ABSTRACT
Background: The knee-osteoarthritis (KOA) is a risk for muscular degeneration by the elevation of creatine kinase-muscle (CK-MM). The present study was aiming to normalize the elevated level of CK-MM by topical phytotherapeutic protocol correlated with anatomical measurements, the Kellgren- Lawrence (KL) grading systems of radiographic KOA, body mass index (BMI), overall improvement of pain under visual analogue scale (VAS) and pain, stiffness and physical function under WOMAC index. Methods: Baseline data from 108 patients (66.67 % females) with KOA aged 40-75 years old were recruited in this cross-sectional study. Bilateral anatomical measurements included the gap at the knee between the short head of the biceps femoris and the surface of the bed, diameter of muscles of thighs and calves, angles of straight leg raising, flexion and extension in different positions and BMI were measured using appropriate instruments. The elevated level of CK-MM, scored KL grading system and pain under VAS and WOMAC index were also evaluated at the baseline and after 42 days of treatment. Results: All the bilateral leg anatomical measurements were symmetry at the end of the 42nd session (P<0.0001). The significant changes were observed in VAS (P<0.00001), WOMAC index (P<0.0001), CK-MM level (P<0.0001), BMI (P<0.0001) and improvement of KL grading scores. Conclusions: The improvements of damaged leg muscles due to muscular dystrophy, connective tissue damage etc. confirmed with normalization of elevated serum CK-MM level, above mentioned anatomical measurements, BMI, VAS, WOMAC index and KL grading systems may be synergistic effect of phytochemicals during specific phytotherapeutic treatment protocol.
ABSTRACT
Background: Knee-osteoarthritis (KOA) is a degenerative joint disease. Elevated level of aldolase-A (AldoA) in serum indicates skeletal muscle damage in KOA. The present study was attempted to normalize the elevated level of AldoA by topical phytotherapeutic protocol correlated with leg-anatomy, body mass index (BMI), pain, stiffness and physical function and the Kellgren-Lawrence (KL) grading-systems. Methods: Baseline data from144 patients (61.80% females) with KOA aged 40-75 years old were recruited in this cross-sectional study. Bilateral anatomy of legs including the gap at the knee between the short head of the biceps femoris and the surface of the bed, diameter of muscles 4cm above and below the patella, angles of straight leg raising, flexion and extension in different positions and BMI were measured using appropriate instruments. AldoA was estimated in serum. The KL grading-system of radiographic KOA and overall pain under VAS and pain, stiffness and physical function under WOMAC index were also evaluated. All the parameters were compared between the baseline and post-42 days of treatment. Results: The anatomical features were observed symmetry in both legs at the end of the 42nd session with highly statistical significance (P<0.0001). The significant changes were also observed in VAS (P<0.00001), WOMAC index (P<0.001), AldoA level (P<0.0001), BMI (P<0.0001) and improvement of KL grading systems was noted for both knee-joints. Conclusion: The functional improvements of skeletal muscles confirmed with normalization of elevated AldoA level, leg-anatomical measurements, BMI, VAS, WOMAC index and KL grading systems of radiographic KOA due to the effects of phytochemicals present in phytoextracts.
ABSTRACT
Background: Knee-osteoarthritis (KOA) is a common disease worldwide. C-reactive protein (CRP) in serum is a marker enzyme for inflammation and elevated in KOA. The present study was aiming to normalize the elevated level of CRP by topical phytotherapeutic protocol correlated with anatomical measurements, body mass index and radiological images in KOA. Materials & Methods: Baseline data from153 patients (101 females and 52 males) with KOA aged 40-70 years old were recruited in this cross-sectional study. Bilateral anatomical measurements included the gap at the knee between the short head of the biceps femoris and the surface of the bed, diameter of muscles 4cm above and below the patella and calf, and flexion and extension in supine, prone and standing positions and body mass index (BMI) were measured using appropriate instruments. The elevated level of serum CRP and pain under visual analogue scale (VAS) and WOMAC osteoarthritis index were also evaluated at the baseline and after 42nd sessions by topically applied specialized phytotherapeutic treatment protocol. Results: All the bilateral leg anatomical measurements were symmetry at the end of the 42nd sessions (P<0.0001). The significant changes were observed in pain under VAS (P<0.0001) and WOMAC scales (P<0.0001), CRP level (P<0.0001) and BMI (P<0.0001). The radiological features of the knee-joints were also revealed the improvement in KOA. Conclusion: The improvements of inflammation and normalization of elevated serum CRP level confirmed by anatomical measurements, BMI, VAS and WOMAC index and radiological images in KOA by topical phytotherapy. This study revealed that combinations of phytochemicals during topical application may be synergistic effect.
ABSTRACT
Background: In several parts of the globe, knee osteoarthritis (KOA) occurs as a painful chronic disease. The aim of the study was to determine the risk factors for musculo-postural abnormalities by detecting abnormal anatomical leg parameters caused by knee-osteoarthritis (KOA). Methods: Baseline data were collected and evaluated from 207 patients aged between 40-65 years (58.94% females) with KOA and an equal number of subjects without-KOA. Anatomical measurements included the gap at the knee between the short head of the biceps femoris and the level of the bed (KGB), diameter of muscles at the thigh (DTM), the calf (DCM) and 4cm above and below the patella (DAP and DBP) and flexion supine, prone and standing (KFS, KFP and KFSt) and extension supine, prone and standing (KES, KEP and KESt) in different postural positions for both legs of both groups using appropriate instruments and Body Mass Index (BMI). The study was also correlated with radiological images. Results: Risk factors for KOA based on abnormal leg anatomical-features were observed with statistical significance (P<0.001) and R2 (97-100%). The present results were evaluated after analyses of anatomical and flexion and extension range of motion measurements in different postural positions for both legs with KOA along with radiological features. The BMI of the experimental group was higher than that of the control group with high statistical significance (P<0.001). Conclusions: Abnormal muscle morphology and musculo-postural-features of the legs may be a suitable diagnostic protocol for the detection of early progression and risk of KOA.
ABSTRACT
Backgrounds: The disease risk factor prediction with calcium-phosphorus ratio (CPR) and/or parathyroid hormone (PTH) levels are suitable biomarkers. The aim of the present study was to investigate the functional instability of these biomarkers in the blood on the risk of osteoarthritic disorder (OAD) by using receiver operating characteristic (ROC) curves. Methods: Separate evaluations were performed for subjects 132 with OAD and 109 without OAD symptoms using questionnaires, standardized physical and radiographic examinations, and risk factor identification (hypoparathyroidism, hypocalcaemia and hyperphosphatemia diseases). The blood levels of PTH, calcium, and phosphorus were measured by using appropriate kits. ROC curve and logistic regression analyses were performed for the PTH and CPR levels. Results: The area under the ROC curve (AUC), 95% CI for the AUC, for the OAD compared with the non-OAD cohorts were 0.985, 0.969-1.000, and P<0.001 for the PTH analysis and 0.579, 0.506-0.652, and P<0.05 for the CPR analysis. In the OAD cohort, the AUC and the PTH risk were higher for men than for women; AUC=1.000 for men, and AUC=0.977 for women, with both AUC values highly significant (P<0.001). The CPR risk was higher for men (AUC=0.614, 95% CI=0.483-0.746, P=0.079) than for women (AUC=0.516, 95% CI=0.419-0.613, P=0.736) but was not statistically significant in either sex. Conclusion: A functional instability risk that is higher in male than female OAD cohorts causes lower PTH and CPR levels during OADs, which can be considered one of the OAD diagnostic protocols besides radiological images.