Effects of a progressive resistance exercise program in patients with hand osteoarthritis: A randomized, controlled trial with a blinded assessor.

OBJECTIVE: To assess the effectiveness of a progressive resistance strength program on pain, function and strength in hand osteoarthritis patients. DESIGN: Randomized controlled trial. SETTINGS: Outpatients, University Hospital. SUBJECTS: Sixty hand osteoarthritis patients were randomly allocated to exercise group (n = 30) or control group (n = 30). INTERVENTION: The exercise group performed a progressive resistance strength program for hand muscles over 12 weeks. Both groups had a single education session. MAIN MEASURES: The primary outcome was pain intensity (numeric pain scale). The secondary outcomes were - AUSCAN Hand Osteoarthritis Index, Cochin Hand Functional Scale for function and grip and pinch strength. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks. RESULTS: The mean age were 68.9 (8.8) and 64.7 (8.9) for control and exercise groups, respectively. No significant differences between-group was observed for pain after 12 weeks (mean difference between groups was -1.30 (-0.02 to 2.62) for dominant hand and -1.33 (0.01-2.65) for non-dominant hand at T12, with P = 0.085 and 0.295, respectively). Regarding secondary outcomes, statistically significant differences between groups were found in exercise group: AUSCAN index - total score (P = 0.005), pain (P = 0.006), function (P = 0.047), and Cochin scale (P = 0.042) with the following mean difference between groups: -9.9 (4.07-15.73), -3.26 (1.06-5.46), -5.03 (1.20-8.86), and -6.27 (0.18-12.36), respectively. CONCLUSION: No difference was observed for pain (numerical pain scale) after the progressive resistance exercise program performed, however in exercise group, an improvement was observed on secondary outcomes such as pain during activities and function for patients with hand osteoarthritis. LEVEL OF EVIDENCE: 1b.

Serum platelet-activating factor acetylhydrolase activity: a novel potential inflammatory marker in type 1 diabetes.

Plasma activity of the platelet-activating factor acetylhydrolase (PAF-AH) plays an important role in inflammation and atherosclerotic process in chronic diseases. We aimed to evaluate the levels of PAF-AH activity and their association with the metabolic profile and chronic complications in patients with type 1 diabetes. The study included 118 outpatients (54 males) aged 27.1+/-11.3 years with disease duration of 12.3+/-8.5 years with (n=38) or without (n=80) diabetes complications and 96 control subjects (48 males) matched for age, gender, body mass index and smoking habits. The serum levels of PAF-AH activity were higher in patients either with or without chronic complications (16+/-5.3 and 14+/-5.4 nmol/(min mL), respectively) than in controls (13+/-5.1 nmol/(min mL), P=0.02). In the total population, PAF-AH activity was correlated with age, HDL-cholesterol, total cholesterol and LDL-cholesterol. In patients, PAF-AH activity was correlated with age, HbA1c, uric acid, HDL-cholesterol, cholesterol, LDL-cholesterol, cholesterol/HDL-cholesterol ratio and the LDL-cholesterol/HDL-cholesterol ratio. It is concluded that PAF-AH plasma activity could be a novel candidate for low-grade inflammatory marker in patients with type 1 diabetes.