Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 9 de 9
Filtrar
1.
Clin Biomech (Bristol, Avon) ; 109: 106097, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37738920

RESUMEN

BACKGROUND: Higher impact loading during walking is implicated in the pathogenesis of knee osteoarthritis. Accelerometry enables the measurement of peak tibial acceleration outside the laboratory. We characterized the relations of peak tibial acceleration to knee pain and impact loading during walking in adults with knee osteoarthritis. METHODS: Adults with knee osteoarthritis reported knee pain then walked at a self-selected speed on an instrumented treadmill for 3 min with an ankle-worn inertial measurement unit. Ground reaction forces and tibial acceleration data were sampled for 1 min. Vertical impact peaks, and average and peak instantaneous load rates were determined and averaged across 10 steps. Peak tibial acceleration was extracted for all steps and averaged. Pearson's correlations and multiple linear regression analyses assessed the relation of peak tibial acceleration to pain and impact loading metrics, independently and after controlling for gait speed and pain. FINDINGS: Higher peak tibial acceleration was associated with worse knee pain (r = 0.39; p = 0.01), and higher vertical average (r = 0.40; p = 0.01) and instantaneous (r = 0.46; p = 0.004) load rates. After adjusting for gait speed and pain, peak tibial acceleration was a significant predictor of vertical average (R2 = 0.33; p = 0.003) and instantaneous (R2 = 0.28; p = 0.02) load rates, but not strongly associated with vertical impact peak. INTERPRETATIONS: Peak tibial acceleration during walking is associated with knee pain and vertical load rates in those with knee osteoarthritis. Clinicians can easily access measures of peak tibial acceleration with wearable sensors equipped with accelerometers. Future work should determine the feasibility of improving patient outcomes by using peak tibial acceleration to inform clinical management.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Adulto , Osteoartritis de la Rodilla/etiología , Marcha , Caminata , Aceleración , Dolor/complicaciones , Fenómenos Biomecánicos
2.
J Orthop Res ; 41(12): 2610-2616, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-37132504

RESUMEN

As the lower extremity is a linked-joint system, the contribution of movements at the hip and ankle, in addition to the knee, to gait patterns should be considered for persons with knee osteoarthritis (OA). However, the relationships of joint coordination variability to OA symptoms, particularly knee pain, and joint loading is unknown. The purpose of this study was to determine the relationship of joint coordination variability to knee pain severity and joint loading in persons with knee OA. Thirty-four participants with knee OA underwent gait analysis. Vector coding was used to assess coordination variability during the early, mid, and late stance phase. Hip-knee coupling angle variability (CAV) during midstance was associated with Knee Injury and Osteoarthritis Outcome Score (KOOS) pain (r = -0.50, p = 0.002) and Visual Analog Scale pain (r = 0.36, p = 0.04). Knee-ankle CAV during midstance was associated with KOOS pain (r = -0.34, p = 0.05). Hip-knee CAV during early and midstance were associated with knee flexion moment (KFM) impulses (r = -0.46, p = 0.01). Knee-ankle CAV during early and midstance were associated with peak KFM (r = -0.51, p < 0.01; r = -0.70, p < 0.01). Moreover, knee-ankle CAV during early, mid, and late stance phase were associated with KFM impulses (r = -0.53, p < 0.01; r = -0.70, p < 0.01; r = -0.54, p < 0.01). These findings suggest that joint coordination variability may be a factor that influences pain and knee joint loading in persons with knee OA. Statement of Clinical Significance: Movement coordination of the hip, knee, and ankle should be considered in the clinical management and future research related to knee OA.


Asunto(s)
Osteoartritis de la Rodilla , Humanos , Dimensión del Dolor , Articulación de la Rodilla , Marcha , Dolor/etiología , Fenómenos Biomecánicos , Caminata
3.
Phys Ther ; 101(11)2021 11 01.
Artículo en Inglés | MEDLINE | ID: mdl-34730830

RESUMEN

OBJECTIVE: The purpose of this study was to describe adverse events (AEs) and dropouts (DOs) in randomized controlled trials of therapeutic exercise for hip osteoarthritis (HOA) and to identify whether Consolidated Standards of Reporting Trials (CONSORT) guidelines were followed. METHODS: The Cochrane Library, Embase, PubMed, and CINAHL databases were searched. Randomized controlled trials of therapeutic exercise for HOA published in English from January 1, 1980 to August 1, 2020 were included. Studies were excluded if other interventions were provided, if participants had previous hip arthroplasty, or if AEs and DOs for HOA participants were not reported separately. The internal validity of each study (Physiotherapy Evidence Database [PEDro] scoring) was assessed, participant and intervention characteristics were extracted, and the existence of a clear statement and reasons for AEs and DOs was reported. Descriptive statistics characterized results. Data heterogeneity prohibited the use of meta-analysis. RESULTS: Fourteen studies (mean PEDro score = 7.4; range = 6-10) from 10 countries were included, with 707 participants exercising. Exercise intensity was unspecified in 72.2% of exercise arms. Six studies (42.9%) included a statement of AEs, and 32 AEs were reported. All studies had a DO statement, but 29.0% of DOs occurred for unknown reasons. Six studies (42.9%) gave reasons for DOs that could be classified as AEs in 9 participants; 41 participants (5.8%) experienced exercise-related AEs. CONCLUSION: Reports of AEs were inconsistent, some DOs were potentially misclassified, and primary components of exercise interventions were frequently unreported. Despite these limitations, the overall low number of nonserious AEs suggests that the exercise-related risk of harm is minimal for individuals with HOA. IMPACT: Understanding the risk of harm associated with exercise for HOA can better inform safe dosing of exercise, clinical implementation, and replicability. Informative, consistent reporting of AEs, DOs, and exercise is needed. Greater use of the CONSORT harms-reporting checklist is warranted.


Asunto(s)
Investigación Biomédica/normas , Terapia por Ejercicio/métodos , Osteoartritis de la Cadera/rehabilitación , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Humanos , Medición de Riesgo
4.
Phys Ther ; 101(10)2021 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-34180534

RESUMEN

OBJECTIVE: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials of therapeutic exercise for knee osteoarthritis (OA). METHODS: Data sources were the Cochrane Library, Embase, PubMed, and CINAHL. Databases were searched to identify randomized controlled trials of therapeutic exercise for knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary outcome was exercise-related harm. Physiotherapy Evidence Database (PEDro) scoring described study quality and risk of bias. Descriptive and inferential statistics characterized results. Meta-analysis was not performed due to data heterogeneity. RESULTS: One hundred and thirteen studies (152 arms) from 25 countries were included, with 5909 participants exercising. PEDro scores ranged from 4 to 9. Exercise intensity was not specified in 57.9% of exercise arms. Fifty studies (44.2%) included an AE statement and 24 (21.2%) reported AEs, yielding 297 patients. One hundred and three studies (91.2%) had a DO statement. Sixteen studies (15.5%) provided reasons for DOs that could be classified as AEs among 39 patients, yielding a 13.1% increase in AEs. Thus, 336 patients (6.0%) experienced exercise-related harm among studies with a clear statement of AEs and DOs. A significant difference existed in misclassification of DOs pre- and post-CONSORT-2010 (12.2% vs 3.1%; $\chi^{2}_{1} = 21.2$). CONCLUSIONS: In some studies, the reason for DOs could be considered AEs, leading to potential underreporting of harm. Improvements in reporting of harm were found pre- and post-CONSORT-2010. Greater clarity regarding AE and DO definitions and therapeutic exercise intensity are needed to determine safe dosing and mode of therapeutic exercise for knee OA. IMPACT: More adherence to the CONSORT statement is needed regarding reporting of and defining of AEs, DOs, and therapeutic exercise intensity; however, despite this, therapeutic exercise seems to be associated with minimal risk of harm.


Asunto(s)
Terapia por Ejercicio , Osteoartritis de la Rodilla/rehabilitación , Ensayos Clínicos Controlados Aleatorios como Asunto , Ejercicio Físico , Humanos , Osteoartritis de la Rodilla/terapia , Medición de Riesgo
5.
Trials ; 22(1): 388, 2021 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-34098998

RESUMEN

BACKGROUND: Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA. METHODS: Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT) to evaluate intervention reporting. Correlations between quality assessment scores and CERT and TIDieR scores evaluated the relationship between internal validity and external applicability. The year of publication was compared to the quality of reporting scores. RESULTS: Fourteen RCTs were included in the analysis. On average, studies were awarded 9.43 ± 1.95 out of 12 points for the TIDieR checklist (range 4-12) and 13.57 ± 4.01 out of 19 points for the CERT (range 5-19). Pearson's correlation coefficient suggested that the quality of reporting had improved over time and that there was a fair, positive relationship between internal validity and external applicability. DISCUSSION: Whilst the quality of intervention reporting is improving, many RCTs of therapeutic exercise in HOA lack the detail necessary to allow accurate evaluation and replication. Researchers are encouraged to utilise the standardised reporting guidelines to increase the translation of effective interventions into clinical practice.


Asunto(s)
Osteoartritis de la Cadera , Lista de Verificación , Consenso , Ejercicio Físico , Terapia por Ejercicio , Humanos , Osteoartritis de la Cadera/diagnóstico , Osteoartritis de la Cadera/terapia
6.
Osteoarthr Cartil Open ; 2(4): 100097, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36474880

RESUMEN

Objective: This study aims to 1) determine the feasibility of conducting a full-scale randomized controlled trial (RCT) evaluating the efficacy of a gait retraining program on decreasing knee pain and impact loading in people with knee osteoarthritis, and 2) provide an estimate of treatment effects for a gait retraining program compared to a traditional walking program. Methods: Forty individuals with knee osteoarthritis will be enrolled in this randomized, double-blind, feasibility trial with two parallel groups. Participants will be randomly allocated to a gait retraining program aimed to decrease peak axial acceleration of the lower leg (i.e., tibia) by 20% or a traditional walking program. Both programs involve 8 sessions of walking on a treadmill. Feasibility will be assessed with recruitment, enrollment, and retention rates, and number of adverse events and unanticipated problems. Treatment effects will be estimated with measures of knee pain and impact loading collected at baseline, follow-up (<1 week post-intervention), and retention (≥1 month post-intervention) visits. Knee pain will be evaluated with the Western Ontario and McMaster Universities Osteoarthritis Index and impact loading will be measured during walking with three-dimensional motion analysis. Conclusion: Findings of this study will inform the feasibility of a full-scale RCT investigating the efficacy of a gait retraining program for people with knee osteoarthritis. Trial registration: (NCT04148807).

7.
Disabil Rehabil Assist Technol ; 13(2): 140-145, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28326859

RESUMEN

We developed a 3D vision-based semi-autonomous control interface for assistive robotic manipulators. It was implemented based on one of the most popular commercially available assistive robotic manipulator combined with a low-cost depth-sensing camera mounted on the robot base. To perform a manipulation task with the 3D vision-based semi-autonomous control interface, a user starts operating with a manual control method available to him/her. When detecting objects within a set range, the control interface automatically stops the robot, and provides the user with possible manipulation options through audible text output, based on the detected object characteristics. Then, the system waits until the user states a voice command. Once the user command is given, the control interface drives the robot autonomously until the given command is completed. In the empirical evaluations conducted with human subjects from two different groups, it was shown that the semi-autonomous control can be used as an alternative control method to enable individuals with impaired motor control to more efficiently operate the robot arms by facilitating their fine motion control. The advantage of semi-autonomous control was not so obvious for the simple tasks. But, for the relatively complex real-life tasks, the 3D vision-based semi-autonomous control showed significantly faster performance. Implications for Rehabilitation A 3D vision-based semi-autonomous control interface will improve clinical practice by providing an alternative control method that is less demanding physically as well cognitively. A 3D vision-based semi-autonomous control provides the user with task specific intelligent semiautonomous manipulation assistances. A 3D vision-based semi-autonomous control gives the user the feeling that he or she is still in control at any moment. A 3D vision-based semi-autonomous control is compatible with different types of new and existing manual control methods for ARMs.


Asunto(s)
Robótica , Dispositivos de Autoayuda , Extremidad Superior , Adulto , Anciano , Diseño de Equipo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Interfaz Usuario-Computador , Adulto Joven
8.
Health Promot Int ; 31(2): 423-9, 2016 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25524471

RESUMEN

A 6-month pilot study explored the effects of a yoga program on the physical activity (PA) level of overweight or obese sedentary adults. Fourteen community-dwelling overweight or obese sedentary adults participated in a 6-month program (2-month yoga program and 4-month follow-up) delivered by two types of instruction [the direct guidance of an instructor (face-to-face group) vs. the self-learning method of using a DVD (DVD group)]. Measurements included program adherence (class attendance and home practice; min/week) and level of PA [metabolic equivalent (MET)-hour/week] at baseline, 2, 4 and 6 months. Descriptive statistics and nonparametric tests were used to describe the sample and examine differences by group and time. There were no significant differences in demographic variables by group assigned. Participants showed significant PA changes from baseline to each measurement point. The direct guidance of an instructor was preferred over the self-learning method. At each time interval, the DVD group showed higher levels of PA than the face-to-face group; the only difference that achieved statistical significance occurred at 4 months. The PA level significantly changed over 6 months in the DVD group, but not in the face-to-face group. The results indicate that a yoga program may be utilized as a 'stepping-stone' toward regular exercise among overweight sedentary adults. Research with a larger sample is needed to further evaluate the effects of the program on the level of PA among this population.


Asunto(s)
Ejercicio Físico , Yoga , Promoción de la Salud/métodos , Humanos , Masculino , Persona de Mediana Edad , Obesidad/prevención & control , Obesidad/terapia , Sobrepeso/psicología , Sobrepeso/terapia , Proyectos Piloto , Conducta Sedentaria , Estados Unidos
9.
J Sch Health ; 84(10): 654-60, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25154529

RESUMEN

BACKGROUND: This study examined the relationship between actual body weight and self-perceived weight, and how perception of one's weight affects weight management behaviors among US adolescents. METHODS: Adolescents ages 16-19 years with objectively-measured weight and height and self-reported perception of weight, weight-loss efforts, and health-related behaviors (N = 642) from the 2009-2010 National Health and Nutritional Examination Survey (NHANES) were included. Sociodemographic variables, body mass index percentile, weight perception, weight-loss efforts, and health-related behaviors were examined using Wald chi-square, Student's t test, analysis of variance, and logistic regression. RESULTS: Approximately 15% were overweight, and 20% were obese; 26% inaccurately perceived their weight. Ethnic minority groups displayed higher rates of overweight and obesity. Overweight adolescents had a higher rate of inaccurate weight perception than obese adolescents. More girls correctly perceived their weight status than boys. Nearly 25% had tried to lose weight during the past year. Among overweight and obese adolescents, accurate weight perception was significantly and positively related to weight-loss efforts after controlling for sociodemographic variables and actual weight. CONCLUSIONS: Accurate body weight perception is a significant factor in adolescents' weight-loss efforts. Targeting counseling for body weight perception and weight management toward boys and overweight adolescents may impact obesity in this age group.


Asunto(s)
Imagen Corporal , Conductas Relacionadas con la Salud , Sobrepeso/psicología , Sobrepeso/terapia , Pérdida de Peso , Adolescente , Índice de Masa Corporal , Pesos y Medidas Corporales , Etnicidad/psicología , Femenino , Humanos , Masculino , Sobrepeso/etnología , Obesidad Infantil/etnología , Obesidad Infantil/psicología , Obesidad Infantil/terapia , Autoimagen , Autoinforme , Factores Sexuales , Factores Socioeconómicos , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...