Quadriceps strengthening exercises may not change pain and function in knee osteoarthritis.

It is believed that Quadriceps strength training may reduce pain and improve functional activity in patients with knee osteoarthritis (OA). This improvement is generally attributed to an increase in quadriceps strength. This study investigated whether quadriceps muscle strength increases with decreasing pain, improving functional activity in knee OA. Twenty-four patients with knee OA participated in an 8-week treatment protocol including traditional physical therapy and strength training 3 sessions per week. Measurements were conducted before and after the intervention and included the peak torque of quadriceps muscle, pain by visual analogue scale (VAS), short Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and functional activity by the 2 minute walking test (2MWT) and time up & go test (TUGT). After the intervention, analysis of data illustrated that changes in quadriceps muscle strength correlated with changes in VAS (r2 = 0.310, p = 0.005), WOMAC (r2 < 0.278, p < 0.008) and 2MWT (r2 < 0.275, p < 0.009) significantly, although the correlation slope was negligible. No correlation was found between muscle strength and TUGT. However, the strength training significantly improved quadriceps muscle strength (p = 0.013), pain and functional activity (p = 0.000). This study showed that reduction in pain and improvement in functional activity occurs independently from an increase in quadriceps muscle strength in knee OA. It seems that increased quadriceps muscle strength may not be a cause of improvement in pain and functional activity in knee OA.

The effect of adding whole body vibration training to strengthening training in the treatment of knee osteoarthritis: A randomized clinical trial.

Strengthening training (ST) and whole body vibration training (WBV) alone may improve symptoms of osteoarthritis of the knee. In this study, we investigated the effect of adding WBV training to quadriceps and hamstring muscles strengthening training on functional activity, pain, quality of life and muscle strength in patients with knee osteoarthritis. 28 volunteers were randomly allocated to two groups; 1) quadriceps and hamstring muscles strengthening training (ST group, 13 patients) and 2) quadriceps and hamstring muscles strengthening training along with WBV training (ST + WBV group, 15 patients). The treatment protocol for both groups involved 3 sessions per week for 8 weeks. All measurements were performed before and after intervention. The measurements included: pain by means of a visual analogue scale (VAS), quality of life by means of the WOMAC scale, functional activity by the 2 min walking test (2MWT), time up & go test (TUGT) and 50-foot walking test (50FWT) and the muscle peak torque (MPT), total work (TW) and muscle power (MP) as muscle performance of quadriceps and hamstring muscles by an Isokinetic Biodex machine. After intervention, the comparison of mean changes between two groups showed improvement in the WBV + ST group in terms of 2MWT, MPT, TW and MP variables (P < 0.05). However, no significant difference was found between the experimental groups in term of pain, quality of life, TUGT and 50FWT. These results suggest that adding whole body vibration training to strengthening training may provide better treatment effects for patients with knee osteoarthritis.

Short term effects of kinesio taping on pain and functional disability in young females with menstrual low back pain: A randomised control trial study.

BACKGROUND: Menstrual low back pain (LBP) in young females can reduce daily activity and cause functional disability, while the progressive application of kinesio-taping (KT) on pain reduction and functional correction has been stated. OBJECTIVE: This study has been designed to investigate the efficacy of the lumbar vertebral column KT in young female with menstrual LBP. METHODS: Thirty-two young females with menstrual LBP participated in this crossover study and were assigned randomly in two separate groups. The first group received KT during their first menstrual cycle and No-KT in their next menstrual, while the other group had no KT during the first mentrual cycle and received KT during the next menstrual cycle. The primary outcome measurements included the visual analogue scale (VAS) of pain, Oswestry disability index and McGill pain questionnaire score which were planned to collect at the end of the third day of the menstrual cycle. RESULTS: Comparing pain and disability between two conditions, of menstrual cycle with KT and menstrual cycle without KT, revealed significant reduction in VAS (mean change = 1.7; 95%CI = 0.6 to 2.8; P= 0.005), McGill pain score (mean change = 20.1; 95%CI = 8.7 to 31.3; P= 0.001) and functional disability (mean change = 12.3; 95%CI = 7.2 to 17.5; P< 0.0001) by using KT during menstrual cycle. CONCLUSIONS: Results showed that KT may effectively reduce pain and disability. The findings may support the clinical application of kinesiotaping in young females with menstrual LBP.

Uphill and Downhill Walking in Multiple Sclerosis: A Randomized Controlled Trial.

BACKGROUND: Various exercise protocols have been recommended for patients with multiple sclerosis (MS). We investigated the effects of uphill and downhill walking exercise on mobility, functional activities, and muscle strength in MS patients. METHODS: Thirty-four MS patients were randomly allocated to either the downhill or uphill treadmill walking group for 12 sessions (3 times/wk) of 30 minutes' walking on a 10% negative slope (n = 17) or a 10% positive slope (n = 17), respectively. Measurements were taken before and after the intervention and after 4-week follow-up and included fatigue by Modified Fatigue Impact Scale; mobility by Modified Rivermead Mobility Index; disability by Guy's Neurological Disability Scale; functional activities by 2-Minute Walk Test, Timed 25-Foot Walk test, and Timed Up and Go test; balance indices by Biodex Balance System; and quadriceps and hamstring isometric muscles by torque of left and right knee joints. Analysis of variance with repeated measures was used to investigate the intervention effects on the measurements. RESULTS: After the intervention, significant improvement was found in the downhill group versus the uphill group in terms of fatigue, mobility, and disability indices; functional activities; balance indices; and quadriceps isometric torque (P < .05). The results were stable at 4-week follow-up. CONCLUSIONS: Downhill walking on a treadmill may improve muscle performance, functional activity, and balance control in MS patients. These findings support the idea of using eccentric exercise training in MS rehabilitation protocols.

Localised application of vibration improves passive knee extension in women with apparent reduced hamstring extensibility: a randomised trial.

QUESTION: Does the localised application of vibration over the hamstrings improve hamstring extensibility? DESIGN: Randomised controlled trial with concealed allocation, intention-to-treat analysis, and assessor blinding. PARTICIPANTS: 30 non-athletic females (aged 18-22 yrs) with limited hamstring extensibility bilaterally. INTERVENTION: The experimental group received 3 sessions of localised application of vibration per week for 8 weeks. At each session, 3 sets of vibration were applied over the left and right hamstring muscles. The control group continued their usual daily activities. Both groups were asked to perform no specific exercises during the 8-week intervention period. OUTCOME MEASURES: Hamstring muscle extensibility was measured bilaterally at baseline and at the end of the 8-week intervention period by measuring passive knee extension in supine with 90 deg of hip flexion. RESULTS: At baseline, the mean lack of knee extension was 27 deg (SD 9) in the experimental group and 24 deg (SD 8) in the control group. At 8 weeks, this had changed to 13 deg (SD 5) in the experimental group and 23 deg (SD 9) in the control group. This was a significant treatment effect: mean between-group difference of 13 deg (95% CI 11 to 16). CONCLUSION: An 8-week regimen of localised application of vibration over the hamstring muscles significantly reduces knee extension lack in women with reduced range on the passive knee extension test.

Whole-body vibration and the prevention and treatment of delayed-onset muscle soreness.

CONTEXT: Numerous recovery strategies have been used in an attempt to minimize the symptoms of delayed-onset muscle soreness (DOMS). Whole-body vibration (WBV) has been suggested as a viable warm-up for athletes. However, scientific evidence to support the protective effects of WBV training (WBVT) on muscle damage is lacking. OBJECTIVE: To investigate the acute effect of WBVT applied before eccentric exercise in the prevention of DOMS. DESIGN: Randomized controlled trial. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 32 healthy, untrained volunteers were randomly assigned to either the WBVT (n  =  15) or control (n  =  17) group. INTERVENTION(S): Volunteers performed 6 sets of 10 maximal isokinetic (60°/s) eccentric contractions of the dominant-limb knee extensors on a dynamometer. In the WBVT group, the training was applied using a vibratory platform (35 Hz, 5 mm peak to peak) with 100° of knee flexion for 60 seconds before eccentric exercise. No vibration was applied in the control group. MAIN OUTCOME MEASURE(S): Muscle soreness, thigh circumference, and pressure pain threshold were recorded at baseline and at 1, 2, 3, 4, 7, and 14 days postexercise. Maximal voluntary isometric and isokinetic knee extensor strength were assessed at baseline, immediately after exercise, and at 1, 2, 7, and 14 days postexercise. Serum creatine kinase was measured at baseline and at 1, 2, and 7 days postexercise. RESULTS: The WBVT group showed a reduction in DOMS symptoms in the form of less maximal isometric and isokinetic voluntary strength loss, lower creatine kinase levels, and less pressure pain threshold and muscle soreness (P < .05) compared with the control group. However, no effect on thigh circumference was evident (P < .05). CONCLUSIONS: Administered before eccentric exercise, WBVT may reduce DOMS via muscle function improvement. Further investigation should be undertaken to ascertain the effectiveness of WBVT in attenuating DOMS in athletes.

The effect of infrared laser on sensory radial nerve electrophysiological parameters.

OBJECTS: It has been claimed that laser may have bio-stimulation effect on the nerve tissues. This study has been designed to investigate the effect of different doses of infra-red (IR) laser exposure on the electrophysiological parameters of sensory nerves. METHODS AND SUBJECTS: Forty healthy subjects (20-35 years old) with no history of neurological conditions participated in this study. IR laser (780 nm, 20 mw) was applied over five blocks (1 cm2 each and 0.5 J/cm2) of 5 cm length of the left and right superficial radial nerve. The IR laser radiation was started from proximal to distal in the right hand and vise versa in the left hand. Antidromic sensory nerve conduction velocity was evaluated before and after first (0.5 J), third (1.5 J) and fifth (2.5 J) exposures. During the test, we measured the onset and peak latency, amplitude and duration of sensory action potentials. RESULTS: Paired t-test was used to assess the difference between pre- test and post- test data. After IR laser exposure with all doses, significant increased in latencies was observed (P < 0.001), while significant decreased in amplitude and duration was found only in the group who received the doses of 1.5 and 2.5 J of exposure (P < 0.001). There was no difference between right and left hands. CONCLUSION: Our results showed that the minimal dose of IR laser may not produce enough effects on the sensory nerves, while the higher doses such as 1.5 and 2.5 J may activate the mechanism of nerve blockage.