Effect of laying on of hands as a complementary therapy for pain and functioning in older women with knee osteoarthritis: A randomized controlled clinical trial.

AIM: To assess the effects of laying on of hands (LooH) as a complementary therapy to kinesiotherapy, on pain, joint stiffness, and functional capacity of older women with knee osteoarthritis (KOA) compared to a control group. METHODS: In this randomized controlled clinical trial, participants were assigned into 3 groups: LooH with a spiritual component ("Spiritist passe" Group - SPG), LooH without a spiritual component (LooH Group - LHG), and a control group receiving no complementary intervention (Control Group - CG). Patients were assessed at baseline, 8 weeks, and 16 weeks. Primary outcomes were joint stiffness and functional capacity (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and pain (WOMAC and visual analog scale). Secondary outcomes were anxiety, depression, mobility, and quality of life. Differences between groups were evaluated using an intention-to-treat approach. RESULTS: A total of 120 women (mean age = 69.2 ± 5.2 years) with KOA were randomized (40 participants per group). At 8 weeks, SPG differed significantly from the LHG for WOMAC Functional Status (between-group difference in the change = 0.97; 95% CI: 0.35 to 1.59, P = .001); Anxiety levels (between-group difference in the change = 1.38; 95% CI: 0.11 to 2.65, P = .027); and also from the CG for all outcomes with exception of WOMAC Stiffness. After 16 weeks, SPG differed significantly from the LHG only for WOMAC Functional Status (between-group difference in the change = 0.92; 95% CI: 0.32 to 1.52, P = .001]) and also from the CG for all outcomes with exception of WOMAC Stiffness and timed up-and-go. CONCLUSION: Our results suggest that LooH with a "spiritual component" may promote better long-term functional outcomes than both LooH without a "spiritual component" and a control group without LooH.

Effects of laying on of hands with and without a spiritual context on pain and functionality of older women with knee osteoarthritis: study protocol for a randomized controlled trial.

BACKGROUND: Laying on of hands (LooH) is a culturally-accepted therapy in several traditions. In Brazil, "Spiritism" (third-largest religious tradition in number of followers) uses LooH with the name of "Spiritist Passe" (SP). However, there are few studies assessing SP's role in medical outcomes. The present study aims to investigate the effects of LooH, with and without a spiritual context, on pain, joint stiffness, and functional capacity of older women (≥60 years old) with knee osteoarthritis (KOA). METHODS/DESIGN: In this triple-blind, prospective randomized controlled trial, older women with KOA are assigned to three groups: LooH with a spiritual context group, LooH group without a spiritual context, and a control group receiving no intervention. Patients are assessed by a blinded researcher at baseline, 8 weeks, and 16 weeks. Pain, joint stiffness, and functional capacity are assessed using Western Ontario and McMaster Universities Osteoarthritis Index. Other measures such as anxiety, depression, gait speed, and quality of life will also be assessed. To detect differences between groups, a post-intervention comparison between the three groups and a mean change (post-pre) comparison among the three groups will be done using analysis of variance. All statistical analyses will be performed using an intention-to-treat approach and a per-protocol analysis. DISCUSSION: A pragmatic design using SP, LooH without spiritual context, and no LooH may provide further scientific evidence on SP's feasibility and efficacy for KOA patients. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT02917356.

Electromyographic normalization of vastus lateralis and biceps femoris co-contraction during gait of elderly females / Normalização eletromiográfica da co-contração do vasto lateral e bíceps femoral durante a marcha de idosas

Abstract Introduction: Analyze muscle co-contraction using electromyographic signals, which are normalized to compare individuals, muscles and studies. Maximum voluntary isometric contraction (MVIC) and peak electrical activity (PEA) during movement are the most widely used forms of normalization. Objective: Compare inter-subject variability and investigate the association between the co-contraction indices of the vastus lateralis and biceps femoris during gait, normalized by MVIC and PEA. Methods: Thirty elderly women, aged 70.33 ± 3.69 years took part. Electrical muscle activity during MVIC and gait was recorded using a Biopac MP100 electromyograph. MVIC was performed in a Biodex isokinetic dynamometer. For normalization, the signals were divided by the Root Mean Square values of MVIC and PEA of gait. Results: The coefficient of variation of non-normalized data was 69.3%, and those normalized by PEA and MVIC were 30.4% and 48.9% respectively. Linear regression analysis resulted in a prediction model: PEA = 0.04 + 0.16 x MVIC. The goodness of fit of the regression model was statistically significant (p=0.02). The confidence interval (95% CI) for the intercept was between 0.02 and 0.29 and for MVIC between 0.03 and 0.06. Conclusions: The data normalized by PEA showed less variation than those normalized by MVIC. A 100% variation in data normalized by MVIC resulted in a 16% variation in data normalized by PEA, while variation in normalization by MVIC accounts for 17% of the variation in normalization by PEA and vice versa.

Resumo Introdução: Analisa-se co-contração muscular através dos sinais eletromiográficos, os quais são normalizados para permitir comparação entre indivíduos, músculos e estudos. A contração voluntária máxima isométrica (CVMi) e o pico da atividade elétrica (PAE) durante o ato motor são as formas de normalização mais utilizadas. Objetivos: Comparar a variabilidade inter-sujeitos e investigar a associação entre os índices de co-contração, do vasto lateral e bíceps femoral durante a marcha, normalizados pela CVMi e PAE. Métodos: Participaram 30 idosas, idade 70,33 ± 3,69 anos. A atividade elétrica dos músculos durante a CVMi e na marcha foi registrada pelo eletromiógrafo Biopac MP100. A CVMi foi realizada no dinamômetro isocinético Biodex. Para normalização, os sinais foram divididos pelos valores do Root Mean Square da CVMi e pelo PAE da marcha. Resultados: O coeficiente de variação dos dados não normalizados foi 69,3%, e dos normalizados pelo PAE e CVMi foram 30,4% e 48,9% respectivamente. A análise de regressão linear produziu o modelo de predição: PAE = 0,04 + 0,16 x CVMi. O ajuste do modelo de regressão foi estatisticamente significante (p=0,02). O intervalo de confiança (IC95%) para o intercepto foi de 0,02 a 0,29 e para a CVMi foi de 0,03 a 0,06. Conclusão: Os dados normalizados pelo PAE apresentaram menor variação que os normalizados pela CVMi. Uma variação de 100% nos dados normalizados pela CVMi resulta em 16% de variação nos dados normalizados pelo PAE, enquanto a variação da normalização pela CVMi é responsável por 17% de variação da normalização pelo PAE e vice-versa.

Associação entre o teste de Thomas modifi cadoe o teste de Ely no diagnóstico do encurtamentodo músculo reto femoral / Association between the modifi ed Thomas test and Ely test in the diagnosis of rectus femoris muscle shortening

Avaliar a correlação entre o teste de Th omas modifi -cado e teste de Ely para diagnosticar o encurtamento do músculoreto femoral. Método: O comprimento do músculo reto femoralfoi avaliado através dos testes de Ely e de Th omas modifi cado, em30 voluntários, de ambos os sexos, com idades entre 17 e 35 anos.Foram excluídos indivíduos obesos com o índice de massa corporal 30 ou que possuíssem restrições de amplitude de movimento nasarticulações coxofemorais ou joelhos. O cálculo do coefi ciente decorrelação de Pearson foi adotado para verifi car a associação entreos resultados dos testes de Th omas modifi cado e Ely. Resultados:Houve uma fraca correlação negativa estatisticamente signifi canteentre os testes de Th omas modifi cado e de Ely (r ≤ -0,33; p < 0,01).O teste de Th omas modifi cado acusou um maior número de encurtamentosdo reto femoral quando comparado com o teste de Ely.Conclusão: Apesar do teste de Th omas modifi cado e do teste de Elyserem utilizados para a avaliação do comprimento do músculo retofemoral, os resultados deste estudo mostraram existir apenas umafraca correlação negativa entre ambos. Além disso, foi encontradoum número maior de encurtamentos deste músculo através dautilização do teste de Th omas modifi cado...

The purpose of this study was to evaluate the correlationbetween modifi ed Th omas and Ely’s test in order to diagnosethe rectus femoris muscle shortening. Method: Th e muscle lengthwas evaluated within 30 individuals, both genders, convenientlyselected, 17 to 35 years old. Th erefore, the defi ned protocols toperform Ely and modifi ed Th omas’s test have been used. Obeseindividuals with the Body Mass Index > 30 or those who had limitedrange of motion in hip and knees joints were excluded. It wasadopted Pearson for the correlation statistics in order to verify therelationship between modifi ed Th omas and Ely’s tests. Results: Wasobserved a weak negative correlation statistically signifi cant betweenthe tests (r ≤ -0.33, p < 0.01). Th e modifi ed Tomas’ test showed ahigher number of positive cases for the rectus femoris shortening inboth lower extremities when compared to the Ely’s test. Conclusion:Th e results of this study revealed only a weak negative correlationbetween the tests despite being used to measure the length of therectus femoris muscle. Furthermore, we found a greater numberof positive results for rectus femoris shortening through modifi edTh omas’ test compared to the Ely’s test...