa ◽  
The Mean ◽  
Analyze Data

Background and objective: The benefi cial effect of Resisted Exercise (RE) in Knee Osteoarthritis (OA) rehabilitation is often hamstrung by the presence of other comorbidities affecting exercise implementation, hence the need for comparative alternative therapies. This study compared the effect of Burst Mode Alternating Current (BMAC) and RE in the management of patients with knee OA. Methods: Forty-seven consenting patients with primary knee OA participated in this study. The participants were recruited from the outpatient physiotherapy department of a Nigerian teaching hospital. The participants were randomly assigned into either RE plus BMAC (RBMAC) or RE Only (REO) groups. The effects of intervention were assessed in terms of physical function, pain intensity and quadriceps strength at the 4th and 8th week of intervention. Descriptive and inferential statistics were used to analyze data at p<0.05 alpha level. Result: RBMAC and REO led to signifi cant mean changes in physical function (RBMAC – p=0.001: REO – p=0.001), pain intensity (RBMAC − p=0.001: REO – p=0.001), and muscle strength (RBMAC − p=0.001: REO – p=0.001) scores. However, there was no signifi cant difference in the mean change in physical function, pain intensity or muscle strength scores between RE plus BMAC and RE only groups (p>0.05). Conclusion: In conclusion, resisted exercise alone had signifi cant effects on physical function, pain intensity and quadriceps strength in patients with knee osteoarthritis. However, burst mode alternating current did not show additional effects.

scholarly journals Differing Effect of an EMG Biofeedback-­Monitored Exercise Compared to an Un-­monitored One in Vastus Medialis Obliquus and Vastus Lateralis Muscles Amplitude in Knee Osteoarthritis

1970 ◽  
Vol 1 (1) ◽  
pp. 27-33
Author(s):  
Umi Syayyirotin A ◽  
Lukitra Wardhani ◽  
Fatchur Rochman
Keyword(s):  
Knee Osteoarthritis ◽  
Amplitude Ratio ◽  
Vastus Lateralis ◽  
Emg Biofeedback ◽  
Vastus Medialis ◽  
Resistive Exercise ◽  
Vastus Medialis Obliquus ◽  
Randomized Clinical Study ◽  
Before And After ◽  
The Difference

Objectives: The objective of the study was to know the difference of maximum and ratio amplitudes of vastus medialis obliquus and vastus lateralis muscles before and after exercise with and without EMG biofeedback monitoring in knee osteoarthritis patients.Methods: Randomized clinical study design. This study was conducted in Department of Physical Medicine and Rehabilitation Airlangga University, Dr. Soetomo hospital Surabaya. Twenty eight patients with knee osteoarthritis were randomly placed into 2 groups, the first group received progressive resistive exercise with EMG biofeedback, while the other group received training with progressive resistive method only. The ratio and maximum amplitudes of vastus medialis obliquus and vastus lateralis muscles were analyzed before and after 8 weeks exercise.Results: The amplitudes of vastus medialis obliquus and vastus lateralis were improved significantly in group receiving progressive resistive training method with EMG biofeedback monitoring (p=.01 and p=.001, respectively). Comparison between two groups after 8 weeks of progressive resistive exercise showed significant improvements on amplitude of vastus medialis obliquus muscle (p=.014) and amplitude ratio of VMO/VL (p=.034) in EMG biofeedback monitoring group.Conclusions: Progressive resistive exercise with EMG biofeedback monitoring could improvesignificantly the amplitudes of vastus medialis obliquus and vastus lateralis muscles and amplitude ratio of VMO/VL in knee osteoarthritis patients.Keywords: knee osteoarthritis, progressive resistive exercise, EMG biofeedback monitoring.

Electromyography of the vastus medialis and vastus lateralis muscles after neuromuscular electrical stimulation in patients with patellofemoral dysfunction

2014 ◽  
Vol 25 (2) ◽  
pp. 13-21
Author(s):  
Camila Adalgisa Oliveira ◽  
Ivan Luiz de Souza Pires ◽  
George Azevedo Lemos ◽  
Renato Rissi ◽  
Ana Elisa Zuliani Stroppa Marques ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Vastus Lateralis ◽  
Neuromuscular Electrical Stimulation ◽  
Vastus Medialis
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