Preliminary efficacy of aerobic training among university students with migraine symptoms: Study protocol for a pilot randomized controlled trial.

BACKGROUND: Migraine is a primary neurological headache. Treatment of this condition includes medications; however, these medications, when given for a longer duration, can have side effects. If migraine is left untreated or undiagnosed, it is reported that around 2.5% of individuals with migraine may develop to have a chronic condition. This study aims to analyse the preliminary effectiveness of aerobic training on migraine pain level, sleep quality, quality of life, and resting-state brain waves among university students with migraine symptoms. METHODOLOGY: 88 university students with migraine symptoms are the target participants. 4 of 5 on the Migraine Screen Questionnaire, 5 of 7 on the International Classification of Headache Disorders 3rd edition (ICHD-3), and both genders aged 18-40 years will be included. The participants with a score of more than or equal to 5 on the visual aura rating scale, diagnosed with a secondary headache, pregnancy, medication for neurological and cardiorespiratory conditions, and unwilling to participate will be excluded. Based on the disability questionnaire, the participants will be randomly assigned to either of the three groups. The primary outcome is resting-state electroencephalography (EEG) brain, and the secondary outcomes are sleep quality, quality of life, and migraine pain level. The post-test assessments will be performed at week 6. RESULT: After the primary EEG analysis using MATLAB, the amplitude, frequency, frequency band ratio, and power spectrum density will be analysed. Mixed design analysis and intention-to-treat analysis will be used to assess the efficacy of aerobic training. DISCUSSION: Migraines can be unpredictable, sometimes occurring without symptoms. If underdiagnosed or over-looked, it encompasses a serious of long-term effects. Hence with appropriate intervention, the symptoms can be prevented from worsening. But there is an unmet need for evidence-based non-pharmacological approaches to complement pharmacotherapy in migraine prevention. Moreover, an exercise intervention may be more suitable for people with migraine considering their tendency toward inactivity. Although some studies developed exercise programs for untrained patients with migraine, the outcome was primarily in terms of exercise capacity rather than the primary characteristics and secondary brain wave/ sleep quality changes, indicating the need for this study.

Regenerative Medicine as a Potential and Future Intervention for Ankle Sprain

@#Ankle sprain is one of the most common injuries associated with physical activities. Complications including pain and ankle instability are associated with decreased physical activity, reduced sport performance, and increased risk of recurrent ankle injury leading to detrimental effect on activities of daily living. Current management of ankle sprain can be conservative or surgical for serious cases. However, long healing period is required for conservative management in addition to its side effects and the risk of post-operative complications for surgical management. Due to the current challenges and setbacks faced by existing intervention, this paper aims to generate ideas in incorporating regenerative medicine as an intervention for ankle sprain. This review will provide a brief review on the existing management for ankle sprain along with some history, application and the potential of regenerative medicine in speeding up the healing process of ankle sprains.

Knee Pain and Functional Disability of Knee Osteoarthritis Patients Seen at Malaysian Government Hospitals

Introduction: Osteoarthritis (OA) is the main cause of knee pain. It also affects individual’s physical functioning. Anti- inflammatory drugs and knee replacement are the mainstay methods in the management of knee OA in Malaysia. However, patients with knee OA often suffer pain. The general objective of the study is to evaluate the effectiveness of a cognitive behavioural intervention module on knee pain, functional disability and psychological outcomes among knee OA patients attending Orthopedics Clinics in Hospital Putrajaya and Hospital Serdang, Malaysia. This study aims to determine the baseline level of knee pain and functional disability among knee OA patients. Methods: Baseline results on the knee pain and functional disability were obtained from a two arm parallel- group randomized controlled study. Three hundred patients aged 35 to 75 years diagnosed with knee OA were recruited. A set of pre tested and validated Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire was used in this study. Results: Mean baseline of KOOS pain was 56.09 (SD=21.75) and 52.26 (SD=22.08) for the intervention and control groups respectively. Participants in the intervention and control groups had a mean KOOS function in daily living of 61.11 (SD=21.20) and 56.72 (SD=22.13) respectively. Overall mean baseline of KOOS function in sport and recreation was 35.30 (SD=27.38). Conclusions: Majority of participants had moderate level of knee pain and functional disability in daily living. However, participants had more extreme symptoms of functional disability in sport and recreation. Therefore, interventions to reduce knee pain and functional disability symptoms in knee OA are needed.