Comparing Knee Kinetics and Kinematics in Healthy Individuals and Those With Knee Osteoarthritis, With and Without Flat Feet.

Individuals with knee osteoarthritis (KOA) and flat feet are more likely to experience increased pain and cartilage damage. This study aimed to investigate the knee kinetics, kinematics, pain, and physical function in individuals with moderate symptomatic KOA, in comparison to asymptomatic control participants. Thirty volunteers with moderate KOA (with flat feet n = 15, with normal feet n = 15) and 30 asymptomatic people (with flat feet n = 15, with normal feet n = 15) were evaluated. The knee adduction angular impulse, knee flexion moment, knee flexion angular impulse, and knee flexion angle were measured during level walking. The pain was assessed in patients with KOA. The study found that individuals with KOA had a significant increase in the knee adduction angular impulse compared with the asymptomatic people (P < .05). The KOA with flat feet group had significantly lower knee flexion moment, knee flexion angular impulse, and knee flexion angle values than the KOA with normal feet group (P < .05). Furthermore, the KOA with flat feet group had a higher pain score than the KOA with normal feet group. Individuals with osteoarthritis and flat feet had lower knee flexion moments which may indicate reduced knee force exerted through compensatory mechanisms. Despite this reduction, they reported significantly higher levels of pain compared with those without flat feet, a finding that warrants further investigation in future studies.

Effects of Photobiomodulation Therapy on the Expression of Hypoxic Inducible Factor, Vascular Endothelial Growth Factor, and Its Specific Receptor: A Randomized Control Trial in Patients with Diabetic Foot Ulcer.

Background: Impaired angiogenesis is a significant factor contributing to delayed healing in diabetic foot ulcers (DFUs) due to inadequate oxygenation. Objective: This study aimed to investigate the impact of photobiomodulation (PBM) using a Ga-As laser on the release of serum hypoxia-inducible factor 1-α (HIF-1α), vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor-2, and nitric oxide (NO) in diabetic patients with DFUs. Materials and methods: In this double-blind RCT, a total of 30 patients with grade II DFUs were enrolled. The patients were randomly divided into two groups: the PBM (n = 15) and the placebo (n = 15). In the PBM group, a Ga-As laser (904 nm, 2 J/cm2, 90 W) was given for 3 days/week for 4 weeks (11 sessions). In the placebo group, the power was turned off. Both groups received similar standard wound care. Before and after interventions, the levels of serum HIF-1α, VEGF, NO, and sVEGFR-2 were measured. In addition, the percentage decrease in the wound surface area (%DWSA) was measured. Results: Following the intervention, the results revealed that the PBM group had significantly lower levels of VEGF than the placebo group (p = 0.005). The %DWSA was significantly higher in the PBM group compared to the placebo group (p = 0.003). Moreover, VEGF showed a significant negative correlation with %DWSA (p < 0.001). Conclusions: The observed decrease in serum levels of VEGF and an increase in %DWSA, compared to the placebo group, suggests that PBM effectively improves angiogenesis. Furthermore, the significant correlation found between VEGF levels and %DWSA emphasizes the importance of evaluating wound surface in patients as a dependable indicator of enhanced wound angiogenesis. Clinical Trial Registration: NCT02452086.

Different muscle strategy during head/knee level of functional reaching-transporting task to decrease falling probability in postmenopausal women with osteoporosis.

BACKGROUND: The reaching-transporting task as an essential daily activity impacts balance control and falling in older women. This study investigated the different muscle strategies during the head/knee level of the functional reaching-transporting task in postmenopausal women with osteoporosis. METHODS: 24 postmenopausal volunteers were classified into two groups based on the lumbar T-score: osteoporosis (≤ -2.5, n = 12) and non-osteoporosis (> -1, n = 12). Using a custom-designed device, participants randomly performed 12 reaching-transporting tasks at the head and knee levels. Electromyography signals were collected while reaching and transporting phases with a wireless system. The peak of the root means square (PRMS) and time to PRMS (TPRMS) were measured. In addition, the isometric muscle strength and the fear of falling were assessed. RESULTS: The isometric muscle strength in the osteoporotic group was significantly lower than in the non-osteoporotic group (P < 0.05), except for vastus lateralis (VL). The PRMS of VL, (P = 0.010) during the reaching phase and VL (P = 0.002) and gastrocnemius lateralis (GL) (P < 0.001) during transporting phase was greater than the non-osteoporotic group. The PRMS value of the muscles was greater for reaching-transporting at the knee level than the head level; this increase was significant just for VL and biceps femoris during the transporting phase (P = 0.036 and P = 0.004, respectively). CONCLUSION: Osteoporotic women have more muscle activities during the reaching-transporting task, especially at the knee level, compared to the head level. Their muscle weakness may lead to insufficient stability during the task and cause disturbance and falling, which requires further investigation.

The Acute Effects of 2 Different Intensities of Resistance Exercise on Autonomic Function in Heart Failure Patients: A Randomized Controlled Trial.

BACKGROUND: Although a wide spectrum of resistance exercise intensities was recommended in the guidelines, none of them investigated the acute effects of different intensities of the resistance exercise on cardiac autonomic function in patients with chronic heart failure. This study aimed to investigate the acute effects of the low and high intensities of the resistance exercise on heart rate variability in chronic heart failure. METHODS: This randomized controlled trial was performed between October 2019 and December 2020. Fifty-seven patients with chronic heart failure (New York Heart Association class II and class III) underwent hemodynamic, functional capacity, and heart rate variability (time and frequency domains) assessments. They were randomly divided into R1, R2, and control groups. The intervention consisted of performing a short aerobic exercise including 15 minutes of walking at an intensity of 50% reserved heart rate for all 3 groups and additional resistance exercise with the intensity of 50% 1-repetition maximum and 75% 1-repetition maximum for R1 and R2 groups, respectively. RESULTS: The standard deviation of normal to normal intervals and standard deviation of average NN intervals became significantly lower in R2 (P =.031), and both high-frequency power and low-frequency power were significantly higher in R1 (P =.039 and P =.004, respectively) after the intervention. No significant changes were observed in the control group. Between-group changes were not significant for hemodynamics and functional capacity after treatment. The between-group comparison demonstrated a significant increase in root mean square of successive differences of the NN intervals in R1 in comparison to the control (P =.035). CONCLUSIONS: These findings indicate that resistance exercise in 50% 1-repetition maximum in comparison to 75% 1-repetition maximum had more favorable effects on the heart rate variability in chronic heart failure.

Virtual Reality Exergaming Capability to Change Muscle Strategy During the Limits of Stability Test and Reduce Fear of Falling in Primary Osteoporotic Women.

Objective: Muscle strength and balance impairment change the control strategy and increase the probability of falling. This study aimed to investigate the effect of 6-week strength-balance training through virtual reality exergaming (VRE) on muscle strategy during the limits of stability (LOS) test, fear of falling, and quality of life (QOL) in osteoporotic women. Materials and Methods: Twenty volunteer postmenopausal women with osteoporosis were randomly allocated to the VRE (n = 10) and traditional training (TRT as control, n = 10) groups. The VRE and TRT strength-balance training was performed for 6 weeks and three sessions per week. Before and after exercise, the muscle activity (onset time, peak root means square [PRMS]) and hip/ankle activity ratio were assessed by the wireless electromyography system. The muscle activities of the dominant leg were recorded during LOS functional test. The fall efficacy scale and QOL were assessed. Paired t-test was used to compare results within groups, and an independent t-test was used to compare the percentage changes in parameters between the two groups. Results: The VRE improved the onset time and PRMS. The VRE significantly reduced the hip/ankle activity ratio in the LOS test's forward, backward, and right directions (P < 0.05). No significant change was seen in all directions of the LOS functional test in the TRT group (P > 0.05). VRE reduced the fall efficacy scale (P = 0.042). Both VRT and TRT improved the total QOL score (P = 0.010). Conclusion: VRE was more effective in decreasing the onset time and hip/ankle ratio of muscle activation. The VRE is recommended to induce a better ability to reduce the fear of falling and control balance during functional activity in osteoporotic women. Clinical Trial Registration number: IRCT20101017004952N9.

Validation study of the Persian version of the subjective exercise experiences scale (SEES) in Iranian adult individuals.

BACKGROUND: Subjective exercise experiences scale (SEES) is a 12-item questionnaire assessing global psychological responses to exercise, with three constructs including positive well-Being (PWB), psychological distress (PD), and fatigue (FAT). The present study aimed to assess the reliability and validity of the SEES questionnaire in the Iranian population. METHOD: This cross-sectional psychometric study was conducted on 138 adults immediately after 30 min of walking. The internal consistency of the questionnaire was evaluated with Cronbach's alpha coefficient. To assess the test-retest reliability, 38 of the participants were requested to fill in the questionnaire again after a week. The test-retest reliability was analyzed using the intra-class correlation coefficient (ICC). The concurrent validity was examined through the correlation matrix between the domains of SEES and SF12. Principle component analysis was performed to determine the factor loading of the measured variables. IBM SPSS statistics 24 was used for all calculations. RESULTS: Cronbach's alpha was 0.82, 0.82, and 0.81 for the PWB, PD, and FAT, respectively. The ICC value was acceptable for all subscales (ICC for PWB, PD, and FAT were 0.83, 0.88, and 0.74 respectively). There was a weak to moderate correlation between the SEES and SF-12 subclasses. Factor analysis confirmed the three-factor structure of the instrument, explaining 67.21% of the observed variance. Item 3 didn't fit in well with the three constructs and was deleted from the Persian version of the SEES. CONCLUSIONS: The Persian version of the SEES is a valid and reliable instrument to evaluate the psychological response to the exercise stimulus.

The effect of six week virtual reality training on the improvement of functional balance in women with type-I osteoporosis: A preliminary study.

Purpose: This preliminary study aimed to investigate the effects of exergames in a virtual reality environment to improve functional balance during goal-directed functional tasks in postmenopausal women with osteoporosis. Methods: Twelve volunteer postmenopausal women with osteoporosis were randomly assigned to virtual reality (VRT, n = 6) and conventional multimodal (CMT, n = 6) training groups. The exercise was performed for 6 weeks, 3 days weekly, and 18 sessions. Using a force platform, functional balance assessments were made through four dynamic tasks, including performance-based limits of stability (LOS), curve tracking (CT), sit-to-stand (STS), and turning before and after 18 sessions of treatment. Each task's time-dependent center of pressure (COP) variables was separately calculated via Kistler-Mars software. Results: The COP variables of LOS and CT tasks were significantly improved after 6 weeks of CMT and VRT (P ≤ 0.05). In the VRT group, the rising index (P < 0.00), COP sway velocity in STS, and Turn sway were significantly reduced (P < 0.05). Following the VRT, the mean difference of forwarding maximum COP excursion increased (P = 0.03), and errors in CT (P = 0.03) significantly decreased. Conclusion: The VRT and CMT improved the COP sway parameters during weight-shifting tasks. The VRT was more effective than CMT in increasing the ability to control weight-shifting and dynamic functional tasks in postmenopausal women with osteoporosis. This approach in training has suitable potential to provide convenient error feedback learning.

Gait modification with subject-specific foot progression angle in people with moderate knee osteoarthritis: Investigation of knee adduction moment and muscle activity.

BACKGROUND: Subject-specific foot progression angle (SSFPA) as a personalized gait modification is a novel approach to specifically reducing knee adduction. OBJECTIVE: This study aimed to investigate the effect of gait modification with SSFPA on the knee adduction moment and muscle activity in people with moderate knee osteoarthritis (KOA). METHODS: In this clinical trial, nineteen volunteers with moderate KOA were instructed to walk in four different foot progression angle conditions (5° toe-out, 10° toe-out, 5° toe-in, and 10° toe-in) to determine SSFPA that caused the greatest reduction in the greater peak of the knee adduction moment (PKAM). Immediately and after 30 minutes of gait modification with SSFPA, peak root means square (PRMS) and medial and lateral co-contraction index (CCI) were evaluated in the knee muscles. RESULT: Walking with 10° toe-in showed the most reduction in the greater PKAM (17.52 ± 15.39%) compared to 5° toe-in (7.1 ± 19.14%), 10° toe-out (1.26 ± 23.13%), and 5° toe-out (7.64 ± 16.71%). As the immediate effect, walking with SSFPA caused a 20.71 ± 12.07% reduction in the greater PKAM than the basic FPA (p < 0.001). After 30 minutes of gait retraining, the greater PKAM decreased by 10.36 ± 26.24%, but this reduction was not significant (p = 0.17). In addition, PRMS of lateral gastrocnemius increased (p = 0.04), and lateral CCI increased 10.72% during late stance (p = 0.04). CONCLUSION: Our findings suggest the immediate effect of gait modification with SSFPA on decreasing the knee adduction moment. After gait retraining with SSFPA, the increase of lateral muscle co-contraction may enhance lateral knee muscle co-activity to unload the medial knee compartment. Clinical Trial Register Number: IRCT20101017004952N8.

Muscle thickness and pennation angle in overweight persons with moderate haemophilia A after resistance and combined training: A randomized controlled trial.

INTRODUCTION: Muscular atrophy and overweightness develop arthropathy in persons with haemophilia (PWH), and exercise increases their muscle strength and decreases their body weight. Musculoskeletal ultrasonography may be a non-invasive, safe, valid, and reliable tool to investigate muscle thickness (MT) and pennation angle (PA) after exercise training. OBJECTIVES: The present study was conducted to evaluate the effects of 6 weeks of resistance training (RT) and combined resistance and aerobic training (CT) on MT and PA in overweight persons with moderate haemophilia A. MATERIALS AND METHODS: Forty-two persons with moderate haemophilia A with a mean age of 35-55 years and a BMI of 25-30 kg/m2 were randomly assigned to three groups of 14, namely RT, CT, and control. The RT group performed 40 minutes of RT, and the CT group performed 20 min of RT and 20 min of aerobic training. The PA and MT of the biceps brachii (BB), triceps brachii (TB), vastus medialis (VM), vastus lateralis (VL), and medial gastrocnemius (MG) were measured before and after the intervention using B-mode ultrasonography. RESULTS: Significant increases were observed in the MT of VM, VL, MG, BB, and TB and PA of VM, VL, and MG in the RT and CT groups compared to the control group (p < .001). No significant differences were observed between the intervention groups. CONCLUSION: Both RT and CT were effective in enhancing MT and PA in overweight persons with moderate haemophilia A.

Regenerative Effect of Low-Intensity Pulsed Ultrasound and Platelet-Rich Plasma on the Joint Friction and Biomechanical Properties of Cartilage: A Non-traumatic Osteoarthritis Model in the Guinea Pig.

This study was aimed at investigating the effects of platelet-rich plasma (PRP) and low-intensity pulsed ultrasound (LIPUS) on the joint friction parameters and biomechanical properties of articular cartilage in a non-traumatic knee osteoarthritis (OA) model. Fifty adult male Dunkin Hartley guinea pigs were randomly divided into five groups: control, OA60, OA + US, OA + PRP and OA + US + PRP). Non-traumatic knee OA was induced with a single dose of 3 mg of mono-iodoacetate (MIA) by intra-articular injection. Intra-articular PRP was injected twice in the OA + PRP and OA + US + PRP groups. LIPUS was delivered in 10 sessions in the OA + US and OA + US + PRP groups. By use of the pendulum free oscillation test, joint friction (coefficient of friction) was measured. In addition, the instantaneous elastic modulus and aggregate modulus were measured using the stress-relaxation test. MIA injection decreased cartilage thickness, instantaneous elastic modulus and aggregate modulus, and increased joint friction. The friction coefficients in the OA + US and OA + US + PRP groups reached near-normal values, and there was no significant difference compared with the control group (p = 0.232 and p = 0.459, respectively). The instantaneous elastic modulus and aggregate modulus in the OA + US group increased significantly compared with the OA + PRP group (p < 0.05). It seems that both LIPUS and PRP injection effectively improved joint lubrication, but LIPUS was superior to PRP in improving the mechanical properties of the articular cartilage.

Are weight shifting and dynamic control strategies different in postmenopausal women with and without type-I osteoporosis?

OBJECTIVE: Tracking postural control processes at dynamic conditions might help develop an appropriate rehabilitation program in osteoporotic women. This study aimed to investigate the differences in center of pressure (COP) control at weight shifting and dynamic tasks between postmenopausal women with and without type-I osteoporosis. Also, we investigated the correlations between bone mineral density (BMD), the activity-specific balance confidence questionnaire (ABC-Q) score, and postural control parameters. METHOD: A total of 62 volunteer postmenopausal women participated in this study. The participants were classified into non-osteoporotic (NOP, T-score >1, n = 35, age = 60.04± 5.33 years) and osteoporotic (OP, T-score < -2.5, n = 27, age = 61.88 ± 5.34 years) groups. The COP sway was recorded using a Kistler force plate during performance-based Limits of Stability (LOS), Curve Tracking (CT), Sit to Stand (STS), and Turn tasks. In addition, the level of balance confidence in daily activities was evaluated by ABC-Q. RESULTS: In the LOS task, COP sway velocity in the anterior direction (P = 0.02) and COP maximum excursion in the side-to-side direction (right-side P = 0.027 and left-side P = 0.044) were significantly lower in the OP than the NOP group. In the CT task, all the quantified parameters, including errors and area, showed significantly lower values in the OP group than the NOP group (P < 0.05). In the STS task, the rising index score was significantly higher in the OP group than the NOP group (P = 0.014). The two groups had an equal ABC-Q score (P = 0.175). The COP sway variables correlated significantly with the lumbar and femoral neck T-score (P < 0.05). CONCLUSION: BMD decline can change weight shifting and dynamic postural control in postmenopausal women.

Effects of short-term aerobic, resistance and combined exercises on the lipid profiles and quality of life in overweight individuals with moderate hemophilia A: A randomized controlled trial.

Background: Overweight is related to increased risks of cardiovascular diseases and dyslipidemia, and reduced quality of life (QOL). Exercise training improves QOL and modifies cardiovascular risk factors and lipid profile. The present study was conducted to compare three types of exercise in terms of their short term effects on QOL and lipid profile in overweight individuals with moderate hemophilia A (IWMHA). Methods: This study was a randomized, controlled, assessor-blinded trial (IRCT20180128038541N1). Sixty IWMHA with a body mass index (BMI) of 25-30 kg/ m2 and a mean age of 35-55 years were randomly assigned to four groups of 15, namely aerobic training (AT), resistance training (RT), combined training (CT) and control. The intervention groups participated in 45-minute exercises three days a week for six weeks. The 36-item short-form health survey (SF-36) was used to measure QOL. Total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), waist-to-hip ratio (WHR), and waist circumference (WC) were measured before and after six weeks of training. For the data analysis using SPSS version 20, the ANCOVA was used to determine the differences among the four groups. Results: A significant decrease was observed in the intervention groups compared to the control group in terms of weight, BMI, LDL-C, TC, WHR, and WC (p<0.05). Significant increase was observed in HDL-C and SF-36 subscales in the intervention groups compared to the control group (p<0.001). There was no significant difference among the intervention groups (p>0.05). In comparison with the control group, more significant improvement was observed in the TC, TG, LDL-C, HDL-L, and SF-36 subscales in the CT group compared to the RT and AT groups. Conclusion: CT was the most effective training method in improving lipid profile and QOL in overweight IWMHA.

Advanced weight-bearing mat exercises combined with functional electrical stimulation to improve the ability of wheelchair-dependent people with spinal cord injury to transfer and attain independence in activities of daily living: a randomized controlled trial.

STUDY DESIGN: Randomized controlled trial. OBJECTIVE: To determine the effects of advanced weight-bearing mat exercises (AWMEs) with/without functional electrical stimulation (FES) of the quadriceps and gastrocnemius muscles on the ability of wheelchair-dependent people with spinal cord injury (SCI) to transfer and attain independence in activities of daily living (ADLs). SETTING: An outpatient clinic, Iran. METHODS: People with traumatic chronic paraplegia (N = 16) were randomly allocated to three groups. The exercise group (EX; N = 5) performed AWMEs of quadruped unilateral reaching and tall-kneeling for 24 weeks (3 days/week). Sessions were increased from 10 min to 54 min over the 24-week period. The exercise-FES group (EX + FES; N = 5) performed AWMEs simultaneously with FES of the quadriceps and gastrocnemius muscles. The control group performed no exercise and no FES (N = 6). The primary outcomes were the total Spinal Cord Independence Measure-III (SCIM-III) to reflect independence with ADL, and the sum of the four SCIM-III transfer items to reflect ability to transfer. There were six other outcomes. RESULTS: The mean (95% CI) between-group differences of the four transfer items of the SCIM-III for the EX vs. control group was 1.8 points (0.2-3.4), and for the EX + FES vs. control group was 2 points (0.4-3.6). The equivalent differences for the total SCIM-III scores were 2.7 points (-0.6-6.0) and 4.1 points (0.8-7.4), respectively. There were no significant between-group differences for any other outcomes. CONCLUSIONS: Advanced weight-bearing mat exercises improve the ability of wheelchair-dependent people with SCI to transfer and attain independence in ADL.

Topical hydrogel containing Fumaria vaillantii Loisel. extract enhances wound healing in rats.

BACKGROUND: Fumaria species (Fumariacea) has traditionally been used in wound healing in Iranian folk medicine. However, with the discovery of newer agents, its use has faded off into total obscurity. This study explored the wound healing potential of a gel containing 10% Fumaria vaillantii Loisel through topical application of total extract in a model of excisional as well as incisional wound healing in albino Wistar rats. METHODS: Rats were anesthetized, and excisional skin wound was established using a sterilized surgical scissors. The animals were then treated with 10% F.vaillantii topical gel formulation along with the gel base. The treatments were administered once a day after the injury for 21 days. For topical treatment, the hydrogel was formulated and evaluated for chemical and physical characteristics. Histopathological analysis with hematoxylin and eosin (H&E) was used for microscopic examination of the skin tissues on 21-day-old sections of excision wound. To verify collagen formation, hydroxyproline determination was performed 21 days post wound healing. Breaking strength was determined in a 10-day-old incision wound by the uniaxial tensile test. RESULTS: Topical administration of F.vaillantii gel formulation significantly enhanced skin wound closure on the 6th post-wounding day compared to both gel base and the negative control, indicating an accelerated wound healing process, while a significant difference was observed on 10th and 14th post -wound days in F.vaillantii treatment compared to the negative control groups. Gel formulation prepared with a 10% F. vaillantii extract exhibited a response in terms of wound epithelialization, angiogenesis and number of hair follicles at wound area better than the gel base on the 21st post-wound day. Application of gel base produced further advantages by increasing hydroxyproline content and collagen fiber thickness. Our results on incision wound model were supported by histopathological data indicating the role of gel base in the enhancement of breaking strength. CONCLUSION: Traditional use of Fumaria species in the skin diseases was justified in this study by revealing the increase in wound healing activity after hydrogel containing F. vaillantii total extract administration.

Postural instability and position of the center of pressure into the base of support in postmenopausal osteoporotic and nonosteoporotic women with and without hyperkyphosis.

In postmenopausal women, thoracic hyperkyphosis affects postural instability in the sagittal plane, whereas osteoporosis affects it in the frontal plane. Decrease of hip muscle strength can be changed the center of pressure distance to the center of base of support. These results may be important to design the therapeutic exercise for decreasing the postural instability. PURPOSE: In this study, we investigated the effect of bone mineral density (BMD) and thoracic kyphosis on the center of pressure (CoP) sway and its location related to the base of support (BoS). METHODS: Ten young and 39 postmenopausal women voluntarily participated in this study. Postmenopausal women were divided into four groups according to the thoracic kyphosis angle (normal kyphotic < 50° ≤ hyperkyphotic) and T-score values. The isometric strength of the trunk and lower limb muscles were measured. The CoP postural sway was measured in a comfortable double stance position, and the location of the CoP was then determined related to the BoS. RESULTS: In both hyperkyphotic groups (osteoporotic and normal BMD), the strength of back extension and hip adduction showed a significant decrease compared to the normal kyphotic groups. In the osteoporotic groups (hyper- and normal kyphotic), hip abduction and ankle plantar flexion were significantly weaker than those in the nonosteoporotic groups. In both hyperkyphotic groups, velocity of the CoP displacement in the anterior-posterior (AP) direction was significantly higher than that in the young group, while, in both of the osteoporotic groups, velocity of the CoP displacement in the medio-lateral (ML) direction was significantly higher than that in the young group. In postmenopausal women, hip extensor strength negatively and significantly correlated with the CoP distance to the center of the BoS. CONCLUSION: It appears that thoracic hyperkyphosis affects postural instability in the AP direction and that a decrease of BMD affects postural instability in the ML direction.

Correction to: "Comparative repair capacity of knee osteochondral defects using regenerated silk fiber scaffolds and fibrin glue with/without autologous chondrocyes during 36 weeks in rabbit model.

The published online of the original version contains mistakes.

The effects of six-week resistance, aerobic and combined exercises on the pro-inflammatory and anti-inflammatory markers in overweight patients with moderate haemophilia A: A randomized controlled trial.

INTRODUCTION: Overweight increases the secretion of pro-inflammatory cytokines and serves as a major risk factor for arthropathy and cardiovascular diseases (CVD). This condition is becoming increasingly prevalent among patients with haemophilia (PWH). Different forms of exercise training could favourably modify weight-related complications, cardiovascular risk factors and the inflammation. AIM: To investigate the effects of resistance, aerobic and combined exercises on the pro-inflammatory and anti-inflammatory markers in overweight patients with moderate haemophilia A. METHODS: Forty-eight patients with moderate haemophilia A, aged 35-55 years, and body mass index (BMI) of 25-30 kg/m2 were randomly assigned to resistance training (RT, n = 12), aerobic (AT, n = 12), combined training (CT, n = 12) and control (n = 12) groups. The patients participated in 45-minutes exercise sessions three times a week for 6 weeks. Waist circumference (WC), waist-to-hip ratio (WHR), fat mass, fat-free mass, interleukin-10 (IL-10), adiponectin, tumour necrosis factor-α (TNF-α), interleukin-6 (IL-6) and high sensitive C-reactive protein (hs-CRP) were measured before and after the 6 weeks of training. RESULTS: There was significant decrease in WC, WHR, BMI and weight in the AT, RT and CT groups as compared to the control group. Total HJHS scores decreased in the AT, RT, CT groups compared to the control groups (P ≤ 0.001). The decrease in hs-CRP, IL-6 and TNF-α in the CT group was significant compared to the control group (P ≤ 0.02). The increase in IL-10 and adiponectin was not significant in the RT, AT and CT groups compared to the control group. CONCLUSION: CT was the most effective training mode for decreasing the pro-inflammatory cytokines and increasing anti-inflammatory markers in overweight patients with haemophilia A.

What is the effect and mechanism of kinesiology tape on muscle activity?

OBJECTIVE: This study aimed to evaluate the effects of kinesiology tape, anesthesia, and kinesiology tape along with anesthesia, on motor neuron excitability. PARTICIPANTS: Participants included 20 healthy men aged 20-35 years, who were examined over 5 sessions. INTERVENTION: The five experimental sessions included: control without applying the kinesiology tape or Eutectic Mixture of Local Anesthetics (EMLA); treatment only with EMLA; only kinesiology tape application; only sham tape application; and treatment with kinesiology tape and EMLA. MAIN OUTCOME MEASURES: The H-reflex recruitment curve of the soleus and lateral gastrocnemius was recorded by a blinded assessor in the 5 separate sessions randomly assigned with 48 h washout periods. The major H-reflex parameters include: the Hmax/Mmax ratio, the H-reflex threshold stimulation intensity (Hth), the intensity of maximum H-reflex (IntensityHmax), the H-reflex ascending slope (Hslp), and the H-reflex ascending slope fixed into the first three points (first Hslp). RESULTS: The H-reflex parameters (H slope, first Hslp, Hth, and IntensityHmax) were facilitated by application of the kinesiology tape with and without EMLA; however, EMLA inhibited the H-reflex parameters (Hmax/Mmax ratio, Hslp, first Hslp, and Hth) in both the soleus and lateral gastrocnemius. The sham tape did not alter the H-reflex recruitment curve parameters. The statistical model revealed a significant difference between the kinesiology tape and the sham tape and control sessions, between kinesiology tape-EMLA and EMLA, and between kinesiology tape-EMLA and control session. CONCLUSIONS: Results suggest that the kinesiology tape facilitates the muscle activity and the underlying mechanism on the gastrosoleus motor neuron pool involves the cutaneous receptors.

In vivo study of non-invasive effects of non-thermal plasma in pressure ulcer treatment.

According to high incidence and prevalence of pressure ulcers worldwide, the purpose of this study is using of non-thermal atmospheric plasma as a novel therapy for pressure ulcers. Cold plasma was produced by applying a high-voltage (5 kV) and high-frequency (25 kHz), to helium gas. Under general anesthesia and sterile conditions, two circular magnets were used to create pressure ulcers on the dorsal skin of adult rats. The wounds were divided randomly into control and plasma-treated groups. Animals in the plasma-treated group received plasma radiation for 5 days, each day 3 times and every time 60 s. Mechanical assays were performed to determine plasma effects on the mechanical strength of the repaired tissue. The results showed that mechanical strength of repaired wound in the plasma-treated group was significantly higher than that in the control group (p < 0.05). In addition, evidence from histological studies indicates a significantly accelerated wound re-epithelialization in comparison with the control group; angiogenesis and fibrosis (collagen synthesis) were also significantly increased and the inflammation phase of wound healing was shorter in the plasma-treated group. The plasma treatment also resulted in significant wound contraction and acceleration of wound healing. The findings of present study indicate the effects of cold plasma on pressure ulcer treatment.

Angiogenic effects of low-intensity cathodal direct current on ischemic diabetic foot ulcers: A randomized controlled trial.

AIMS: This study investigated the effect of low-intensity cathodal direct current (CDC) of electrical stimulation (ES) on the release of hypoxic inducible factor-1α (HIF-1α), nitric oxide (NO), vascular endothelial growth factor (VEGF), and soluble VEGF receptor-2 (sVEGFR-2) in the wound fluid of ischemic diabetic foot ulcers (DFUs). METHODS: This study was a randomized, single-blind, placebo-controlled trial. Thirty type 2 diabetes patients with ischemic foot ulcerations were randomly assigned to receive either low-intensity CDC at sensory threshold (ES group, n=15) or placebo treatment (control group, n=15) for 1h/day, 3days/week, for 4weeks (12 sessions). After debridement during the first and twelfth treatment sessions, wound fluid was collected before and after ES application to determine the levels of HIF-1α, NO, VEGF, and sVEGFR-2. Wound surface area (WSA) was measured at the first, sixth, and twelfth sessions. RESULTS: At the first session, after ES application, wound-fluid levels of HIF-1α were significantly increased (+61.98pg/mL) compared to the control group (-3.85pg/mL, P=0.01). After ES application at the first and twelfth sessions, wound-fluid levels of VEGF were also significantly increased (+36.77 and +39.57pg/mL, respectively) compared to the control group (+4.15 and +0.15pg/mL, P=0.007 and P=0.019, respectively). There was no significant effect on NO and sVEGFR-2 levels between the groups. CONCLUSIONS: Low-intensity CDC has positive effects on the release of HIF-1α and VEGF in the wound area of ischemic DFUs. Furthermore, our results suggest that applying ES to ischemic DFUs can be a promising way to promote angiogenesis and to achieve better outcomes in diabetic wound healing.