Effectiveness of lower limb rehabilitation protocol using mobile health on quality of life, functional strength and functional capacity among knee osteoarthritis patients who were overweight and obese: A randomized controlled trial

Objective: This study aimed to investigate the effectiveness of the lower limb rehabilitation protocol (LLRP) using mobile health (mHealth) on quality of life (QoL), functional strength, and functional capacity among knee OA patients who were overweight and obese. Materials and Methods: In the current trial, 114 patients were recruited and randomized into either the rehabilitation group with mobile health (RGw-mHealth) receiving reminders by using mHealth to carry on the strengthening exercises of LLRP and instructions of daily care (IDC), the rehabilitation group without mobile health (RGwo-mHealth) following the strengthening exercises of LLRP and instructions of daily care (IDC) and control group (CG) only following the IDC for duration of 12-weeks. The reminders for using mHealth were provided two times a day for three days a week. Primary outcome measures were QoL assessed by the Western Ontario and McMaster Universities Osteoarthritis Index summary score, and functional strength by Five-Repetition Sit-To-Stand Test. Secondary outcome measure was functional capacity assessed by the Gait Speed Test. The assessments of QoL, functional strength, and functional capacity were taken at baseline and posttest after 12-weeks of intervention. Results: After 12 weeks of intervention, patients in all three groups had statistically significant improvement in QoL within groups (p < 0.05). Furthermore, patients in the RGw-mHealth and RGwo-mHealth had statistically significant improvement in functional strength and walking gait speed within groups (p < 0.05). The pairwise between-group comparisons (Bonferroni post hoc test) of the mean changes in QoL, functional strength, and functional capacity at posttest assessments revealed that patients in the RGw-mHealth had statistically significant greater mean change in QoL, functional strength and functional capacity relative to both the RGwo-mHealth and CG (p < 0.001). Conclusion: Improvement in QoL, functional strength, and functional capacity was larger among patients in the RGw-mHealth compared with the RGwo-mHealth or CG. Keywords: Osteoarthritis, knee, overweight, rehabilitation. mobile health.

Efficacy of Serial Ultrasonographic Examinations in Predicting Return to Play in Agility Dogs with Shoulder Lameness

The aim of this study is to investigate the use of shoulder ultrasound as a method of predicting the likelihood of returning to competition in agility dogs with shoulder teno-muscular injuries after a standardised rehabilitation protocol. Thirty-two agility dogs with a clinical and ultrasonographic diagnosis of shoulder teno-muscular injury were included in a prospective study with physical and ultrasound examinations at the time of diagnosis (T0) and at two (T2), four (T4) and six (T6) months; during this period, the dogs received rehabilitation treatments. The endpoint of the study was to obtain information regarding participation in agility competitions 12 months after diagnosis, based on telephone interviews with the owners. The clinical lameness score (CLS) and the ultrasound lesion score (ULS) were used as outcome measurements. The CLS indicated partial recovery from a shoulder injury at T2 (78%), while the ULS indicated no satisfactory recovery at T2 in any patient. At 4 months, the CLS alone was not a valuable predictor of full recovery from a shoulder injury in agility dogs. Relative Risk indicated that, at T2, ultrasound was 23.8 times more valuable in identifying a shoulder lesion as compared to clinical lameness score (CLS), and it was 2.53 times more valuable at T4.

Short-Term Effects of Strengthening Exercises of the Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function, and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Background. Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of the cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. A single-blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the rehabilitation protocol group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the control group (CG) were provided with leaflets explaining the IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical function. The secondary outcome measures were BMI, exercise adherence, and patients’ satisfaction assessed by using the numeric rating scale ranging from 0 to 10. The paired-sample t-test was used to analyze the differences within groups from baseline to posttest evaluations. The analysis of variance 2 × 2 factor was used to analyze the differences in BMI, knee pain, stiffness, and physical function between the groups. Results. Participants in the RPG and CG reported a statistically significant reduction in knee pain and stiffness ( p ≤ 0.05 ) within the group. The reduction in the scores of knee pain was higher in participants in the RPG than that in participants in the CG ( p = 0.001 ). Additionally, participants in the RPG reported greater satisfaction ( p = 0.001 ) and higher self-reported exercise adherence ( p = 0.010 ) and coordinator-reported exercise adherence ( p = 0.046 ) than the participants in the CG. Conclusion. Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

Short-Term Effects of Strengthening Exercises of Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Background. Osteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. Methodology. Single blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the Rehabilitation Protocol Group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the Control Group (CG) were provided with leaflets explaining IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness and physical function. The secondary outcome measures were BMI, exercise adherence, and patients satisfaction by the numeric rating scale ranging from 0 to 10. Paired Samples t-test was used to analyze the differences within groups from baseline to post-test evaluations. The analysis of variance was used to analyze the difference of BMI, knee pain, stiffness, and physical function between the groups. Results. Participants in the RPG and CG reported a statistically significant reduction in knee pain, and stiffness (p ≤ 0.05) within group. The reduction in the scores of knee pain was higher in participants of the RPG than the CG (p = 0.001). Additionally, participants in the RPG reported greater satisfaction (p = 0.001), higher self-reported exercise adherence (p = 0.010) and coordinator-reported exercise adherence (p = 0.046) compared to the participants in the CG. Conclusion. Short-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI.

Long-standing pubic-related groin pain in professional academy soccer players: a prospective cohort study on possible risk factors, rehabilitation and return to play

Background Despite being a common overuse entity in youth soccer, scientific data on risk factors, rehabilitation and return to play for long-standing pubic-related groin pain is still rare. The current prospective cohort study aims to evaluate potential risk-factors, propose a criteria-based conservative rehabilitation protocol and assess return-to-play outcomes among professional youth soccer players suffering from long-standing pubic-related groin pain. Methods Male soccer players with long-standing (> 6 weeks) pubic-related groin pain from a professional soccer club’s youth academy were analyzed for possible risk factors such as age, team (U12 - U23), younger/older age group within the team, position and preinjury Functional movement score. All injured players received a conservative, standardized, supervised, criteria-based, 6-level rehabilitation program. Outcome measures included time to return to play, recurrent groin pain in the follow-up period and clinical results at final follow-up two years after their return to play. Results A total of 14 out of 189 players developed long-standing pubic-related groin pain in the 2017/2018 season (incidence 7.4%). The average age of the players at the time of the injury was 16.1 ± 1.9 years. Risk factor analysis revealed a significant influence of the age group within the team (p = .007). Only players in the younger age group were affected by long-standing pubic-related groin pain, mainly in the first part of the season. Injured players successfully returned to play after an average period of 135.3 ± 83.9 days. Only one player experienced a recurrence of nonspecific symptoms (7.1%) within the follow-up period. The outcome at the 24-month follow-up was excellent for all 14 players. Conclusions Long-standing pubic-related groin pain is an overuse entity with a markedly high prevalence in youth soccer players, resulting in a relevant loss of time in training and match play. In particular, the youngest players in each team are at an elevated risk. Applying a criteria-based rehabilitation protocol resulted in an excellent return-to-play rate, with a very low probability of recurrence. Trial registration The trial was retrospectively registered under DRKS00016510 in the German Clinical Trials Register on 19.04.2021.