Immediate Efficacy of Neuromuscular Exercise in Patients with Severe Osteoarthritis of the Hip or Knee: A Secondary Analysis from a Randomized Controlled Trial

2014 ◽  
Vol 41 (7) ◽  
pp. 1385-1394 ◽  
Author(s):  
Allan Villadsen ◽  
Søren Overgaard ◽  
Anders Holsgaard-Larsen ◽  
Robin Christensen ◽  
Ewa M. Roos
Keyword(s):  
Activities Of Daily Living ◽  
Effect Size ◽  
Daily Living ◽  
Exercise Intervention ◽  
Muscle Power ◽  
Functional Performance ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Link Type ◽  
Outcome Score

Objective.Knowledge about the effects of exercise in severe and endstage osteoarthritis (OA) is limited. The aim was to evaluate the efficacy of a neuromuscular exercise program in patients with clinically severe hip or knee OA.Methods.This was a randomized controlled assessor-blinded trial. Patients received an educational package (care-as-usual) only, or care-as-usual plus an 8-week neuromuscular exercise intervention (NEMEX-TJR). NEMEX-TJR was supervised by a physiotherapist, twice weekly for 1 h. The primary outcome was Activities of Daily Living (ADL) subscale from the Hip disability and Osteoarthritis Outcome Score (HOOS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The secondary outcomes were the HOOS/KOOS subscales Pain, Symptoms, Sport and Recreation, and Joint-related Quality of Life. Exploratory outcomes were functional performance measures and lower limb muscle power.Results.Included were 165 patients, 56% female, average age 67 years (SD ± 8), and a body mass index of 30 (SD ± 5), who were scheduled for primary hip or knee replacement. The postintervention difference between mean changes in ADL was 7.2 points (95% CI 3.5 to 10.9, p = 0.0002) in favor of NEMEX-TJR compared with control. Second, there were statistically significant differences between groups in favor of NEMEX-TJR on all self-reported outcomes and most functional performance tests (walk, chair stands, and 1-leg knee bends). Stratified analyses according to joint revealed moderate effect size for ADL for hip patients (0.63, 95% CI 0.26 to 1.00). Corresponding effect size for knee patients was small (0.23 95% CI −0.14 to 0.60).Conclusion.Feasibility of neuromuscular exercise was confirmed in patients about to have total joint replacement. Self-reported activities of daily living and objective performance were improved and pain reduced immediately following 8 weeks of neuromuscular exercise. While the effects were moderate in hip OA, they were only small in knee OA.ClinicalTrials.govIdentifier:NCT01003756.

scholarly journals Adherence to a Lifestyle Exercise and Nutrition Intervention in University Employees during the COVID-19 Pandemic: A Randomized Controlled Trial

2021 ◽  
Vol 18 (14) ◽  
pp. 7510
Author(s):  
Guillermo García Pérez de Sevilla ◽  
Olga Barceló Guido ◽  
María de la Paz De la Cruz ◽  
Ascensión Blanco Fernández ◽  
Lidia B. Alejo ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Effect Size ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Nutrition Intervention ◽  
Sitting Time ◽  
Post Intervention ◽  
University Employees ◽  
Randomized Controlled

Healthy lifestyles should be encouraged in the workplace through the occupational health teams of the companies. The objective of the present study was to evaluate the adherence to a lifestyle intervention carried out in university employees during the COVID-19 pandemic and its impact on health-related quality of life (HrQoL). A randomized controlled trial following the CONSORT guidelines was performed, consisting of three supervised interventions lasting for 18 weeks: an educational intervention on healthy habits, a nutritional intervention, and a telematic aerobic and strength exercise intervention. Lifestyle and HrQoL were analyzed six months post-intervention to assess adherence. Twenty-three middle-aged participants completed the study. The intervention group significantly improved their lifestyle according to the Health Promoting Lifestyle Profile II questionnaire, especially in the categories of Health Responsibility, Physical Activity, and Nutrition, with a large effect size. Sitting time was reduced by 2.5 h per day, with a moderate effect size. Regarding HrQoL, the intervention group showed a clinically significant improvement in the Physical Component Summary. Despite the lockdown and the mobility restrictions caused by the COVID-19 pandemic, this intervention performed on university employees achieved adherence to a healthier lifestyle and improved their HrQoL, which is of great clinical relevance.

Minimally Important Difference in the Foot and Ankle Outcome Score Among Patients Undergoing Hallux Valgus Surgery

2019 ◽  
Vol 40 (6) ◽  
pp. 694-701 ◽  
Author(s):  
Sameer Desai ◽  
Alexander C. Peterson ◽  
Kevin Wing ◽  
Alastair Younger ◽  
Trafford Crump ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Hallux Valgus ◽  
Daily Living ◽  
Patient Reported Outcomes ◽  
Minimally Important Difference ◽  
Foot And Ankle ◽  
Outcome Score ◽  
Patient Reported ◽  
Bunion Correction ◽  
Correction Surgery

Background: Patient-reported outcomes are increasingly used as measures of effectiveness of interventions. To make the tools more useful, therapeutic thresholds known as minimally important differences have been developed. The objective of this study was to calculate minimally important differences for the domains of the Foot and Ankle Outcome Score for hallux valgus surgery. Methods: The study was based on a retrospective analysis of patients newly scheduled for bunion correction surgery and completing patient-reported outcomes between October 2013 and January 2018. This study used anchor- and distribution-based approaches to calculate the minimally important difference for the instrument’s 5 domains. Confidence intervals were calculated for each approach. There were 91 participants included in the study. Results: Using anchor- and distribution-based approaches, the minimally important difference for the pain domain ranged from 5.8 to 10.2, from 0.3 to 6.9 for the symptoms domain, 8.3 to 10.3 for the activities of daily living domain, 7.4 to 11.1 for the quality of life domain, and from 7.0 to 15.7 for the sports and recreation domain. Small differences in the activities of daily living domain may be more clinically important for patients with better function. Discussion: The range of minimally important difference values for each domain indicate how the Foot and Ankle Outcome Score corresponded to bunion correction surgery. The sports and recreation domain showed considerable variability in the range of values and may be associated with the domain’s lack of responsiveness. Overall, most minimally important difference values for the domains of FAOS ranged from above 4 to below 16. Level of Evidence: Level III, retrospective comparative series.

scholarly journals Association of Varus Thrust With Pain and Stiffness and Activities of Daily Living in Patients With Medial Knee Osteoarthritis

2016 ◽  
Vol 96 (2) ◽  
pp. 167-175 ◽  
Author(s):  
Naoto Fukutani ◽  
Hirotaka Iijima ◽  
Takahiko Fukumoto ◽  
Daisuke Uritani ◽  
Eishi Kaneda ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Predictor Variable ◽  
Cross Sectional Study ◽  
Sensitivity Analyses ◽  
Varus Alignment ◽  
Cross Sectional ◽  
Medial Knee ◽  
Knee Oa

Background Increasing evidence highlights potential associations between varus thrust and health domains associated with knee osteoarthritis (OA). Objective The aim of this study was to investigate the association between varus thrust and 2 subcategories—“pain and stiffness” and “activities of daily living (ADL)”—of the Japanese Knee Osteoarthritis Measure (JKOM). Design This was a cross-sectional study. Methods In total, 296 outpatients with knee OA visiting orthopedic clinics were enrolled. The inclusion criteria were age ≥50 years, medial knee OA and Kellgren-Lawrence (K/L) grade ≥1 in one or both knees, and the ability to walk independently. Standard posterior-anterior knee radiographs were measured for varus alignment. Participants were video recorded while walking and were evaluated for the presence or absence of varus thrust. Pain and stiffness of the knee joint and ADL were evaluated using the JKOM. Multivariate regressions (outcomes: pain and stiffness and ADL; predictor variable: varus thrust) were performed. Results Varus thrust was present in 46 (16.2%) of 284 patients. Multivariate regression analyses demonstrated that varus thrust is independently associated with pain and stiffness, adjusted for age, sex, body mass index, K/L grade, and varus alignment (β=.17, P=.005). However, the association between varus thrust and ADL was not significant (β=.11, P=.058). Based on sensitivity analyses, including participants of K/L grade 1 had little influence on this analysis. Limitations Only 16.2% of participants had a varus thrust. Moreover, a cause-effect relationship between varus thrust and pain and stiffness remains unknown due to the cross-sectional design of this study. Conclusions Varus thrust was associated with pain and stiffness in patients with medial knee OA. However, the association between varus thrust and ADL did not reach significance.

MO612THE ROLE OF MECHANICAL MUSCLE POWER IN PHYSICAL DYSFUNCTION: A MODEL FOR TAILORING RESISTANCE-BASED REHABILITATION IN CHRONIC KIDNEY DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Thomas Wilkinson ◽  
Eleanor Gore ◽  
Jared Palmer ◽  
Luke Baker ◽  
Emma Watson ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Strength Training ◽  
Physical Function ◽  
Muscle Mass ◽  
Gait Speed ◽  
Daily Living ◽  
Muscle Power ◽  
Mechanical Power ◽  
Relative Power

Abstract Background and Aims Individuals living with CKD are characterised by adverse changes in physical function. Knowledge of the factors that mediate impairments in physical functioning is crucial for developing effective interventions that preserve mobility and future independence. Mechanical muscle power describes the rate of performing work and is the product of muscular force and velocity of contraction. Muscle power has been shown to have stronger associations with functional limitations and mortality than sarcopenia in older adults. In CKD, the role of mechanical muscle power is poorly understood and is overlooked as a target in many rehabilitation programmes, often at the expense of muscle mass or strength. The aims of this study were to 1) explore the prevalence of low absolute mechanical power, low relative mechanical power, and low specific mechanical power in CKD; and 2) investigate the association of mechanical power with the ability to complete activities of daily living and physical performance. Method Mechanical muscle power (relative, allometric, specific) was calculated using the sit-to-stand-5 (STS5) test as per previously validated equations. Legs lean mass was derived from regional analyses conducted using bioelectrical impedance analysis (BIA). Physical performance was assessed using two objective tests: usual gait speed and the ‘time-up-and-go’ (TUAG) test. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index (DASI). Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low, medium and high levels of relative STS power and its main components. Results 102 participants with non-dialysis CKD were included (mean age: 62.0 (±14.1) years, n=49 males (48%), mean eGFR: 38.0 (±21.5) ml.min.1.73m2). The mean estimated relative power was 3.1 (±1.5) W.kg in females and 3.3 (±1.3) W.kg in males. Low relative power was found in 35/102 (34%) patients. Relative power was a significant independent predictor of self-reported ADLs (via the DASI) (B=.413, P=.004), and performance on the TUAG (B=-.719, P<.001) and gait speed (B=.404, P=.003) tests. Skeletal muscle mass was not associated with the DASI or any of the objective function tests Conclusion Patients presenting with low muscle power would benefit from participation in appropriate interventions designed to improve the physiological components accounting for low relative muscle power. Assessment of power can be used to tailor renal rehabilitation programmes as shown in Figure 1. Incorporation of power-based training, a novel type of strength training, designed by manipulating traditional strength training variables and primarily movement velocity and training intensity may present the best strategy for improving physical function in CKD.

Functional performance in activities of daily living of individuals with a dual-diagnosis of schizophrenia and substance-use disorder

2011 ◽  
Vol 26 (S2) ◽  
pp. 1367-1367
Author(s):  
M. Desormeaux-Lefebvre ◽  
B. Tallant ◽  
I. Gelinas ◽  
N. Lariviere
Keyword(s):  
Substance Use ◽  
Activities Of Daily Living ◽  
Substance Use Disorder ◽  
Dual Diagnosis ◽  
Daily Living ◽  
Functional Performance ◽  
Cognitive Impairments ◽  
Addiction Severity Index ◽  
Grocery Shopping ◽  
Cross Sectional

IntroductionResearch on functional performance of individuals with schizophrenia and substance use is limited, focusing primarily on cognitive impairments. Research findings are conflicting, making it difficult to understand how these individuals function despite their cognitive impairments. There is a need to use performance-based assessments to understand how individuals with a dual-diagnosis accomplish their daily living activities.AimsTo describe the functional performance of individuals with a dual-diagnosis in two activities of daily living, using a performance-based assessment.ObjectivesTo compare the functional performance of individuals with a dual-diagnosis, in grocery shopping and budgeting.MethodsThis descriptive cross-sectional study included ten participants with a dual-diagnosis of schizophrenia and substance-use disorder, aged 21 to 35, living independently in the community. They were evaluated on two tasks, budgeting and grocery shopping, using the Perceive-Recall-Plan-Perform (PRPP) system of task analysis (Chapparo & Ranka, 2005). The PRPP is a standardized criterion-referenced task-based assessment, and is valuable in describing individuals’ community functioning with regards to information-processing difficulties. Substance use was evaluated with the Addiction Severity Index (McLellan et al., 1989).ResultsPreliminary results indicate lower scores on both tasks, in the planning quadrant of the PRPP, particularly the evaluating sub-quadrant, which involves cognitive monitoring and appraisal processes. This trend occurs despite the participant's prior familiarity with tasks. Conclusions: This study is a first step in describing the functional performance of individuals with a dual diagnosis of schizophrenia and substance use in activities of daily living. This information will lead to improved rehabilitation for these clients.

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