Cold Water Immersion Directly and Mediated by Alleviated Pain to Promote Quality of Life in Indonesian with Gout Arthritis: A Community-based Randomized Controlled Trial

Background: Gout arthritis is an autoinflammatory arthritis that generates chronic long-term pain. Pain impacts physical activities, joint mobility, stress, anxiety, depression, and quality of life. Cold-water immersion therapy reduces inflammation and pain associated with gout arthritis. However, cold-water immersion therapy has not been conducted among people worldwide with gout arthritis. Objective: To investigate the cold-water immersion intervention on pain, joint mobility, physical activity, stress, anxiety, depression, and quality of life among acute gout patients. Methods: A community-based randomized control trial design with two parallel-intervention groups: a cold-water immersion group (20–30°C 20 minutes/day for 4 weeks) and a control group. In total, 76 eligible participants in Tomohon City, Indonesia, were recruited using a multi-stage sampling method and were randomly assigned using block randomization. A generalized estimating equation model was used to analyze the results (coef. β) and produce 95% confidence intervals (CIs). A path analysis was used to analyze mediating effects. Results: Significant pain alleviation ( β = −2.06; −2.42), improved joint mobility ( β = 1.20, 1.44), physical activity ( β = 2.05, .59), stress ( β = −1.25; −1.35), anxiety ( β = −.62; −1.37), and quality of life ( β = 5.34; 9.93) were detected after cold-water immersion at the second-week, and were maintained to the fourth-week time point, compared to pre-intervention and the control group. Depression ( β = −1.80) had decreased by the fourth week compared to the pre-test and control group. Cold-water immersion directly mediated alleviation of pain ( β = −.46, p ≤ .001) and to promote the quality of life ( β = .16, p = .01). Conclusions: Cold-water immersion decreased pain, stress, anxiety, and depression, and increased joint mobility, physical activity, and quality of life. It mediated alleviation of pain to increase the quality of life.

Effects of midfoot joint mobilization on perceived ankle-foot function in chronic ankle instability. A crossover clinical trial

BackgroundChronic ankle instability (CAI) is a complex clinical entity that commonly includes ankle-foot impairment.ObjectiveTo investigate the effects of midfoot joint mobilizations and a one-week home exercise program (HEP) compared to a sham intervention and HEP on pain, patient-reported outcomes (PROs), ankle-foot joint mobility, and neuromotor function in young adults with CAI.MethodsTwenty participants with CAI were instructed in a stretching, strengthening, and balance HEP and were randomized a priori to receive midfoot joint mobilizations (forefoot supination, cuboid glide and plantar 1st tarsometatarsal) or a sham laying-of-hands. Changes in foot morphology, joint mobility, strength, dynamic balance, and PROs assessing pain, physical, and psychological function were assessed pre-to-post treatment and one-week following. Participants crossed-over to receive the alternate treatment and were assessed pre-to-post treatment and one-week following. Linear modelling was used to assess changes in outcomes.ResultsParticipants who received midfoot mobilization demonstrated significantly greater perceived improvement immediately posttreatment in the single assessment numeric evaluation (Sham: 5.0±10.2%; Mobilization: 43.9±26.2%; β: 6.8 p<0.001, Adj R2:0.17) and Global Rating of Change (Sham: −0.1±1.1; Mobilization: 1.1±3.0; β: 1.8 p=0.01, Adj R2:0.12). Following the mobilization intervention, participants demonstrated greater improved rearfoot inversion mobility (Sham: 4.4±8.4°; Mobilization: −1.6±6.1°; β: −6.37, p=0.01, Adj R2:0.19), plantarflexion mobility (Sham: 2.7°±6.4; Mobilization: −1.7°±4.3; β: −4.36, p=0.02, Adj R2:0.07), and posteromedial dynamic balance (Sham: 2.4±5.9%; Mobilization: 6.0±5.4%; β: 3.88, p=0.04, Adj R2:0.10) compared to controls at 1-week post-treatment.ConclusionParticipants with CAI who received midfoot joint mobilization had greater perceived improvement and physical signs that may benefit this clinical population.

LIMITED JOINT MOBILITY IN A CHILD WITH TYPE 1 DIABETES MELLITUS.

Chronic uncontrolled type 1 diabetes mellitus (type 1DM) is a very major risk for chronic systemic complications; specifically, the microvascular and macrovascular ones. Limited joint mobility (LJM) is a rare disease that complicates all types of diabetes and might indicate the high-risk odd for the diabetic patients to develop microvascular complications. We are reporting a 13-year-old female child with chronic uncontrolled type 1DM presenting with full blown clinical picture of bilateral hand LJM associated with significant growth failure yet has no clinical or biochemical evidence of microvascular complications. Literature research studies have emphasized the rarity of this manifestation in pediatric type 1 diabetic patients; however, it is an important clue and warning sign for microvascular complication occurrence in these patients.

Improving the development of flexibility of gymnasts 8-9 years old using the «stretching» program

The article deals with the issues of improving the development of flexibility of gymnasts of 8-9 years old using the «stretching» program. The work shows that flexibility is an important component of sportsmanship in training gymnasts, since its insufficient development significantly complicates the process of formation of specific skills, coordination of movements, limits the possibility of manifestation and increase of strength and speed abilities, increases the likelihood of damage to muscles, tendons, joints. It was determined that the methods and techniques that help to maximize the use of stretching in order to increase the elasticity of the muscles of young gymnasts, improve the flexibility of their joints and minimize the risk of injury, are combined into a single stretching program. Stretching is a range of exercises designed to improve flexibility and mobility in the joints. Flexibility is one of the most important physical qualities that determines a person's ability to perform movements with a large amplitude. The main importance of stretching is the ability to lengthen muscle fibers by stretching, increase the range of motion in the joints, and accelerate the body's recovery after intense physical exertion. With correct (without jerking) slow stretching, the initial muscle contraction turns into relaxation. As a result of regular exercise, joint mobility and muscle elasticity increase. Stretching exercises perfectly relax muscles, improve their tone, supply oxygen, nutrients, and promote the elimination of toxins. According to the results of the study, it was found that the proposed complexes of exercises «stretching» programs contribute to an increase in the level of development of flexibility of gymnasts of 8-9 years old.

Multifocal periapical cement dysplasia in Ehlers-Danlos Typ VIII combined with leukoencephalopathy in de novo-mutation of c.890G>A, G297D [pEDS]

Periodontal Ehlers-Danlos syndrome type VIII (pEDS) is rare and caused by mutation in complement 1 subunit. Lack of attached gingiva, pretibial plaques, joint mobility, skin fragility, and easy bruising consolidate the diagnosis. We describe a case of de novo-mutation of pEDS with generalized periapical cemento dysplasia (PCD) and leukoencephalopathy.

Distal transradial artery access for coronary angiography in a patient having rheumatoid arthritis-related severe arthropathies

Conventional radial access has become the default access for coronary angiography. Sometime, it is difficult to take a conventional radial access, especially in patients having severe arthropathies leading to limited wrist joint mobility. In such scenarios, distal transradial access (dTRA) can be adopted. We describe a case of an elderly male patient having rheumatoid arthritis with arthropathies. He presented to us with unstable angina; coronary angiogram was advised for ischaemia assessment. Right dTRA was adopted due to severe joint deformity at wrist joint, limiting joint extension. A successful coronary angiogram was performed via the right dTRA without major discomfort and complications. Haemostasis was secured with TR band radial artery compression device. In this case report, we have evaluated the importance of practising dTRA in a patient with severe arthropathies.

​Evaluation of the Efficacy of Mobility Plus® in the Management of Osteoarthritis and Joint Inflammation in Canines

Background: Joint health is very vital in canines. Immediate attention and diagnosis will help to prevent suffering in canines. This study was designed to evaluate the in vivo efficacy of the poly-herbal formulation Mobility Plus® for arthritis, inflammation and analgesic activities in canines. Methods: A total of 18 client-owned dogs with a history of joint inflammation, hip dysplasia and arthritis were selected (n = 18) and supplemented with one tablet of Mobility Plus® daily until complete recovery. The changes in assessment parameters scores, viz. lameness score, joint mobility score, pain on palpation score, weight-bearing score and the overall clinical condition score were evaluated. The results revealed that lameness, joint mobility, pain and weight-bearing scores significantly (p less than 0.001) decreased in dogs as early as day 15; hence, the overall clinical condition score also decreased significantly (p less than 0.001) as early as day 15 after Mobility Plus® supplementation. Result: Present study revealed that lameness, joint mobility, pain and weight-bearing scores significantly (p and lt; 0.001) decreased in dogs as early as day 15; hence, the overall clinical condition score also decreased significantly (p and lt; 0.001) as early as day 15 after Mobility Plus® supplementation. Supplementation of Mobility Plus® has antiarthritic and anti-inflammatory activities. Mobility Plus® could be recommended for the amelioration of joint inflammation and osteoarthritis conditions in canines.

Integrative flexibility training to improve joint mobility and range of movement in jazz dancing girls

Flexibility is one of the physical capacities associated with improved performance in jazz dancers girls. However, jazz training being a complex physical activity is not only based on flexibility training, it also focuses on the development of motor skills, technique, posture, and rhythm. Therefore, it is important to demonstrate whether a passive stretching training, with minimum frequency, generates favorable results on flexibility. The purpose of this study is to determine the effect of flexibility training on active and passive range of motion (ROM), as well as joint mobility in girls jazz dancers by chronological caracterizar la muestra age group. 30 jazz dancers with an average age of 8.5 ± 1.6 years with no more than four years practicing professional sports practice, enrolled in an integrative flexibility training program developed once a week for 12 weeks, and were assessed for active and passive hip joint mobility through goniometry in conjunction with six flexibility tests. There was an increase in all flexibility variables with a moderate size-effect, except for the joint ROM in active and passive left abduction and active right flexion, which had a high effect. In conclusion, training focused on static exercises can be considered an effective strategy to develop ROM, because it's possible to increase flexibility and stretch in lower extremities with a frequency of once a week in jazz dancing girls.