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Objective To investigate the effects of a new sling exercise treatment combined with injections of sodium hyaluronate on the radiographic findings and clinical variables of patients with patellofemoral pain.Methods Seventy patients with patellofemoral pain syndrome were divided into a group which was treated using a new sling exercise therapy combined with injections of sodium hyaluronate (the combined therapy group,n=34) and another which received only sodium hyaluronate injections (the control group,n=36).The patients of both groups were assessed pre-and post-treatment.The clinical assessment modalities were pain scores (using a visual analogue scale,VAS),quadriceps and hamstring strength and range of motion in the active flexion and extension of the knee.Q angles were measured supine and standing.Patellofemor tilt angle and congruence and sulcus angle were determined by CT scanning.Results After 5 weeks the average VAS pain score of the combined therapy group was significantly lower than that of the control group.Muscle strength and range of motion in the combined therapy group were both significantly higher than pro-treatment,the Q angles were significantly smaller,and the congruence and sulcus angles were significantly better.Conclusion Five weeks of practicing the new sling exercise therapy combined with injections of sodium hyaluronate can yield satisfactory clinical and radiologic outcomes in patients with patellofemoral pain syndrome.
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Objective To investigate the effects of sensorimotor therapy on patients with knee osteoarthritis.Methods Ninety-two patients with knee osteoarthritis were divided into a treatment group and a control group by using random digits table. Both groups received conventional rehabilitation therapy, including knee isometric and isotonic contraction training, ultrashort wave diathermy as well as aerobic exercise. The treatment group was also administered with sensorimotor training, in addition to the conventional training,including the muscle strengthening and control training of quadriceps and hamstring muscle using sling exercise therapy system and on the Thera-band mattress. The visual analogue scale (VAS) for pain, manual muscle testing and knee range of motion as well as the Japanese Orthopedic Association knee function evaluation form were used to evaluate the patients. Results There was no statistic difference between the 2 groups before treatment, with regard to the evaluation parameters used in this study. After 2 months of treatment, both groups improved significantly (P ＜0.05),with the treatment group improved to a significantly greater extent (P ＜0.05). Conclusions Sensorimotor training in addition to the conventional rehabilitation treatment can further relieve the pain of patients with knee osteoarthritis joints arthritis and improve the function of patients with knee osteoarthritis.
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Objective To explore the effect of psychological intervention on knee osteoarthritis patients. Methods A total of 92 OA patients were included into a one-month randomized controlled followup study, 47 of them were treated with combined psychological intervention, the other 45 cases were routinely treated. All cases were investigated on their demographic information , physiological parameters and score of the short form-36 health survey questionnaires (SF-36), self-rating depression scale (SDS) and self-rating anxiety scale (SAS). Statistics method used t-test and variance analysis. Results There was no signi-ficant difference in terms of the physiologic parameters changes between before and after treatment (P＞0.05) of the two groups. ① The SDS scores of the two groups decreased gradually after the treatment (P＜0.05),while there was remarkable descending of SDS score in patients of psychological intervention group (P＜0.05). ② The SAS scores of the two groups decreased gradually after the treatment (P＜0.05). And there was no significant difference between the two groups (P＞0.05). Compared with the non-intervention group, the fourfactors scores including physical function, pain, vitality and role limitations due to emotional problems of the intervention group were significantly improved (P＜0.05). Anegative correlation was observed between SDS and PF, BP, GH, VT and SF (r=-0.739-0521,P＜0.05). SAS was correlated negatively with VT and SF (r=-0.699～-0.475,P＜0.05). Conclusion Psychological intervention could ameliorate the depression of knee osteoarthritis patients. The quality of life of knee osteoarthritis patients can be improved by psychological intervention.
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BACKGROUND: Learning memory disorder is one of the major manifestations of aging. The model of aging induced by D-galactose is a commonly used animal model in recent years, and long-term D-galactose exposure may cause nerve cell morphological changes in animals.OBJETCIVE: To observe spatial learning memory behavior during Dgalactose-induced aging process in order to further explore in vivo evoked long-term potentiation in hippocampus dentate gyrus and synaptic morphological changes in hippocampal CA3 region.DESIGN: Randomized controlled observation.SETTING: Anatomical Teaching and Research Secti , Shanghai Second Medical University; Department of Physiology, Shanghai Traditional Chinese Medicine University.MATERIALS: The experiment was carried out at the Physiological Laboratory of Shanghai Traditional Chinese Medicine University between August 2000 and April 2001. Totally 22 male Wistar rats of 3-month birth age were included and randomized into normal group and D-galactose group with 11 rats in each group. D-galactose was produced by Shanghai No. 2 Chemical Reagent Factory, Morris water maze was home-made by the Institute of Geriatrics, Shanghai Traditional Chinese Medicine university.METHODS: Rats were subjected to hypodermic injection of 1 mL normal saline every day in normal group, or D-galactose of 800 mg/kg daily for 6consecutive weeks in D-galactose group. Rat spatial learning memory behavior was assessed by the latency of Morris water maze; hippocampal dentate gyrus community potentials evoked by monopulse stimulation on perforating fibers were recordedin vivo; meanwhile, the amplitude of monopulse evoked potentials was determined before and after high frequency stimulation, with the amplitude before high frequency stimulation taken as baseline. Transmission electromicroscope was applied in combination with imaging analysis to observe synaptic morphology and structure in rat hippocampal CA3 region. Water labyrinth latency was compared using the variance analysis of repetitive survey design, t-test was used to compare the differences of peak potential latency of community potentials at various time points after long-term potentiation. Moreover, inducing rate of longterm potentiation was compared by χ2-test, XY-540 type biological imaging processing system was used to analyze electromicroscopic pictures, and all available data were analyzed with t-test.MAN OUTCOME MEASURES: [1] Main outcomes: Changes of Morris water maze latency, as well as inducing rate of long-term potentiation and community potentials. [2] Secondary outcomes: Synaptic morphological and structural changes in hippocampal CA3 region.RESULTS: Totally 22 rats were enrolled in this study, with no one lost during water labyrinth test, but one rat in both normal group and D-galactose group died during electrophysiological experiment. Finally 3 rats were randomly selected from each group for electromicroscopic observation. [1]Comparison of the latency for Morris water maze: In contrast with that of normal group, latency for seeking submarine platform was obviously prolonged in D-galactose group [(14.77±10.10), (51.36±12.45) s, P ＜ 0.05].[2] Comparison of evoked potential in hippocampus dentate before high frequency stimulation: The two groups did not obviously differ in community potential amplitude and community potential latency [(1.05±0.47),(0.91±0.41) mV; (5.46±2.09), (5.38±2.26) ms; P ＞ 0.05]. [3] Inducing rate of long-term potentiation in hippocampal dentate gyrus: Compared to that of normal group, inducing rate in D-galactose group obviously reduced after high frequency stimulation (80%, 20%, χ2=7.20, P ＜ 0.01). [4] Comparison of community potential ratio at different time points after high frequency stimulation: Compared to that of normal group, it was notably reduced in D-galactose group at post-stimulation 20, 30, 60 minutes, respectively (1.104±0.196, 0.919±0.162; 1.354±0.212, 0.999±0.219; 1.236±0.174,0.875±0.311; P ＜ 0.05). [5] Comparison of synaptic struc tural parameters in hippocampal CA3 region: Compared to that of normal group, postsynaptic dense bodies became thickened in hippocampal CA3 region of D-galactose group [(40.60±18.26), (26.35±8.15) nm, P ＜ 0.05], the synapse gap increased [(17.69±6.28), (26.95±5.67) nm, P ＜ 0.05] while synaptic active zone was shortened [(265.13±76.50), (229.13±90.68) nm, P ＜ 0.05].CONCLUSION: Hypodermic injection of D-galactose does harm to rat spatial learning memory by reducing the long-term potentiation, inducing rate in rat hippocampal dentate gyrus, attenuating the increase of long-term potentiation-evoked potential amplitude, and even remarkably changing the synaptic ultrastructure in rat hippocampal CA3 region. It suggests that Dgalactose inhibits the long-term potentiation at hippocampal dentate gyrus and affects synaptic structure in hippocampal CA3 region, which is considered as the basis of spatial learning memory behavioral disorder.