scholarly journals Relationship of Patellofemoral Osteoarthritis to Changes in Performance-Based Physical Function Over 7 Years: The Multicenter Osteoarthritis Study

2021 ◽  
pp. jrheum.210270
Author(s):  
Harvi F. Hart ◽  
Tuhina Neogi ◽  
Michael LaValley ◽  
Daniel White ◽  
Yuqing Zhang ◽  
...  

Objective Determine the relationship of patellofemoral osteoarthritis (OA) to changes in performancebased function over 7 years. Methods 2666 participants (62.2±8.0 years, BMI 30.6±5.9kg/m2; 60% female) from the Multicenter Osteoarthritis Study with knee radiographs at baseline and who completed repeated chair stands and 20- meter walk test at baseline, 2.5, 5, and 7 years were included. Generalized linear models assessed the relation of radiographic patellofemoral OA and radiographic patellofemoral OA with frequent knee pain to longitudinal changes in performance-based function. Analyses were adjusted for age, sex, BMI, tibiofemoral OA, and injury/surgery. Results Linear models demonstrated a significant group by time interaction for the repeated chair stands (p=0.04) and the 20-meter walk test (p<0.0001). Those with radiographic patellofemoral OA took 1.01seconds longer on the repeated chair stands (p=0.02) and 1.69seconds longer on the 20-meter walk test (p<0.0001) at 7 years compared with baseline. When examining the relation of radiographic patellofemoral OA with frequent knee pain to performance-based function there was a significant group by time interaction for repeated chair stands (p=0.05) and the 20-meter walk test (p<0.0001). Those with radiographic patellofemoral OA with frequent knee pain increased their time on the repeated chair stands by 1.12seconds (p=0.04) and 1.91seconds (p<0.0001) on the 20-meter walk test over 7 years. Conclusion Individuals with radiographic patellofemoral OA and those with radiographic patellofemoral OA with frequent knee pain have worsening of performance-based function over time. This knowledge may present opportunities to plan for early treatment strategies for patellofemoral OA to limit functional decline over time.

2013 ◽  
Vol 40 (9) ◽  
pp. 1505-1512 ◽  
Author(s):  
Sandhya C. Nair ◽  
Johannes W.J. Bijlsma ◽  
Jacobien H. van der Werf ◽  
Maaike J. van der Veen ◽  
Suzanne P. Linn-Rasker ◽  
...  

Objective.To explore the relationship between rheumatoid arthritis (RA) disease activity and functional disability over time, considering indirect (predictive) and direct (concurrent) associations as well as the influence of radiographic joint damage and treatment strategy.Methods.Functional disability [Health Assessment Questionnaire (HAQ)], disease activity [28-joint Disease Activity Score (DAS28)], and radiographic joint damage [Sharp/van der Heijde score (SHS)] were measured in 4 consecutive randomized controlled trials with increasingly intensive (tight control) treatment strategies. Average followup time for the 3 cohorts was 97, 53, and 50 months, respectively. Next to current DAS28, the previous DAS28 was used to study the predictive effect of a change in DAS28 on progression of functional disability (HAQ). Finally, it was investigated whether SHS mediated the predictive effect of DAS28.Results.In patients treated with intensive treatment strategies, the progression of HAQ over time was statistically significantly less (p < 0.0001). The predictive influence of DAS28 on HAQ progression increased over the duration of the disease. SHS was not found to influence HAQ progression and did not mediate the predictive effect of DAS28. In the less intensively treated patients, the direct effect of disease activity decreased with disease duration, and contrarily, SHS did influence HAQ progression, but was not found to (fully) mediate the predictive effect of DAS28.Conclusion.In patients with RA treated with modern treatment strategies, there is less functional decline over time. Further, disease activity does predict functional decline but joint damage does not. This might indicate that factors associated with cumulative disease activity but not visible on radiographs can influence functional decline in patients with RA. This further underlines the importance of disease activity as a treatment target in early RA and in established RA.


2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S283-S283
Author(s):  
Daniel Ilzarbe ◽  
Inmaculada Baeza ◽  
Elena De la Serna ◽  
Mireia Rosa ◽  
Olga Puig-Navarro ◽  
...  

Abstract Background Functional connectivity (FC) during the resting-state is reduced in schizophrenia, especially within the Default Mode Network (DMN) (Dong 2018), and between the hippocampus, striatum and ventral tegmental area (VTA), which together conform a Midbrain Network (Gangadin 2019). Cross-sectional studies in adult samples have reported altered FC between dopamine synthesizing centers in midbrain and cortical areas in schizophrenia (Martino 2018). Conceptualizing schizophrenia as a neurodevelopmental disorder, we hypothesize that these changes may take place in early ages, prior to the clinical onset of psychosis. Therefore, we aim to examine FC of the DMN and Midbrain networks longitudinally in adolescents at increased risk of developing psychosis compared with youth with early onset psychosis and healthy volunteers (HV). Methods This longitudinal case-control study encompassed adolescents (12.6–18.9 years old) with psychosis risk syndrome (PRS; n=47), first episode of psychosis (FEP; n=59), and age and sex-matched HV (n=34). Fourteen out of the 30 PRS with follow-up assessment developed psychosis (t-PRS). Resting-state fMRI data was available for 88 subjects at baseline and follow-up [no significant differences in relation to drop-outs]: 10 t-PRS re-scanned at 3–12 months (at transition), and 14 PRS who did not transited (nt-PRS), 35 FEP; and 29 HV re-scanned at 10–36 month follow-up. After exclusion due to poor acquisition or excess movement, the final sample encompassed: 27 FEP, 9 t-PRS, 12 nt-PRS and 28 HV. Individual time series were extracted from Regions of Interest (ROI): for the DMN, the medial Prefrontal Cortex (mPFC), precuneus (PC), and bilateral temporo-parietal junction (Schilbach 2016); and for the Midbrain Network, the associative and limbic striatum, VTA and subiculum (Gangadin 2019). The orthogonal parameters of movement, white matter and cerebrospinal fluid (and their derivatives) and head motion scrubbing regressors were regressed out before performing the correlations. Multivariate mixed-effect models were estimated, including group (4), time and group by time interaction as fixed effects; and time and individual variability as random effects. Results There were no significant differences within-network FC. There was a significant group by time interaction in FC between the two networks (p = .02), driven by VTA-PC (pFDR = .02) and VTA-mPFC (pFDR = .04). Post-hoc analyses showed a significant reduction in FC in nt-PRS over time (psFDR ≤ .03), with FEP and t-PRS showing an opposite pattern (psFDR ≤ .01) in both networks. There was a trend-level reduction in FC over time in HV (ps ≤ .09), which showed significant differences relative to FEP (ps ≤ .04) in the VTA-PC and VTA-mPFC, and with t-PRS in the VTA-PC (p = .02). There was no significant difference between HV and nt-PRS. Cumulative dose of antipsychotics was negatively correlated with FC between mPFC-VTA in FEP at follow-up (r = -.41; p = .04); yet group by time effects survived when used as covariable. Sex, socio-economic status or global intelligence quotient did not exert significant effects. Discussion Our findings suggest that the onset of psychosis during adolescence impacts on the age-normative reduction of FC between the DMN and Midbrain networks, characteristic of the network segregation which takes place during typical brain functional development (Satterthwaite 2013). Antipsychotic medication on cortico-subcortical FC appear to have a reversing effect on these findings, although longitudinal group differences in network connectivity persist despite controlling for this effect. Our data sheds light on the changes in the organization of brain function taking place in the early stages of psychosis, coinciding with a key developmental period.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Omar Gharisia ◽  
Everett Lohman ◽  
Noha Daher ◽  
Alan Eldridge ◽  
Amjad Shallan ◽  
...  

Abstract Background The cross-body and the modified sleeper stretch have been used to improve posterior shoulder soft tissue flexibility and to increase glenohumeral joint internal rotation (GHJ IR) in overhead athletes. However, due to the inability to stabilize patient’s scapula and control GHJ rotation with the cross-body stretch and the potential for subacromial impingement or symptoms’ aggravation with the modified sleeper stretch, a new stretching technique (Passive Glenohumeral Internal Rotation with Clam Shell Bridging) was developed as an alternative to these commonly used stretches that may allow for greater stability of the scapula without reproducing symptoms. Thus, the current study aimed to examine and compare a novel stretching technique to the traditional modified sleeper stretch to determine the effect on glenohumeral IR range of motion (ROM) and self-reported pain in overhead athletes with glenohumeral internal rotation deficits (GIRD). Methods Forty-two overhead athletes with GIRD [mean age 25.9 ± 2.6 years, 20 males and 22 females] participated in this study. Participants were randomly assigned into either novel stretching group or modified sleeper stretching group. IR ROM was measured with a digital inclinometer before, immediately, and at week 4 post intervention, while pain was measured with Numeric Pain Rating Scale before and at week 4 post intervention. Results There was no significant group by time interaction effect for IR ROM (p = 0.27); however, there was a significant change over time (p < 0.001, η2 = 0.77). Both groups demonstrated a significant increase in IR from baseline to immediate and week 4, and from immediate to week 4 (p < 0.001). There was a significant group by time interaction for pain intensity (p < 0.001, η2 = 0.72). Results showed a significant reduction in pain intensity over time in the novel group (p = 0.001, d = 2.18), but not in the traditional group (p = 0.231, d = 0.46). Conclusion Both stretches appear to be effective at improving IR ROM in overhead athletes with GIRD. However, the novel stretching might be more effective at reducing shoulder pain and thus may be more appropriate for symptomatic patients. Trial registration Prospectively registered in February 6, 2017 under Clinical Trial Registry # NCT03044236.


2020 ◽  
Vol 7 (1) ◽  
pp. 205510292090562
Author(s):  
Douglas JR Kerr ◽  
Frank P Deane ◽  
Trevor P Crowe

This quasi-experimental study explores the effects of a narrative coaching board game intervention aimed at enhancing participants’ sense of self-mastery as part of facilitating narrative identity reconstruction. Three mixed analyses of variance compared differences between clinical ( n = 31) and non-clinical ( n = 31) groups over time on a measure of mastery. There were no significant group-by-time interaction effects, but both groups demonstrated a statistically significant improvement in mastery over time. From a complex adaptive system perspective, changes may indicate adaptive growth in recovery. A serious board game may be a useful way of facilitating narrative identity reconstruction in recovery.


2016 ◽  
Vol 50 (12) ◽  
pp. 1186-1197 ◽  
Author(s):  
Rothanthi Daglas ◽  
Kelly Allott ◽  
Murat Yücel ◽  
Christos Pantelis ◽  
Craig A. Macneil ◽  
...  

Objectives: Cognitive deficits are apparent in the early stages of bipolar disorder; however, the timing and trajectory of cognitive functioning following a first episode of mania remains unclear. The aim of this study was to assess the trajectory of cognitive functioning in people following a first episode of mania over a 12-month period, relative to healthy controls. Method: The cohort included 61 participants who had recently stabilised from a first treated manic episode, and 21 demographically similar healthy controls. These groups were compared on changes observed over time using an extensive cognitive battery, over a 12-month follow-up period. Results: A significant group by time interaction was observed in one measure of processing speed (Trail Making Test – part A,) and immediate verbal memory (Rey Auditory Verbal Learning Test – trial 1), with an improved performance in people following a first episode of mania relative to healthy controls. On the contrary, there was a significant group by time interaction observed on another processing speed task pertaining to focussed reaction time (Go/No-Go, missed go responses), with first episode of mania participants performing significantly slower in comparison with healthy controls. Furthermore, a significant group by time interaction was observed in inhibitory effortful control (Stroop effect), in which healthy controls showed an improvement over time relative to first episode of mania participants. There were no other significant interactions of group by time related to other measures of cognition over the 12-month period. Conclusion: Our findings revealed cognitive change in processing speed, immediate memory and one measure of executive functioning over a 12-month period in first episode of mania participants relative to healthy controls. There was no evidence of change over time for all other cognitive domains. Further studies focussed on the at-risk period, subgroup analysis, and the effects of medication on the cognitive trajectory following first episode of mania are needed.


2021 ◽  
Author(s):  
Omar Gharisia ◽  
Everett Lohman ◽  
Noha Daher ◽  
Alan Eldridge ◽  
Amjad Shallan ◽  
...  

Abstract Background: The cross-body and the modified sleeper stretch have been used to improve posterior shoulder soft tissue flexibility and to increase glenohumeral joint internal rotation (GHJ IR) in overhead athletes. However, due to the inability to stabilize patient’s scapula and control GHJ rotation with the cross-body stretch and the potential for subacromial impingement or symptoms’ aggravation with the modified sleeper stretch, a new stretching technique (Passive Glenohumeral Internal Rotation with Clam Shell Bridging) was developed as an alternative to these commonly used stretches that may allow for greater stability of the scapula without reproducing symptoms, as well as providing an inhibition component to the posterior shoulder girdle muscles. Thus, the current study aimed to examine and compare a novel stretching technique to the traditional modified sleeper stretch to determine the effect on glenohumeral IR range of motion (ROM) and self-reported pain in overhead athletes with glenohumeral internal rotation deficits (GIRD). Methods: Forty-two overhead athletes with GIRD [mean age 25.9 ± 2.6 years, 20 males and 22 females] participated in this study. Participants were randomly assigned into either novel stretching group or modified sleeper stretching group. IR ROM was measured with a digital inclinometer before, immediately, and at week 4 post intervention, while pain was measured with Numeric Pain Rating Scale before and at week 4 post intervention.Results: There was no significant group by time interaction effect for IR ROM (p=0.27); however, there was a significant change over time (p<0.001, η2=0.77). Both groups demonstrated a significant increase in IR from baseline to immediate and week 4, and from immediate to week 4 (p<0.001). There was a significant group by time interaction for pain intensity (p=0.032, η2=0.31). Results showed a significant reduction in pain intensity over time in the novel group (p=0.001, η2=0.85), but not in the traditional group (p=0.150, η2=0.27).Conclusion: Both stretches appear to be effective at improving IR ROM in overhead athletes with GIRD. However, the novel stretching might be more effective at reducing shoulder pain and thus may be more appropriate for symptomatic patients. Trial registration: Prospectively registered in February 6, 2017 under Clinical Trial Registry # NCT03044236


Author(s):  
Marko D. M. Stojanović ◽  
Mladen Mikić ◽  
Patrik Drid ◽  
Julio Calleja-González ◽  
Nebojša Maksimović ◽  
...  

The main aim of the present study was to compare the effects of flywheel strength training and traditional strength training on fitness attributes. Thirty-six well trained junior basketball players (n = 36; 17.58 ± 0.50 years) were recruited and randomly allocated into: Flywheel group (FST; n = 12), traditional strength training group (TST; n = 12) and control group (CON; n = 12). All groups attended 5 basketball practices and one official match a week during the study period. Experimental groups additionally participated in the eight-week, 1–2 d/w equivolume intervention conducted using a flywheel device (inertia = 0.075 kg·m−2) for FST or free weights (80%1 RM) for TST. Pre-to post changes in lower limb isometric strength (ISOMET), 5 and 20 m sprint time (SPR5m and SPR20m), countermovement jump height (CMJ) and change of direction ability (t-test) were assessed with analyses of variance (3 × 2 ANOVA). Significant group-by-time interaction was found for ISOMET (F = 6.40; p = 0.000), CMJ (F = 7.45; p = 0.001), SPR5m (F = 7.45; p = 0.010) and T test (F = 10.46; p = 0.000). The results showed a significantly higher improvement in CMJ (p = 0.006; 11.7% vs. 6.8%), SPR5m (p = 0.001; 10.3% vs. 5.9%) and t-test (p = 0.045; 2.4% vs. 1.5%) for FST compared to the TST group. Simultaneously, th FST group had higher improvement in ISOMET (p = 0.014; 18.7% vs. 2.9%), CMJ (p = 0.000; 11.7% vs. 0.3%), SPR5m (p = 0.000; 10.3% vs. 3.4%) and t-test (p = 0.000; 2.4% vs. 0.6%) compared to the CON group. Players from the TST group showed better results in CMJ (p = 0.006; 6.8% vs. 0.3%) and t-test (p = 0.018; 1.5% vs. 0.6%) compared to players from the CON group. No significant group-by-time interaction was found for sprint 20 m (F = 2.52; p = 0.088). Eight weeks of flywheel training (1–2 sessions per week) performed at maximum concentric intensity induces superior improvements in CMJ, 5 m sprint time and change of direction ability than equivolumed traditional weight training in well trained junior basketball players. Accordingly, coaches and trainers could be advised to use flywheel training for developing power related performance attributes in young basketball players.


Author(s):  
Xiaming Du ◽  
Chao Zhang ◽  
Xiangqi Zhang ◽  
Zhen Qi ◽  
Sulin Cheng ◽  
...  

This study investigated the impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease (NAFLD). A total of 63 eligible women randomly participated in the Nordic walking training (AEx, n = 33), or maintained their daily lifestyle (Con, n = 30) during intervention. Bone mineral content (BMC) and density (BMD) of whole body (WB), total femur (TF), femoral neck (FN), and lumbar spine (L2-4) were assessed by dual-energy X-ray absorptiometry. Serum osteocalcin, pentosidine, receptor activator of nuclear factor kappa-B ligand (RANKL) levels were analyzed by ELISA assay. After an 8.6-month intervention, the AEx group maintained their BMCTF, BMDTF, BMCL2−4, and BMDL2−4, and increased their BMCFN (p = 0.016), while the Con group decreased their BMCTF (p = 0.008), BMDTF (p = 0.001), and BMDL2−4 (p = 0.002). However, no significant group × time interaction was observed, except for BMDL2−4 (p = 0.013). Decreased pentosidine was correlated with increased BMCWB(r = −0.352, p = 0.019). The intervention has no significant effect on osteocalcin and RANKL. Changing of bone mass was associated with changing of pentosidine, but not with osteocalcin and RANKL. Our results suggest that Nordic walking is effective in preventing bone loss among postmenopausal women with pre-diabetes and NAFLD.


SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A144-A144
Author(s):  
Kathleen O’Hora ◽  
Beatriz Hernandez ◽  
Laura Lazzeroni ◽  
Jamie Zeitzer ◽  
Leah Friedman ◽  
...  

Abstract Introduction The prevalence of insomnia complaints in older adults is 30–48%, compared to 10–15% in the general population. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a first-line, non-pharmacological sleep treatment for Insomnia. However, the relative impact of Behavioral (BT) and Cognitive (CT) components compared to that of CBT-I in older adults is unknown. Methods 128 older adults with insomnia were randomized to receive CBT-I, BT, or CT. Sleep diaries and the Insomnia Severity Index (ISI) were collected pre- and post-treatment and at a 6-month follow-up. We conducted split-plot linear mixed models with age and sex as covariates to assess within and between subject changes to test effects of group, time, and their interaction on ISI, sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), time in bed (TIB), sleep efficiency (SE), and percent of treatment responders (ISI decrease&gt;7) and remitters (ISI&lt;8). Effect size (d) was calculated by dividing the difference between means by the root-mean-squared error of the mixed effects model. Results All treatments lead to a significant improvement across outcome measures at post-treatment (p’s&lt;0.001) and 6-months (p’s&lt;0.01), with the exception of TIB, response, and remission. For TIB, there was a significant Group x Time interaction (p&lt;0.001): while all treatments significantly reduced TIB post-treatment relative to baseline, CBT-I (p&lt;0.001,d=-2.26) and BT (p&lt;0.001,d=-1.59) performed significantly better than CT (p=0.003, d=-0.68). In contrast, at 6-months CBT-I (p&lt;0.001,d=-1.16) performed significantly better at reducing TIB than CT (p=0.195,d=-0.24) or BT (p=0.023,d=-0.61) relative to baseline. There was also a non-significant trend for a Group x Time interaction for remission status (p=0.062). Whereas, the percentage of remitters within all groups post-treatment did not differ from chance (p&gt;0.234), at 6 months, the percentage of remitters was significantly higher than chance in CBT-I (73.63%,p=0.026) and BT (78.08%,p=0.012), but not CT (47.85%,p=0.826). There were no other significant time or interaction effects (all p&gt;0.05). Conclusion CBT-I and its components are effective in improving subjective insomnia symptoms in older adults. Evidence suggests CBT-I may be superior to either CT or BT alone in improving TIB in older adults. Support (if any) NIMHR01MH101468; MIRECC at VAPAHCS


Author(s):  
Angus R. Teece ◽  
Christos K. Argus ◽  
Nicholas Gill ◽  
Martyn Beaven ◽  
Ian C. Dunican ◽  
...  

Background: Preseason training optimises adaptations in the physical qualities required in rugby union athletes. Sleep can be compromised during periods of intensified training. Therefore, we investigated the relationship between sleep quantity and changes in physical performance over a preseason phase in professional rugby union athletes. Methods: Twenty-nine professional rugby union athletes (Mean ± SD, age: 23 ± 3 years) had their sleep duration monitored for 3 weeks using wrist actigraphy. Strength and speed were assessed at baseline and at week 3. Aerobic capacity and body composition were assessed at baseline, at week 3 and at week 5. Participants were stratified into 2 groups for analysis: <7 h 30 min sleep per night (LOW, n = 15) and >7 h 30 min sleep per night (HIGH, n = 14). Results: A significant group x time interaction was determined for aerobic capacity (p = 0.02, d = 1.25) at week 3 and for skinfolds at week 3 (p < 0.01, d = 0.58) and at week 5 (p = 0.02, d = 0.92), in favour of the HIGH sleep group. No differences were evident between groups for strength or speed measures (p ≥ 0.05). Conclusion: This study highlights that longer sleep duration during the preseason may assist in enhancing physical qualities including aerobic capacity and body composition in elite rugby union athletes.


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