RESUMO
BACKGROUND: Knee osteoarthritis has an inflammatory component that is linked to pain and joint pathology, yet common non-surgical and non-pharmacological interventions (e.g., exercise, calorie restricting diets) do not typically target inflammation. We aimed to evaluate the feasibility of a telehealth delivered anti-inflammatory diet intervention for knee osteoarthritis. METHODS: This 9-week single-arm feasibility study recruited participants aged 40-85 years with symptomatic knee osteoarthritis (inclusion criteria: average pain ≥4/10 or maximal pain ≥5/10 during past week). All participants received a telehealth-delivered anti-inflammatory dietary education intervention involving 1:1 consultations at baseline, 3- and 6-week follow-up. The diet emphasised nutrient-dense wholefoods and minimally processed anti-inflammatory foods and discouraged processed foods considered to be pro-inflammatory. The primary outcome of feasibility was assessed via: i) eligibility, recruitment and retention rates; ii) self-reported dietary adherence; iii) adverse events; and iv) treatment satisfaction. Post-intervention interviews evaluated the acceptability of the dietary intervention delivered via telehealth. Secondary outcomes included changes in self-reported body mass, Knee injury and Osteoarthritis Outcome Score (KOOS), health-related quality of life (EuroQoL-5D), analgesic use and global rating of change. Worthwhile effects were determined by the minimal detectable change (MDC) for all five KOOS-subscales (pain, symptoms, activities of daily living, sport/recreation, quality of life) being contained within the 95% confidence interval. RESULTS: Forty-eight of seventy-three (66%) individuals screened were eligible and 28 enrolled over 2 months (82% female, mean age 66 ± 8 years, body mass index 30.7 ± 4.8 kg.m-2). Six participants withdrew prior to final follow-up (21% drop-out). Of those with final follow-up data, attendance at scheduled telehealth consultations was 99%. Self-reported adherence to diet during the 9-week intervention period: everyday = 27%, most of time = 68% and some of time = 5%. Two minor adverse events were reported. Change scores contained the MDC within the 95% confidence interval for all five KOOS subscales. Suggestions to improve study design and limit drop-out included an initial face-to-face consultation and more comprehensive habitual dietary intake data collection. CONCLUSION: This study supports the feasibility of a full-scale randomised controlled trial to determine the efficacy of a primarily telehealth-delivered anti-inflammatory dietary education intervention in adults with symptomatic knee osteoarthritis. TRIAL REGISTRATION: ACTRN12620000229976 prospectively on 25/2/2020.
Assuntos
Osteoartrite do Joelho , Atividades Cotidianas , Adulto , Idoso , Anti-Inflamatórios , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/terapia , Qualidade de Vida , Resultado do TratamentoRESUMO
CONTEXT: Muscle injuries of the hip stabilizers are considered rare in sport. OBJECTIVE: This report presents a previously unreported case of a contact injury resulting in acute strain of quadratus femoris, obturator externus, and inferior gemellus in an amateur Australian rules football player. DESIGN: Level 4-case report. CASE PRESENTATION: A player was tackled ipsilateral to the injured leg, while in hip flexion in a lunged position. The case describes the diagnostic process, initial management, and return to play for this athlete. RESULTS: Following rehabilitation, the player was able to return to sport at 8 weeks without ongoing issues. CONCLUSIONS: A literature search for sports-related contact injuries to either muscle returned only one result. All other documented cases of injury to these muscle groups are confined to noncontact mechanisms or delayed presentations. Despite conventional teaching, the action of the deep external rotators of the hip appears to be positionally dependent. Knowledge of this type of injury and mechanism may be useful for future clinical reasoning and differential diagnosis in patients with this type of presentation.
Assuntos
Traumatismos em Atletas , Músculo Esquelético , Entorses e Distensões , Humanos , Masculino , Adulto Jovem , Traumatismos em Atletas/diagnóstico por imagem , Traumatismos em Atletas/terapia , Austrália , Diagnóstico Diferencial , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/lesões , Volta ao Esporte , Entorses e Distensões/diagnóstico por imagem , Entorses e Distensões/terapia , EsportesRESUMO
OBJECTIVE: The aim of our study was to assess a group of patients with calf muscle tears and evaluate the integrity of the connective tissue boundaries and interfaces. Further, we propose a novel MRI grading system based on integrity of the connective tissue and assess any correlation between the grading score and time to return to play. We have also reviewed the anatomy of the calf muscles. MATERIALS AND METHODS: We retrospectively evaluated 100 consecutive patients with clinical suspicion and MRI confirmation of calf muscle injury. We evaluated each calf muscle tear with MRI for the particular muscle injured, location of injury within the muscle and integrity of the connective tissue structure at the interface. The muscle tears were graded 0-3 depending on the degree of muscle and connective tissue injury. The time to return to play for each patient and each injury was found from the injury records and respective sports doctors. RESULTS: In 100 patients, 114 injuries were detected. Connective tissue involvement was observed in 63 out of 100 patients and failure (grade 3 injury) in 18. Mean time to return to play with grade 0 injuries was 8 days, grade 1 tears was 17 days, grade 2 tears was 25 days and grade 3 tears was 48 days (p<0.001). CONCLUSION: The integrity of the connective tissue can be used to estimate and guide the time to return to play in calf muscle tears.
Assuntos
Traumatismos em Atletas/diagnóstico por imagem , Tecido Conjuntivo/lesões , Traumatismos da Perna/diagnóstico por imagem , Músculo Esquelético/lesões , Volta ao Esporte , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Ruptura , Adulto JovemRESUMO
Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in 'muscle strain'. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thigh 'muscle strain'.
Assuntos
Traumatismos em Atletas/etiologia , Músculo Esquelético/lesões , Entorses e Distensões/etiologia , Traumatismos dos Tendões/etiologia , Coxa da Perna/lesões , Traumatismos em Atletas/patologia , Traumatismos em Atletas/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Recuperação de Função Fisiológica/fisiologia , Recidiva , Ruptura/etiologia , Ruptura/patologia , Ruptura/fisiopatologia , Entorses e Distensões/patologia , Entorses e Distensões/fisiopatologia , Traumatismos dos Tendões/patologia , Traumatismos dos Tendões/fisiopatologiaAssuntos
Dor Aguda/terapia , Dor Musculoesquelética/terapia , Manejo da Dor/métodos , Esportes , Terminologia como Assunto , Dor Aguda/diagnóstico por imagem , Dor Aguda/etiologia , Dor Aguda/psicologia , Atletas/psicologia , Traumatismos em Atletas , Comunicação , Tomada de Decisão Compartilhada , Humanos , Dor Musculoesquelética/diagnóstico por imagem , Dor Musculoesquelética/etiologia , Dor Musculoesquelética/psicologia , Encaminhamento e Consulta , Autoeficácia , Esportes/psicologiaAssuntos
Traumatismos em Atletas/mortalidade , Futebol/lesões , Adolescente , Adulto , Traumatismos em Atletas/história , Traumatismos em Atletas/prevenção & controle , Austrália/epidemiologia , Criança , Feminino , Futebol Americano/história , Futebol Americano/lesões , Futebol Americano/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Masculino , Jornais como Assunto/história , Jornais como Assunto/estatística & dados numéricos , Segurança , Futebol/história , Futebol/estatística & dados numéricos , Adulto JovemRESUMO
Despite increased knowledge of hamstring muscle injuries, the incidence has not diminished. We now know that not all hamstring injuries are the same and that certain types of injuries require prolonged rehabilitation and return to play. The slow stretch type of injury and injuries involving the central tendon both require longer times to return to play. A number of factors have been proposed as being indicators of time taken to return to play, but the evidence for these is conflicting. Recurrence rates remain high and it is now thought that strength deficits may be an important factor. Strengthening exercise should be performed with the hamstrings in a lengthened position. There is conflicting evidence regarding the efficacy of platelet-rich plasma injection in the treatment of hamstring injuries so at this stage we cannot advise their use. Various tests have been proposed as predictors of hamstring injury and the use of the Nordboard is an interesting addition to the testing process. Prevention of these injuries is the ultimate aim and there is increasing evidence that Nordic hamstring exercises are effective in reducing the incidence.
Assuntos
Traumatismos em Atletas/prevenção & controle , Músculo Esquelético/lesões , Traumatismos em Atletas/reabilitação , Terapia por Exercício/métodos , Humanos , Plasma Rico em Plaquetas , Recidiva , Volta ao EsporteRESUMO
OBJECTIVE: To assess workload-related risk factors for injuries to particular tissue types in cricket fast bowlers. DESIGN: 235 fast bowlers who bowled in 14600 player innings over a period of 15 years were followed in a prospective cohort risk factor study to compare overs bowled in each match (including preceding workload patterns) and injury risk in the 3-4â weeks subsequent to the match. Injuries were categorised according to the affected tissue type as either: bone stress, tendon injuries, muscle strain or joint injuries. Workload risk factors were examined using binomial logistic regression multivariate analysis, with a forward stepwise procedure requiring a significance of <0.05. RESULTS: High acute match workload and high previous season workload were risk factors for tendon injuries, but high medium term (3-month workload) was protective. For bone stress injuries, high medium term workload and low career workload were risk factors. For joint injuries, high previous season and career workload were risk factors. There was little relationship between muscle injury and workload although high previous season workload was slightly protective. CONCLUSIONS: The level of injury risk for some tissue types varies in response to preceding fast bowling workload, with tendon injuries most affected by workload patterns. Workload planning may need to be individualised, depending on individual susceptibility to various injury types. This study supports the theory that tendons are at lowest risk with consistent workloads and susceptible to injury with sudden upgrades in workload. Gradual upgrades are recommended, particularly at the start of a bowler's career to reduce the risk of bone stress injury.
Assuntos
Osso e Ossos/lesões , Articulações/lesões , Músculos/lesões , Traumatismos dos Tendões/etiologia , Atletismo/lesões , Traumatismos em Atletas/epidemiologia , Traumatismos em Atletas/etiologia , Austrália/epidemiologia , Humanos , Estudos Prospectivos , Fatores de Risco , Entorses e Distensões/epidemiologia , Entorses e Distensões/etiologia , Estresse Psicológico , Traumatismos dos Tendões/epidemiologia , Carga de TrabalhoRESUMO
BACKGROUND: Heterogeneous taxonomy of groin injuries in athletes adds confusion to this complicated area. AIM: The 'Doha agreement meeting on terminology and definitions in groin pain in athletes' was convened to attempt to resolve this problem. Our aim was to agree on a standard terminology, along with accompanying definitions. METHODS: A one-day agreement meeting was held on 4 November 2014. Twenty-four international experts from 14 different countries participated. Systematic reviews were performed to give an up-to-date synthesis of the current evidence on major topics concerning groin pain in athletes. All members participated in a Delphi questionnaire prior to the meeting. RESULTS: Unanimous agreement was reached on the following terminology. The classification system has three major subheadings of groin pain in athletes: 1. Defined clinical entities for groin pain: Adductor-related, iliopsoas-related, inguinal-related and pubic-related groin pain. 2. Hip-related groin pain. 3. Other causes of groin pain in athletes. The definitions are included in this paper. CONCLUSIONS: The Doha agreement meeting on terminology and definitions in groin pain in athletes reached a consensus on a clinically based taxonomy using three major categories. These definitions and terminology are based on history and physical examination to categorise athletes, making it simple and suitable for both clinical practice and research.
Assuntos
Dor Abdominal/etiologia , Traumatismos em Atletas/etiologia , Virilha/lesões , Esportes/fisiologia , Terminologia como Assunto , Traumatismos em Atletas/prevenção & controle , Traumatismos em Atletas/terapia , Consenso , Diagnóstico por Imagem , Feminino , Impacto Femoroacetabular/reabilitação , Impacto Femoroacetabular/cirurgia , Previsões , Lesões do Quadril/etiologia , Humanos , Masculino , Anamnese/métodos , Avaliação de Resultados da Assistência ao Paciente , Exame Físico/métodos , Fatores de RiscoRESUMO
Recurrent hamstring injuries are a major problem in sports such as football. The aim of this paper was to use a clinical example to describe a treatment strategy for the management of recurrent hamstring injuries and examine the evidence for each intervention. A professional footballer sustained five hamstring injuries in a relatively short period of time. The injury was managed successfully with a seven-point programme-biomechanical assessment and correction, neurodynamics, core stability, eccentric strengthening, an overload running programme, injection therapies and stretching/relaxation. The evidence for each of these treatment options is reviewed. It is impossible to be definite about which aspects of the programme contributed to a successful outcome. Only limited evidence is available in most cases; therefore, decisions regarding the use of different treatment modalities must be made by using a combination of clinical experience and research evidence.
Assuntos
Músculo Esquelético/lesões , Futebol/lesões , Adulto , Traumatismos em Atletas/terapia , Fenômenos Biomecânicos , Protocolos Clínicos , Terapia por Exercício/métodos , Humanos , Traumatismos da Perna/terapia , Imageamento por Ressonância Magnética , Masculino , Força Muscular/fisiologia , Doenças do Sistema Nervoso/etiologia , Doenças do Sistema Nervoso/fisiopatologia , Recidiva , Terapia de Relaxamento/métodos , Fatores de Risco , Corrida/fisiologia , Futebol/fisiologia , YogaRESUMO
INTRODUCTION: Chronic inflammation plays a key role in knee osteoarthritis pathophysiology and increases risk of comorbidities, yet most interventions do not typically target inflammation. Our study will investigate if an anti-inflammatory dietary programme is superior to a standard care low-fat dietary programme for improving knee pain, function and quality-of-life in people with knee osteoarthritis. METHODS AND ANALYSIS: The eFEct of an Anti-inflammatory diet for knee oSTeoarthritis study is a parallel-group, assessor-blinded, superiority randomised controlled trial. Following baseline assessment, 144 participants aged 45-85 years with symptomatic knee osteoarthritis will be randomly allocated to one of two treatment groups (1:1 ratio). Participants randomised to the anti-inflammatory dietary programme will receive six dietary consultations over 12 weeks (two in-person and four phone/videoconference) and additional educational and behaviour change resources. The consultations and resources emphasise nutrient-dense minimally processed anti-inflammatory foods and discourage proinflammatory processed foods. Participants randomised to the standard care low-fat dietary programme will receive three dietary consultations over 12 weeks (two in-person and one phone/videoconference) consisting of healthy eating advice and education based on the Australian Dietary Guidelines, reflecting usual care in Australia. Adherence will be assessed with 3-day food diaries. Outcomes are assessed at 12 weeks and 6 months. The primary outcome will be change from baseline to 12 weeks in the mean score on four Knee injury and Osteoarthritis Outcome Score (KOOS4) subscales: knee pain, symptoms, function in daily activities and knee-related quality of life. Secondary outcomes include change in individual KOOS subscale scores, patient-perceived improvement, health-related quality of life, body mass and composition using dual-energy X-ray absorptiometry, inflammatory (high-sensitivity C reactive protein, interleukins, tumour necrosis factor-α) and metabolic blood biomarkers (glucose, glycated haemoglobin (HbA1c), insulin, liver function, lipids), lower-limb function and physical activity. ETHICS AND DISSEMINATION: The study has received ethics approval from La Trobe University Human Ethics Committee. Results will be presented in peer-reviewed journals and at international conferences. TRIAL REGISTRATION NUMBER: ACTRN12622000440729.
Assuntos
Osteoartrite do Joelho , Humanos , Anti-Inflamatórios , Austrália , Dieta com Restrição de Gorduras , Inflamação/complicações , Osteoartrite do Joelho/terapia , Dor/complicações , Medição da Dor/métodos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou maisAssuntos
Traumatismos em Atletas/mortalidade , Traumatismos em Atletas/prevenção & controle , Austrália/epidemiologia , Traumatismos Craniocerebrais/mortalidade , Traumatismos Craniocerebrais/prevenção & controle , Dispositivos de Proteção da Cabeça , Humanos , Lesões do Pescoço/mortalidade , Lesões do Pescoço/prevenção & controle , Roupa de Proteção , Traumatismos Torácicos/mortalidade , Traumatismos Torácicos/prevenção & controleRESUMO
Evidence suggests that low carbohydrate dietary (LCD) approaches can improve glycaemic control and may result in type 2 diabetes mellitus (T2DM) remission. This systematic literature review (SLR) aimed to assess the effectiveness of technology-enabled LCD interventions in the management of people with prediabetes or T2DM. Data sources included Medline, Embase, CINAHL, and Web of Science. Randomised (RCTs) or non-randomised (non-RCTs) controlled trials investigating the effect of technology-enabled LCDs (<130 g/day) or very low carbohydrate diets (VLCDs < 50 g/day) on glycosylated haemoglobin A1c (HbA1c) for at least three months and published in English between 2009 and 2023 were included. Risk of bias assessment, data extraction, and synthesis were conducted using standard tools and procedures. Six studies (two RCTs and four non-RCTs, total sample, n = 1519) were identified and included in the SLR. Two studies examining LCDs reported significant reductions in mean HbA1c (0.4% and -1.2%) and weight loss (-3.8 kg and -7.5 kg) at one year. Three studies examining VLCDs reported significant reductions in mean HbA1c (-0.8% to -1.3%) and weight loss (-12 kg to -14 kg) up to two years. Technology-enabled LCD or VLCD interventions can be a novel approach in helping people with prediabetes or T2DM self-manage their condition and possibly achieve remission. However, further research is required to determine the sustainability, effectiveness, and safety of this approach.
Assuntos
Diabetes Mellitus Tipo 2 , Estado Pré-Diabético , Adulto , Humanos , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta , Hemoglobinas Glicadas , Estado Pré-Diabético/terapia , Redução de Peso , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Low-carbohydrate dietary approaches can lead to improvements in blood glucose levels and weight loss, as well as a reduction and/or cessation in medication use in people with type 2 diabetes (T2D). Recent technological advances have led to the development of health-related applications (apps), including a high proportion dedicated to the management of diabetes. The Defeat Diabetes Program is a smartphone- and web-based app that provides guidance on a low-carbohydrate dietary approach for T2D and was designed to be used in conjunction with standard care in the medical management of T2D. The primary aim of this protocol is to provide the rationale and design of a single-arm 12-month pre-post intervention clinical trial using the Defeat Diabetes Program in an Australian community-based cohort of people with T2D who were referred by their general practitioner (GP). The study seeks to engage the GP community to help demonstrate whether the results of using a low-carbohydrate dietary approach for T2D can be achieved by the Defeat Diabetes Program in their patients. This protocol describes (1) the rationale for the selection of primary and secondary outcome measures, (2) the sampling procedures and methodological steps used to identify eligible participants and collect data, and (3) the approach followed to involve and educate GPs to support the trial.
Assuntos
Diabetes Mellitus Tipo 2 , Humanos , Austrália , Hemoglobinas Glicadas , Comportamentos Relacionados com a Saúde , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Sports ankle injuries present commonly in the general practice setting. The majority of these injuries are inversion and plantar flexion injuries that result in damage to the lateral ligament complex. OBJECTIVE: The aim of this article is to review the assessment and management of sports ankle injuries in the general practice setting. DISCUSSION: Assessment of an ankle injury begins with a detailed history to determine the severity, mechanism and velocity of the injury, what happened immediately after and whether there is a past history of inadequately rehabilitated ankle injury. Examination involves assessment of weight bearing, inspection, palpation, movement, and application of special examination tests. Plain X-rays may be helpful to exclude a fracture. If the diagnosis is uncertain, consider second line investigations including bone scan, computerised tomography or magnetic resonance imaging, and referral to a sports physician. Manage all lateral ligament complex ankle sprains with ice, compression, elevation where possible and analgesia. Severe ligament sprains or rupture benefit from a brief period of immobilisation. After initial management, the athlete should complete a 6 week guided rehabilitation program. Athletes with moderate to severe lateral ankle ligament sprains should wear a semirigid or rigid ankle orthosis for at least 6 months following injury.
Assuntos
Traumatismos do Tornozelo/diagnóstico , Traumatismos do Tornozelo/terapia , Traumatismos em Atletas , Padrões de Prática Médica , Adolescente , Traumatismos do Tornozelo/fisiopatologia , Traumatismos do Tornozelo/reabilitação , Austrália , Testes Diagnósticos de Rotina , Medicina de Família e Comunidade , Feminino , HumanosRESUMO
PURPOSE: Our purpose was to define the macroscopic anatomy of the infrapatellar fat pad (IFP) when viewed at arthroscopy and to document the common variations. METHODS: Ninety-six consecutive patients between 8 and 50 years of age with no previous knee surgery or fat pad pathology underwent arthroscopic examination of the knee. The fat pad of each patient was observed and described regarding size, color, consistency, and the presence of lobules, villous synovium, and lingulae. RESULTS: The macroscopic arthroscopic anatomy of the IFP was defined. Male fat pads were larger than female fat pads. Two separate parts were described-medial and lateral-with medial dominence being most typical. The specific normal anatomic appearance of each section was defined regarding size, color, consistency, and attributes. Ligamentum mucosum, as the separation limit between the sections, was found in most knees. CONCLUSIONS: The macroscopic anatomy of the IFP is described at arthroscopy performed for internal pathology of the knee. Two distinct parts were defined-medial and lateral-with medial dominance. A typical fat pad was yellow and included an infrapatellar lingula (85%), lobulation (65%), and villous synovium (65%). We found a ligamentum mucosum in 79% of cases. CLINICAL RELEVANCE: Knowledge of the macroscopic anatomy of the IFP and variations will allow the accurate diagnosis of pathology of the fat pad, rather than being a diagnosis of exclusion.
Assuntos
Tecido Adiposo/anatomia & histologia , Artroscopia , Joelho/anatomia & histologia , Adolescente , Adulto , Criança , Feminino , Humanos , Traumatismos do Joelho/patologia , Traumatismos do Joelho/cirurgia , Masculino , Pessoa de Meia-Idade , Valores de Referência , Adulto JovemRESUMO
OBJECTIVE: To evaluate whether patient characteristics and/or radiographic disease patterns predict symptomatic response to treatment with glucosamine in osteoarthritis (OA) of the knee. DESIGN: Exploratory prospective correlational study. SETTING: Institutional. PATIENTS: 39 participants with chronic knee pain from the local community. INTERVENTIONS: Glucosamine sulphate (1.5 g/day) for 12 weeks. MAIN OUTCOME MEASURES: Pain and physical function were assessed with visual analogue scales (VASs) and participant-perceived global change scores (GCSs). Regression modelling evaluated the relationship between treatment outcome and age, body mass index (BMI), pain and function self-efficacy and presence/absence of osteophytes in the medial and lateral tibiofemoral joint (TFJ) and patellofemoral joint (PFJ) compartments. RESULTS: 13 (33%) participants were men. The mean (SD) age and BMI were 53.6 (13.1) years and 27.9 (4.6) kg/m(2), respectively. 13 (33%), 19 (49%) and 24 (62%) participants had medial TFJ, lateral TFJ and PFJ osteophytes, respectively. Glucosamine significantly improved pain (mean change on VAS = -1.4, 95% CI -0.6 to -2.2; p = 0.002) and activity restriction (-1.9, 95% CI -1.0 to -2.8; p<0.001). At 12 weeks, 30 (77%) and 27 (69%) participants reported improvement in pain and physical function, respectively. Regression modelling showed that no evaluated variables predicted change in pain on VAS. Decreased function self-efficacy, presence of PFJ osteophytes and absence of medial TFJ osteophytes predicted functional improvement on VAS. BMI, pain self-efficacy and function self-efficacy predicted improvement in pain by GCS. CONCLUSIONS: Although glucosamine significantly improved symptoms, most of the variance in outcome at 12 weeks was unexplained by the predictors evaluated. However, glucosamine may be more effective at improving symptoms in patients with knee OA who have a lower BMI, PFJ osteophytes and lower functional self-efficacy.