Effectiveness of Triamcinolone Hexacetonide Intraarticular Injection in Interphalangeal Joints: A 12-week Randomized Controlled Trial in Patients with Hand Osteoarthritis

2015 ◽  
Vol 42 (10) ◽  
pp. 1869-1877 ◽  
Author(s):  
Natalia de Oliva Spolidoro Paschoal ◽  
Jamil Natour ◽  
Flavia S. Machado ◽  
Hilda Alcântara Veiga de Oliveira ◽  
Rita Nely Vilar Furtado
Keyword(s):  
Adverse Effects ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Hand Function ◽  
Intraarticular Injection ◽  
Pinch Strength ◽  
Hand Osteoarthritis ◽  
Triamcinolone Hexacetonide ◽  
Link Type ◽  
Pain At Rest

Objective.To evaluate the effectiveness and tolerance of intraarticular injection (IAI) of triamcinolone hexacetonide (TH) for the treatment of osteoarthritis (OA) of hand interphalangeal (IP) joints.Methods.Sixty patients who underwent IAI at the most symptomatic IP joint were randomly assigned to receive TH/lidocaine (LD; n = 30) with TH 20 mg/ml and LD 2%, or just LD (n = 30). The injected joint was immobilized with a splint for 48 h in both groups. Patients were assessed at baseline and at 1, 4, 8, and 12 weeks by a blinded observer. The following variables were assessed: pain at rest [visual analog scale (VAS)r], pain at movement (VASm), swelling (physician VASs), goniometry, grip and pinch strength, hand function, treatment improvement, daily requirement of paracetamol, and local adverse effects. The proposed treatment (IAI with TH/LD) was successful if statistical improvement (p < 0.05) was achieved in at least 2 of 3 VAS. Repeated-measures ANOVA test was used to analyze intervention response.Results.Fifty-eight patients (96.67%) were women, and the mean age was 60.7 years (± 8.2). The TH/LD group showed greater improvement than the LD group for VASm (p = 0.014) and physician VASs (p = 0.022) from the first week until the end of the study. In other variables, there was no statistical difference between groups. No significant adverse effects were observed.Conclusion.The IAI with TH/LD has been shown to be more effective than the IAI with LD for pain on movement and joint swelling in patients with OA of the IP joints. Regarding pain at rest, there was no difference between groups. Trial registration number: ClinicalTrials.gov (NCT02102620).

scholarly journals Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: A randomized controlled trial

2002 ◽  
Vol 47 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Tanja Alexandra Stamm ◽  
Klaus Peter Machold ◽  
Josef Sebastian Smolen ◽  
Sabine Fischer ◽  
Kurt Redlich ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Hand Function ◽  
Hand Osteoarthritis ◽  
Randomized Controlled ◽  
Joint Protection ◽  
Hand Exercises

scholarly journals The effects of a novel bicarbonate loading protocol on serum bicarbonate concentration: a randomized controlled trial

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Adam Marcus ◽  
Amerigo Rossi ◽  
Andrew Cornwell ◽  
Steven A. Hawkins ◽  
Nazareth Khodiguian
Keyword(s):  
Sodium Bicarbonate ◽  
Repeated Measures ◽  
Controlled Trial ◽  
Elevated Serum ◽  
Self Report ◽  
Serum Bicarbonate ◽  
Bicarbonate Concentration ◽  
Link Type ◽  
Men 2 ◽  
Gastrointestinal Distress

Abstract Background Previous studies have shown that sodium bicarbonate ingestion may enhance intense exercise performance, but may also cause severe gastrointestinal distress. The purpose of this study was to determine whether a modified sodium bicarbonate (SB) ingestion protocol would elevate serum bicarbonate concentration more than previous methods without causing gastrointestinal distress. Methods In randomized order, seven (5 men, 2 women) elite middle-distance runners ingested either placebo, Modified SB (600 mg·kg− 1 over 19.5 h), or Acute SB (300 mg·kg− 1) in opaque gelatin capsules. Baseline and post-ingestion blood samples were analyzed for bicarbonate, pH, sodium, hematocrit, and lactate. Repeated measures ANOVA (2 time points × 3 conditions) were analyzed to determine differences in serum bicarbonate, lactate, sodium, blood pH, and hematocrit. Gastrointestinal distress was assessed via self-report on a Likert scale of 1–10. Simple (condition) and repeated (time) within-participant contrasts were used to determine the location of any statistically significant main and interaction effects (p ≤ 0.05). Results Both Modified SB (7.6 mmol·L− 1, p < 0.01) and Acute SB (5.8 mmol·L− 1, p < 0.01) increased serum bicarbonate concentration compared to the placebo (p ≤ 0.05). Post-ingestion serum bicarbonate concentration was significantly higher for the Modified SB (34.7 ± 2.2 mmol·L− 1, 28.0% increase) trials than the Acute SB (33.5 ± 2.0 mmol·L− 1, 20.9% increase) trials (p = 0.05). There was no reported severe GI distress in the Modified SB trials, but two cases in the Acute SB trials. Conclusions Modified SB elevated serum bicarbonate concentration more than Acute SB, without any severe gastrointestinal side effects. Consequently, it is recommended that future experimentation involving SB by researchers and athletes use the novel ingestion protocol described in this study due to its potential for improved effectiveness and reduced gastrointestinal impact. Trial registration ClinicalTrials.gov ,NCT03813329. Registered 23 January 2019 - Retrospectively registered,

scholarly journals Associations between hand function and electrophysiological measurements in hand osteoarthritis patients of different ages with or without carpal tunnel syndrome

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Young Hoon Kim ◽  
Eun Young Han ◽  
Jinseok Kim ◽  
Kyu-Bum Seo ◽  
Young Tae Jeon ◽  
...  
Keyword(s):  
Carpal Tunnel Syndrome ◽  
Carpal Tunnel ◽  
Nerve Conduction ◽  
Hand Function ◽  
Sensory Nerve ◽  
Male Gender ◽  
Pinch Strength ◽  
Hand Osteoarthritis ◽  
Hand Grip ◽  
Tunnel Syndrome

Abstract Osteoarthritis is a common degenerative disease that most frequently involves the hand. The objective was to compare clinical functional outcome measures including hand grip, pinch strength, and dexterity with various electrophysiological measures in patients of different ages with hand osteoarthritis with or without the presence of carpal tunnel syndrome (CTS). Patients with hand osteoarthritis (208 patients, 404 hands) who underwent hand-function tests and motor and sensory nerve conduction studies (NCS) between June 2015 and June 2016 were enrolled. The patients’ hands were assigned to carpal tunnel syndrome (CTS) (206 hands; mean age, 56.37 ± 10.52; male:female, 46:160) or control groups (198 hands; mean age, 57.88 ± 9.68; male:female, 55:143). The strength of hand grip and lateral pinch, the time required to complete the nine-hole pegboard test (9HPT), and motor and sensory nerve conduction parameters were measured and compared across age groups and between hands with or without CTS. The CTS group showed significantly lower hand grip and lateral pinch strength, and a longer time to complete the 9HPT in comparison with the control group. Female patients showed significantly lower hand grip and lateral pinch strength than male patients. However, there was no difference in the 9HPT completion time between genders. Multivariate regression analysis identified the amplitude of the median compound muscle action potential (CMAP), age, and male gender as independent predictors of grip strength (adjusted R2 = 0.679), and amplitude of median CMAP and male gender as independent predictors of KP strength (adjusted R2 = 0.603). Velocity of median CMAP, amplitude of median sensory nerve action potential, and age were identified as independent predictors of 9HPT time (adjusted R2 = 0.329). Nerve conduction measurements were significantly related to hand-function test results, and CTS induced significant deficits in strength and performance of the affected hand.

scholarly journals Ixekizumab improves sleep and work productivity in patients with non-radiographic axial spondyloarthritis: results from the COAST-X trial at 52 weeks

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Atul Deodhar ◽  
Philip Mease ◽  
Helena Marzo-Ortega ◽  
Theresa Hunter ◽  
David Sandoval ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Axial Spondyloarthritis ◽  
Controlled Trial ◽  
Work Productivity ◽  
Analysis Of Covariance ◽  
Activity Impairment ◽  
Work Activity ◽  
Work Impairment ◽  
Link Type ◽  
Dosing Regimens

Abstract Background Patients with non-radiographic axial spondyloarthritis experience negative impacts on sleep, work productivity, and activity impairment. Ixekizumab, a monoclonal antibody selectively targeting interleukin-17A, has shown efficacy in treating the signs and symptoms of non-radiographic axial spondyloarthritis. This analysis evaluated the effect of ixekizumab treatment on sleep, work productivity, and activity impairment in patients with non-radiographic axial spondyloarthritis. Methods COAST-X (NCT02757352) was a 52-week, phase 3, multicenter, randomised placebo-controlled trial evaluating 80-mg ixekizumab every 2 weeks and every 4 weeks in patients with active non-radiographic axial spondyloarthritis. Sleep disturbance was measured with the Jenkins Sleep Evaluation Questionnaire (JSEQ) and analysed using mixed-effects models for repeated measures. Work productivity and activity impairment were measured using the Work Productivity and Activity Impairment Questionnaire for Spondyloarthritis and analysed using analysis of covariance. Absenteeism, presenteeism, and overall work impairment were assessed for patients reporting paid work; activity impairment was assessed regardless of work status. Results Overall, patients treated with both dosing regimens of ixekizumab reported numerically greater improvements in sleep than placebo through Week 52. At Weeks 16 and 52, patients treated with ixekizumab every 4 weeks had significantly greater improvements in presenteeism (p = 0.007 and p = 0.003, respectively) and overall work impairment (p = 0.014 and p = 0.005, respectively) and numeric improvements in absenteeism than placebo. Patients treated with ixekizumab every 2 weeks had numerically greater improvements in absenteeism, presenteeism, and overall work impairment than placebo. Both dosing regimens of ixekizumab were associated with significantly greater improvements in activity impairment than placebo (ixekizumab every 4 weeks: p = 0.003 at Week 16 and p = 0.004 at Week 52; ixekizumab every 2 weeks: p = 0.007 at Week 16 and p = 0.006 at Week 52). Conclusions Treatment with ixekizumab improved sleep, work productivity, and activity impairment in patients with nr-axSpA. Improvements in presenteeism and overall work impairment were sustained and consistent in the patients treated with ixekizumab every 4 weeks from Week 16 to Week 52. Improvements in activity impairment were sustained and consistent in both ixekizumab-treated groups from Week 16 to Week 52. Trial registration NCT02757352, May 2, 2016.

The effect of hand osteoarthritis on grip and pinch strength and hand function in postmenopausal women

2003 ◽  
Vol 22 (6) ◽  
pp. 420-424 ◽  
Author(s):  
Selda Bagis ◽  
Gunsah Sahin ◽  
Yasemin Yapici ◽  
Ozlem Bolgen Cimen ◽  
Canan Erdogan
Keyword(s):  
Postmenopausal Women ◽  
Hand Function ◽  
Pinch Strength ◽  
Hand Osteoarthritis

scholarly journals The impact of upper limb exercise on function, daily activities and quality of life in systemic lupus erythematosus: a pilot randomised controlled trial

RMD Open ◽  
2020 ◽  
Vol 6 (1) ◽  
pp. e001141 ◽  
Author(s):  
Kyriaki Keramiotou ◽  
Christos Anagnostou ◽  
Evangelia Kataxaki ◽  
Antonios Galanos ◽  
Petros P Sfikakis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Upper Limb ◽  
Lupus Erythematosus ◽  
Controlled Trial ◽  
Hand Function ◽  
Exercise Group ◽  
Daily Activities ◽  
Pinch Strength ◽  
Limb Exercise

ObjectiveTo assess the effect of upper limb exercise on hand function, daily activities performance and quality of life of patients with systemic lupus erythematosus (SLE).MethodsWe performed a pilot randomised, 24-week follow-up, unmasked controlled trial. Inclusion criteria were upper limb arthralgias, a Disabilities of Arm, Shoulder and Hand (DASH) questionnaire score >10 and a stable treatment over the past 3 months. Patients were randomly allocated in the routine care (control) or exercise group that received an individually tailored 30-min daily upper-limb exercise programme by a hand therapist for 12 weeks. We evaluated at 0, 6, 12 and 24 weeks the performance of daily activities for both groups with DASH questionnaire and Health Assessment Questionnaire (HAQ), the grip and pinch strength with Jamar dynamometer and pinch gauge tool, respectively, the dexterity with Purdue pegboard test, the quality of life with Lupus Quality of Life (LupusQoL) Questionnaire and the pain level by Visual Analogue Scale (VAS) score.ResultsFrom 293 consecutive SLE patients, data from 32 patients allocated to the exercise group and 30 to the control group were analysed. There was a significant difference between the two groups in percentage changes of DASH, HAQ, grip strength, pinch strength, LupusQoL-physical health and fatigue, and VAS scores from baseline to 6, 12 and 24 weeks, and from baseline to 12 weeks for dexterity test (p<0.001). No interaction was observed between exercise and disease activity or medication use at baseline and during the observation period.ConclusionUpper-limb exercise significantly improves hand function, pain, daily activity performance and quality of life in SLE.Trial registration numberNCT03802578.

scholarly journals Sustained efficacy of a concise self-management programme for hands in systemic sclerosis: a longitudinal case–control observational study

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3330-3339
Author(s):  
Sibila F. Landim ◽  
Manoel B. Bertolo ◽  
Ana Paula Del Rio ◽  
Zoraida Sachetto ◽  
Juliana Zonzini Gaino ◽  
...  
Keyword(s):  
Observational Study ◽  
Range Of Motion ◽  
Repeated Measures ◽  
Hand Function ◽  
Case Control ◽  
Management Programme ◽  
Self Management ◽  
Pinch Strength ◽  
Control Group ◽  
Hand Exercises

Abstract Objectives In a longitudinal case–control observational study, we evaluated the benefits of a self-management programme for hands developed for patients with SSc. Methods Patients with SSc included in the intervention group (IG) received a concise self-management programme with emphasis on hand exercises and were evaluated during 24 weeks regarding hand pain, hand function, range of motion, grip and tip and key pinch strength. Results were compared with a control group (CG) with no intervention using an analysis of variance for repeated measures with variables transformed into ranks (P ≤ 0.05). Effect sizes were calculated using Cohen’s test. Results Of 90 patients who were evaluated, seven were excluded at enrolment and 26 were excluded during the follow-up. Data from 57 subjects (IG 40, CG 17) were used for analysis. Groups were similar at baseline, except for the Scleroderma HAQ and tip and key pinch strength. Outcome improvements were noted only in the IG (P ≤ 0.05, large effect size). In the CG, variables did not change or had even worsened (hand grip strength and finger motion). Conclusions This self-management programme based on hand exercises for SSc resulted in pain reduction and hand function, strength and range of motion improvement. It can be a simple and useful intervention, especially when a regular rehabilitation programme is not available.

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