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Objective:To compare the short-term effects of hip muscles strengthening and quadriceps strengthening on knee osteoarthritis (KOA), and discuss the advantages of hip muscles strengthening. Methods:From October, 2015 to May, 2016, 42 old females with KOA were divided into two groups equally. They received hip strengthening (HS group) and quadriceps strengthening (QS group) for two weeks, respectively. The pain, stiffness and physical function scores of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured. Isokinetic strength peak torque (PT) was assessed for knee extensors and flexors, and 6-minute Walk Test was also evaluated. They were followed up two months later. Results:Before exercise, there was no significant difference in all the indexes between two groups (P > 0.05). Two weeks after exercise, the knee flexor PT (t = -4.038, P = 0.001) and 6-minute walk distance (t = -2.474, P = 0.022) increased in QS group; the pain, stiffness and physical function scores of WOMAC (t > 2.487, P < 0.05), the knee extensor and flexor PT (|t| > 6.370, P < 0.001), and 6-minute walk distance (t = -2.241, P = 0.037) improved in HS group; the scores of WOMAC were lower (t > 2.087, P < 0.05) and the knee extensor PT was higher (t = -5.028, P < 0.001) in HS group than in QS group. At two-months' follow-up, the drop-out rate was significantly lower in HS group than in QS group (χ2 = 13.480, P < 0.001). Conclusion:Hip muscles strengthening is a good choice for KOA in the early stage of treatment, which could avoid the pain in quadriceps training, increase quadriceps strength and improve physical function.
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Knee osteoarthritis is a common chronic degenerative disease in the elderly. Its occurrence and development are closely related to biomechanical factors. The force of knee joint is affected by different factors, such as joint morphology, lower limb alignment, muscle contractions, external load, soft tissue traction and so on. Due to the limitation of in vivo measurement, biomechanical parameters based on motion analysis techniques have been widely used in clinical research. At present, biomechanical parameters which are widely studied and applied in clinical research include knee adduction moment, knee adduction impulse, knee flexion moment, and knee varus thrust. It is important to observe the changes of knee joint biomechanical parameters during the occurrence and development of knee osteoarthritis for researching etiology, diagnosis, intervention and treatment.
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Knee osteoarthritis (KOA) is a common chronic degenerative joint disease. Hip muscle training, with the advantage of convenience and non-invasion, has been attached great importance by people gradually. Hip muscle training may affect keen medial compartment load, the strength and the electromyography signal of the muscle around the knee joint, and strong hip abductor can protect cartilage, which leads to change the load of the knee joint, and alleviate clinical symptoms. This article reviewed the mechanism of hip muscle training for knee osteoarthritis from the views of biomechanical simulation and electromyography.
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Baduanjin is a kind of traditional Chinese medical gymnastics. This paper reviewed the effect of Baduanjin exercise on the primary prevention of stroke, as well as on motor function, activities of daily living, quality of life and cognitive function of stroke patients and the related mechanisms.
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Background@#Emerging evidences have indicated that the composition of gut microbiota was significantly influenced by central nervous system diseases. The digestion and metabolism disturbances of patients with amyotrophic lateral sclerosis (ALS) might be strongly associated with ALS; however, this has rarely been evaluated in these populations. This study was to evaluate bacterial and archaeal composition of gut flora and the corresponding metabolism performance of these micro-organisms in fecal samples of patients with ALS.@*Methods@#A comparative study was performed on the intestinal microbiota from eight patients with ALS and eight healthy individuals at Huadong Hospital during November 2017 to April 2018; meanwhile, the metabolite concentrations of human endotoxin, short-chain fatty acids (SCFA), NO2-N/NO3-N, and γ-aminobutyric acid were also evaluated by spectrophotometry methods. The correlations between intestinal microbiota and metabolite concentration were compared between the two groups using one-way analysis of variance; the relative abundance of beneficial and harmful micro-organisms in fecal samples was also analyzed.@*Results@#In general, the richness and evenness of bacterial and archaeal communities of healthy individuals were healthier than that of patients with ALS. The phylum Firmicutes/Bacteroidetes ratio, genus Methanobrevibacter showed an enhancive tendency in patients with ALS, whereas the relative abundance of beneficial micro-organisms (genera Faecalibacterium and Bacteroides) presented a significant decrease tendency in patients with ALS. In addition, the average concentrations of human endotoxin, SCFA, NO2-N/NO3-N, and γ-aminobutyric acid in patients with ALS and healthy individuals were 64.2 vs. 65.3 EU/mL, 57.5 vs. 55.3 μg/mL, 5.7 vs. 5.3 ng/mL, and 6.1 vs. 5.4 μmol/L, respectively, indicating that the digestion and metabolism functions of gastrointestinal tract of patients might decline with this disease.@*Conclusions@#The relative abundance of beneficial and harmful micro-organisms respectively showed decrease and increase tendency in patients with ALS.
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BACKGROUND@#Emerging evidences have indicated that the composition of gut microbiota was significantly influenced by central nervous system diseases. The digestion and metabolism disturbances of patients with amyotrophic lateral sclerosis (ALS) might be strongly associated with ALS; however, this has rarely been evaluated in these populations. This study was to evaluate bacterial and archaeal composition of gut flora and the corresponding metabolism performance of these micro-organisms in fecal samples of patients with ALS.@*METHODS@#A comparative study was performed on the intestinal microbiota from eight patients with ALS and eight healthy individuals at Huadong Hospital during November 2017 to April 2018; meanwhile, the metabolite concentrations of human endotoxin, short-chain fatty acids (SCFA), NO2-N/NO3-N, and γ-aminobutyric acid were also evaluated by spectrophotometry methods. The correlations between intestinal microbiota and metabolite concentration were compared between the two groups using one-way analysis of variance; the relative abundance of beneficial and harmful micro-organisms in fecal samples was also analyzed.@*RESULTS@#In general, the richness and evenness of bacterial and archaeal communities of healthy individuals were healthier than that of patients with ALS. The phylum Firmicutes/Bacteroidetes ratio, genus Methanobrevibacter showed an enhancive tendency in patients with ALS, whereas the relative abundance of beneficial micro-organisms (genera Faecalibacterium and Bacteroides) presented a significant decrease tendency in patients with ALS. In addition, the average concentrations of human endotoxin, SCFA, NO2-N/NO3-N, and γ-aminobutyric acid in patients with ALS and healthy individuals were 64.2 vs. 65.3 EU/mL, 57.5 vs. 55.3 μg/mL, 5.7 vs. 5.3 ng/mL, and 6.1 vs. 5.4 μmol/L, respectively, indicating that the digestion and metabolism functions of gastrointestinal tract of patients might decline with this disease.@*CONCLUSIONS@#The relative abundance of beneficial and harmful micro-organisms respectively showed decrease and increase tendency in patients with ALS.
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@#Knee osteoarthritis (KOA) is a common degenerative joint disease. Biomechanics of lower extremity plays an important role in KOA. Foot progression angle, with the advantages of non-invasive, convenience, has been attached great importance by people gradually. Changing foot progression angle may effect the knee adduction torque, tibia rotation, muscle activity, which leads to change the load of the knee joint, and alleviate the pain, improve the function of knee joint and the quality of life of the patients.
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Objective To determine key muscles during muscle strength training of patients with knee osteoarthritis (KOA) by studying the correlation of KOA symptoms and disease stages with knee extensor/flexor strength. Methods Ninety-nine community volunteers were recruited and stratified into healthy group, single KOA group, and bilateral KOA group. The relationship between isokinetic extensor/flexor strength and KOA symptom, full-body aerobic exercise capacity, joint function were analyzed by knee isokinetic muscle strength test, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), 6-minute walk test, and CS-30 test. ResultsKnee isokinetic extensor peak torque of the symptomatic leg was significantly lower than that of the asymptomatic leg in single KOA group. There were significant differences in knee isokinetic extensor/flexor peak torque of both the severe and mild symptomatic leg in bilateral KOA group. Knee isokinetic extensor peak torque in bilateral KOA group was significantly lower than that in healthy group. Knee isokinetic extensor/flexor peak torque of KOA patients was positively related to 6-minute walk test, CS-30 test, while negatively related to age. Knee isokinetic extensor peak torque was negatively related to pain score and physical function score of WOMAC. Conclusions Both knee extensor and flexor strength are related to KOA. Therefore, during KOA rehabilitation therapies, muscle training for knee extensors (particularly quadriceps femoris muscles) and knee flexors (hamstring muscles, gastrocnemius muscles) need to be valued.
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<p><b>OBJECTIVES</b>Knee osteoarthritis (OA) is a major cause of pain and functional limitation. Short-term Baduanjin () exercise had been testified to be beneficial to the disease. This study conducted an initial assessment of the one-year Baduanjin exercise on knee OA.</p><p><b>METHODS</b>The recruited patients practiced Baduanjin at the community recreational center. Sessions were held for 30 min five times a week for one year. Knee pain, stiffness, physical disability, general health, knee extensors and flexors strength, and aerobic ability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Medical Outcomes Study Short Form-36 (SF-36), the 6-Minute Walk Test (6-MWT), and the Isokinetic Strength of the Knee Extensors and Flexors (ISKEF). Body mass index (BMI) was also calculated before and after the study period for comparison.</p><p><b>RESULTS</b>Twenty-eight patients signed the informed consent. Six patients withdrew from the trial. Twenty-two patients (29 knees) completed the one-year study. After one-year Baduanjin exercise, WOMAC pain (132.0±69.6 vs. 56.2±67.6, P=0.000), stiffness (64.7±54.8 vs. 22.3±34.6, P=0.000), and physical function subscales (386.1±275.8 vs. 182.0±235.7, P=0.003); SF-36 body pain (45.7±20.0 vs. 57.4±17.9, P=0.005), general health (50.5±20.0 vs. 62.1±16.1, P=0.004), role emotional (64.4±26.1 vs. 73.5±21.3, P=0.047), and health transition (3.3±1.0 vs. 2.6±1.0, P=0.008); BMI (25.0±2.9 vs. 24.4±2.9, P=0.032); 6-MWT (565.7±94.6 vs. 610.5±66.7, P=0.036); and ISKEF Peak Torque (the Knee Extensors: 60.5±25.5 vs. 76.8±31, P=0.000; the Knee Flexors: 29.3±15.9 vs. 37.1±15.8, P=0.001) were significantly improved. No adverse effects resulted from the exercise.</p><p><b>CONCLUSIONS</b>It suggested that the long-term Baduanjin could be a feasible and safe exercise option for knee OA.</p>
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Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia por Exercício , Osteoartrite do Joelho , TerapêuticaRESUMO
Objective To investigate the gait stability of healthy old and young adult volunteers during walking using the nonlinear time series analysis method so as to comprehensively assess the dynamic balance of human and provide important references for the prediction of fall risk. Methods The Vicon motion capture system was used to collect three-dimensional kinematic data of healthy volunteers (seven old subjects and ten young subjects) at different walking speed (80%, 100%, 120% of the natural walking speed). The anterior-posterior and medio-lateral motions of the seventh cervical and tenth thoracic vertebrae, as well as the flexion-extension and abduction-adduction angles of the lower extremity joints, were obtained from 30 consecutive gait cycles to calculate the largest Lyapunov exponents and analyze the difference of gait stability between the old and young group and the influence of walking speed on gait stability. Results The gait stability in the young group was better than that in the old group, and there were significant differences in certain motion segments (P＜0.01). The gait stability in both groups were reduced with the increase of speed (P＜0.05). Conclusions The largest Lyapunov exponent based on nonlinear time series analysis method can be used to effectively and quantitatively analyze the gait stability of each motion segment in human during walking.
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<p><b>BACKGROUND</b>Assessing the radiographic features of knee osteoarthritis (OA), especially joint space narrowing, is important for evaluating disease progression. The purpose of this study was to quantitatively analyze joint space narrowing by measuring 2 new variables: the average joint space width (aJSW) and the articulate angle (AA) on X-ray films, and to evaluate the relationship between the 2 variables, knee function and OA symptoms.</p><p><b>METHODS</b>Using the web-based radiology viewer (Cedara I-Reach™ 4.1.1), we measured the 2 variables in 50 knees of 41 patients with knee OA participating in the Shanghai OA Study. We also evaluated the Kellgren-Lawrence (K-L) grade, the Western Ontario and McMaster Universities OA Index (WOMAC), and additional questionnaire in OA knees. The study was approved by the ethics committee of Shanghai Ninth People's Hospital (No. 2009 - 28).</p><p><b>RESULTS</b>The aJSW correlated with the K-L grade (r = -0.57, P < 0.001), kneeling (r = -0.29, P = 0.04), sitting cross-legged on the floor (r = -0.31, P = 0.03), WOMAC pain (r = -0.31, P = 0.03), WOMAC disability (r = -0.35, P = 0.01), pain while squatting (r = -0.37, P = 0.01), and defecating in a squatting position (r = -0.39, P = 0.01). The AA correlated with defecating in a squatting position (r = 0.29, P = 0.05), WOMAC disability (r = 0.30, P = 0.04) and K-L grade (r = 0.44, P = 0.003). The K-L grade also correlated with pain while squatting (r = -0.40, P = 0.005) and defecating in a squatting position (r = -0.34, P = 0.02), WOMAC pain (r = 0.30, P = 0.04), and WOMAC disability (r = 0.30, P = 0.04).</p><p><b>CONCLUSIONS</b>The aJSW closely correlated with knee OA symptoms and function scores, and was more sensitive to knee OA related disabilities than K-L grade and the AA. The aJSW could be used as a new variable for knee OA evaluation.</p>
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Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Articulação do Joelho , Diagnóstico por Imagem , Osteoartrite do Joelho , Diagnóstico por Imagem , Medição da Dor , RadiografiaRESUMO
Objective To study the correlation between the amount of reduction loss and the length of fixator moment arm after treating acrmioclavicular（AC）joint dislocation with the endobutton technique as viewed from mechanics. Methods 24 patients with acute AC joint dislocation were treated with the endobutton technique and made the follow-up from Mar. 2009 to Dec. 2010 in Shanghai Ninth People’s Hospital. The loss of reduction was observed by evaluating the change of distance between the coracoid and clavicle three days and six months after the operation, respectively. Meanwhile, the length from the upper endnobutton midpoint to the proximal end of clavicle (L1) and the whole length of clavicle (L) were measured and the ratio of L1/L as the moment arm of the fixator was calculated to study the correlation between reduction loss and moment arm. Results All the 24 patients received good reduction after the operation, and the distance between the coracoid and clavicle returned to normal. The average distance between the coracoid and clavicle three days and six months after the operation was (28.2±3.9) and (29.5±4.1) mm, respectively. The amount of average reduction loss was (1.3±1.2) mm. The average moment arm was 0.79±0.03. There was a significant negative correlation between the reduction loss and moment arm with the correlation coefficient -0.498(P＜0.05). Conclusions For the treatment of AC joint dislocation using endobutton technique, the position of the endobutton is closely related with the loss of reduction postoperatively. The shorter the moment arm, the greater the loss of reduction would be. The proper moment arm should be around 0.80.
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<p><b>OBJECTIVE</b>To create an externally-applied TCD plaster (Laosun Yutie plaster) for the lumbar muscle strain (LMS).</p><p><b>METHOD</b>(1) The raw material such as angelica, safflower, frankincense, myrrh, clove and so on were turned into solid TCD plaster by a serial of modern treatment technology-distillation, extraction, condense, dehydration. Meanwhile, the naphtha from the distillation process and borneol were dissolved into ethanol solution and the dilution was thus made; (2) The solid TCD plaster and the dilution from the aboved-mentioned process were put together to form the TCD plaster and the corresponding safety experiments were applied to rabits' skin.</p><p><b>RESULT</b>The experimental results showed that it is neither of urgent toxicity, stimulary function, nor of allergy-inducing response.</p><p><b>CONCLUSION</b>The laosun Yutie plaster was a newly externally-applied TCD plaster which could be used safely and handily.</p>