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INTRODUCTION: According to cross-sectional analysis studies supported by microdata, incidence of Osteoarthritis increases in parallel with ageing and obesity, which are common predictors of the disease. The aim of this study is to reveal whether ageing and obesity have an effect on the increase in osteoarthritis prevalence by analyzing cross-country data from Organization for Economic Cooperation and Development countries. METHODS: We used static panel data regression analysis for 36 countries for the period between 2000 and 2017. Along with osteoarthritis prevalence, we used a group of people with a body mass index ≤ 30 within the population as obesity indicator and those older than 65 yrs within the population as ageing indicator. We calculated the effect of ageing and obesity on osteoarthritis prevalence using STATA 13 software. RESULTS: Both variable coefficients, age, and obesity, respectively, were found to be positive and statistically significant at the 1% level. This study shows that both ageing and obesity contribute to an increase in the osteoarthritis prevalence based on macro data from 36 Organization for Economic Cooperation and Development countries. CONCLUSIONS: These findings have significant implications that can be used by both the public and policymakers for preventing the osteoarthritis. Adopting the preventive measures could contribute to decrease in health expenditures.
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Osteoartrite do Joelho , Osteoartrite , Humanos , Prevalência , Organização para a Cooperação e Desenvolvimento Econômico , Estudos Transversais , Osteoartrite/epidemiologia , Osteoartrite/complicações , Obesidade/epidemiologia , Obesidade/complicações , Osteoartrite do Joelho/complicaçõesRESUMO
OBJECTIVE: To compare the effectiveness of sensory-motor training and resistance training in patients with knee osteoarthritis. DESIGN: Randomized controlled trial. SETTING: Istanbul University, Department of Physiotherapy and Rehabilitation. SUBJECTS: Forty-eight participants with knee osteoarthritis. INTERVENTIONS: Following baseline assessment, participants were randomly allocated to sensory-motor training (n = 24) and resistance training (n = 24). Both groups received training three times a week for 8 weeks. MAIN MEASURES: The primary outcome measure was the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The secondary outcome measures were pain level, muscle strength, proprioception, range of motion, quality of life, and patient satisfaction with treatment. Patients were assessed before and after four- and eight-week interventions. RESULTS: There was no significant difference between the groups' total WOMAC scores after four- and eight-week interventions (respectively, p = 0.415, p = 0.828). There was a significant improvement in pain level during movement and in the energy subscale SF-36 for resistance training after the four-week intervention (respectively, p = 0.012, p = 0.007). After the eight-week intervention, a significant difference was noted in favor of resistance training in the secondary outcome measure quality of life (QoL). No significant difference was found in other secondary outcomes. CONCLUSIONS: At the end of the treatment, it was observed that sensory-motor training had a similar effect in the treatment of knee osteoarthritis symptoms to resistance training. These findings may suggest that sensory-motor training is an effective new method to treat patients with knee osteoarthritis.
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Osteoartrite do Joelho , Treinamento Resistido , Humanos , Osteoartrite do Joelho/reabilitação , Qualidade de Vida , Modalidades de Fisioterapia , Dor/reabilitação , Resultado do TratamentoRESUMO
People with knee osteoarthritis have atrophy of the muscles surrounding the knee joint. Therefore, exercise programs primarily have been focused on the strengthening of quadriceps femoris muscle (QFM). Primary aim of this systematic review was to determine which exercise increases strength of the QFM and describe the details of the training programs. Secondary aim was to determine effectiveness of strengthening of the QFM alone on pain and dysfunction in patient with knee osteoarthritis. PubMed, PEDro, and Cochrane were searched. PEDro for methodological quality of randomized controlled trials and Cochrane Collaborations' tool for risk of bias were used. A total of 1128 articles were identified from the database searches. Ten studies which were moderate-to-high level of evidence were included. In the comparison of different strengthening exercises of the QFM, significant difference was not found between training groups. However, strengthening of the QFM exercise training was superior to proprioceptive training. Additional hot packs plus shortwave diathermy or ultrasound or transcutaneous electrical nerve stimulation had superiority to isokinetic strengthening of the QFM alone. Only additional Russian electrical stimulation showed the significant difference compared with strengthening of the QFM exercise. Most of the included studies showed that strengthening of the QFM exercises has an effect on pain reduction and improvement of function. This review indicated that the strengthening of QFM training compared with other knee exercises provided muscle strengthening, pain reduction, and improved function while combination with other electrotherapy modalities or combination with Russian electrical stimulation had superiority to alone strengthening QFM training.
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Terapia por Estimulação Elétrica/métodos , Terapia por Exercício/métodos , Osteoartrite do Joelho/terapia , Adulto , Viés , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular , Músculo Quadríceps , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
BACKGROUND: Functional outcomes of reverse total shoulder arthroplasty (rTSA) can be improved by fixation of the tuberosities. This study compares clinical and radiologic results of patients with comminuted proximal humeral fractures treated with rTSA, with and without autologous grafting. METHODS: Thirty-three patients with proximal humeral fractures were treated with rTSA and tuberosity fixation. In 18 patients (group I; mean age, 75 years), tuberosity fixation was augmented with autografting; in 15 patients (group II; mean age, 71 years), graft augmentation was not used. The mean follow-up was 16.7 (range, 12-24) months in group I and 16.8 (range, 12-25) months in group II. RESULTS: Radiologic tuberosity union was achieved in 14 of 18 (77.8%) patients who underwent autograft augmentation and in 6 of 15 (40.0%) patients treated without autografting. The mean American Shoulder and Elbow Surgeons (ASES) score was 69.6 ± 13.0 in group I and 51.0 ± 20.0 in group II. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 31.9 ± 24.0 in group I and 58.2 ± 24.6 in group II. A significant difference was detected between groups for ASES and DASH scores. Among shoulder range of motion measures, only forward flexion differed significantly between groups I and II (124° ± 23° vs. 98° ± 30°, respectively). External rotation muscle strength was significantly higher in group I (3.36 ± 1.46 kg) than in group II (2.39 ± 2.00 kg). CONCLUSION: In the treatment of complex proximal humeral fractures in elderly patients by rTSA, cancellous block autograft augmentation can increase the rate of tuberosity union and improve functional outcomes.
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Artroplastia do Ombro , Transplante Ósseo , Fraturas Cominutivas/cirurgia , Fraturas do Ombro/cirurgia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Amplitude de Movimento Articular , Recuperação de Função Fisiológica , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: This study compared the effectiveness of joint mobilization combined with stretching exercises (JM&Str) vs steroid injection (SI) in the treatment of plantar fasciitis (PF). METHODS: A total of 43 patients (mean age, 45.5 ± 8.5 years; range, 30-60 years; 23 females) with PF were randomly assigned to receive either JM&Str (n = 22) or SIs (n = 21). JM&Str was applied 3 times per week for 3 weeks for a total of 9 visits. The SI group received 1 injection at baseline. The patients' functional scores were assessed using the Foot and Ankle Ability Measure (FAAM), and pain was evaluated using the Visual Analog Scale (VAS). Outcomes of interest were captured at baseline and at 3-week, 6-week, 12-week, and 1-year follow-ups. The primary aim was examined using a mixed-model analysis of variance (ANOVA). Pairwise comparisons were performed to examine differences between the baseline and follow-up periods using Bonferroni equality at an alpha level of 0.05. RESULTS: Age, sex, body mass index, and dorsiflexion range of motion did not significantly impact pain relief or functional outcome (P > .05) at the 3-, 6- or 12-week follow-ups compared to baseline. Planned pairwise comparisons demonstrated significant improvements in pain relief and functional outcomes in both groups (P < .05) at the 3-, 6-, and 12-week follow-ups compared to baseline. However, at the 12-week and 1-year follow-ups, pain and functional outcomes were significantly improved in only the JM&Str group (P = .002). The overall group-by-time interaction was statistically significant for both FAAM (P = .001; F = 7.0) and VAS (P = .001; F = 8.3) scores. Between-group differences favored the SI group at the 3-week (P = .001, P = .001), 6-week (P = .002, P = .001), and 12-week (P = .008, P = .001) follow-ups for pain relief and functional outcomes. However, no significant differences (P = .62, P = .57) were detected in the measured outcomes at the 1-year follow-up. CONCLUSION: Our study demonstrated that while both groups achieved significant improvements at the 3-, 6-, and 12-week follow-ups, the SI group exhibited better outcomes at all 3 time points. The noted improvements continued in only the JM&Str group for a period of time ranging from 12 weeks to 1 year. LEVEL OF EVIDENCE: Level II, comparative study.
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Anti-Inflamatórios/uso terapêutico , Terapia por Exercício/métodos , Fasciíte Plantar/terapia , Metilprednisolona/análogos & derivados , Adulto , Anestésicos Locais/uso terapêutico , Feminino , Humanos , Injeções , Masculino , Metilprednisolona/uso terapêutico , Acetato de Metilprednisolona , Pessoa de Meia-Idade , Prilocaína/uso terapêutico , Estudos Prospectivos , Método Simples-Cego , Escala Visual AnalógicaRESUMO
PURPOSE: The Western Ontario Meniscal Evaluation Tool (WOMET) is a questionnaire designed to evaluate quality of life related to the health (HRQOL) of patients with meniscus pathology. The purpose of this study was to translate and culturally adapt the WOMET into Turkish, and thereby to determine the reliability and validity of the translated version. METHODS: The WOMET was translated into Turkish in accordance with the stages recommended by Guillemin. Ninety-six patients [35 male, 61 female; mean age: 43.6 ± 11.7 (23-71) years] with meniscal pathology were included in the study. The WOMET was completed twice at 3-7-day intervals. The inter-rater correlation coefficient was used for reliability, and Cronbach's α was used for internal consistency. Patients were asked to answer the Lysholm knee scale and the short form-36 (SF-36) for the validity of the estimation. The distribution of ceiling and floor effects was determined. RESULTS: Mean and standard deviation of the first and second evaluations of the total WOMET were 1,048.9 ± 271.6 and 1,000.4 ± 255.2 (p = 0.03), respectively. The test-retest reliability of the total score, physical function, sports/work/lifestyle and emotion domains were 0.88, 0.78, 0.80 and 0.85, respectively. Cronbach's α was 0.89. WOMET was most strongly related to the physical function scale and the physical component score (ρ 0.54, ρ 0.60, respectively; p < 0.001). The weakest correlations between the WOMET and the SF-36 were for the mental component score and the emotional role functioning (ρ 0.11, ρ 0.03, respectively). We observed no ceiling and floor effects of the overall WOMET score, but 36.5 % of the patients showed floor effect in the question of "numbness", and 40.6 % of the patients showed ceiling effect in the question of "consciousness". CONCLUSION: The Turkish version of the WOMET is valid and reliable. It can therefore be used for HRQOL of patients with meniscal pathology.