Emotional experiences and psychological well-being in 51 countries during the COVID-19 pandemic.

The COVID-19 pandemic presents challenges to psychological well-being, but how can we predict when people suffer or cope during sustained stress? Here, we test the prediction that specific types of momentary emotional experiences are differently linked to psychological well-being during the pandemic. Study 1 used survey data collected from 24,221 participants in 51 countries during the COVID-19 outbreak. We show that, across countries, well-being is linked to individuals' recent emotional experiences, including calm, hope, anxiety, loneliness, and sadness. Consistent results are found in two age, sex, and ethnicity-representative samples in the United Kingdom (n = 971) and the United States (n = 961) with preregistered analyses (Study 2). A prospective 30-day daily diary study conducted in the United Kingdom (n = 110) confirms the key role of these five emotions and demonstrates that emotional experiences precede changes in well-being (Study 3). Our findings highlight differential relationships between specific types of momentary emotional experiences and well-being and point to the cultivation of calm and hope as candidate routes for well-being interventions during periods of sustained stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Do the International Competencies of the Sports Physical Therapist need Updating?

In 2005, the International Federation of Sports Physical Therapy (IFSPT) published the Sports Physiotherapy for All project (SPA)(1) which defined four key Roles and 11 Competencies a sports physical therapist should have, setting the standards for international education ever since. The aim of this international perspective is to reflect on the IFSPT competencies of a sports physical therapist and explore the need for an update.

Outcomes of total hip arthroplasty in calcium pyrophosphate deposition disease patients.

OBJECTIVE: We aim to examine the demographics, clinical characteristics, outcomes, and resource utilization following total hip arthroplasty (THA) in patients with and without calcium pyrophosphate deposition (CPPD) disease. METHODS: We queried the National Inpatient Sample database to identify patients who underwent THA between 2006 and 2014. The ICD-9 code 81.51 was used to determine the patients who underwent THA, and of those, we classified 2 groups of patients: (i) those with ICD-9 codes defining CPPD and (ii) those without any CPPD code. Data collection included patient demographics and comorbidities. Outcomes post-THA were mortality, length of stay (LOS), and costs. Associations between CPPD and specific morbidity were evaluated with chi-square tests. T tests were used for continuous variables. RESULTS: Among the 4,111,808 patients who underwent THA, 6198 (0.15 %) had CPPD, with a mean age of 77 years and 64.2 % were females. CPPD patients were more likely to be older (mean age 77 vs 72.7 years; p<0.001) than non-CPPD patients. The Charlson Comorbidity Index score ≥ 2 was more frequently seen in CPPD, however, the mortality post-THA was lower in the CPPD patients (0.7 % vs 1.7 %, OR 0.35, 95 % CI 0.26- 0.47). THA in CPPD patients was associated with a longer mean length of stay (LOS) (6.04 vs 5.15 days, OR 1.15, 95 % CI 1.09-1.22) while mean total charges were not statistically different between the 2 groups (p = 0.344). CPPD patients were more likely to be discharged to rehabilitation or other nursing facilities (42.5 % vs 35.3 %, p<0.001). The number of THA procedures increased in both CPPD and non-CPPD patients over time. CONCLUSIONS: CPPD patients who underwent THA were more likely to be older, with a greater comorbidity burden, longer LOS and discharged to a non-home setting.

Personal belief on elastic tape and tape tension affect perceived performance, but not muscle activity and endurance.

BACKGROUND: Previous studies reported inconsistent outcomes on elastic taping for three potential reasons: 1) poor control of placebo effect; 2) no consensus regarding the optimal tape tension; and 3) lack of investigation on muscle endurance, as the proposed tape recoiling force may not promote peak force generation but exert a consistently low force and improve submaximal contraction. PURPOSE: This study compared the effects of elastic tape and its tension on muscle activity and endurance in people with extremely positive and negative personal belief on elastic tape. METHODS: Using a validated instrument, we identified 20 participants with extremely positive personal belief on elastic tape (+ belief), and 20 with extremely negative personal belief (- belief). They performed wrist isometric endurance tests under three taping conditions (i.e. no tape, 50%, and 100% tension). We measured isometric wrist extensor muscle endurance, electromyography muscle activity, and self-perceived performance for each condition. RESULTS: The differences between the two groups in isometric muscle endurance (p = .85) and muscle activity (p = .53) were not statistically significant, regardless of tape conditions. However, participants with + belief reported better perceived performance than those with - belief (p < .001, partial eta squared = 0.70). Specifically, 100% tape tension yielded stronger self-perceived performance than 50% tension (Cohen's d = 0.91) and no tape (Cohen's d = 1.86). On the other hand, participants with - belief perceived similar performance across tape tensions (p = .55). CONCLUSION: Elastic tape does not modulate muscle activity and enhance muscle endurance. People with a strong positive personal belief on elastic tape may perceive a better performance with a greater tape tension.

Pyoderma gangrenosum in a patient with familial Mediterranean fever and chronic inflammatory seronegative arthropathy: a unique triad.

Familial Mediterranean fever (FMF) is an autoinflammatory disorder characterised by recurrent fever attacks and serositis. Chronic inflammatory seronegative arthropathy affects the spine and peripheral joints and rarely coexists with FMF. Pyoderma gangrenosum (PG) is a neutrophilic dermatosis that manifests as an ulcerative skin disease that uncommonly occurs in patients with FMF. In this case report, we describe a male patient in his 60s with a history of FMF and chronic inflammatory seronegative arthropathy who developed ulcerative skin lesions consistent with PG. A genetic evaluation revealed a pathogenic variant (V726A) and two variants of uncertain significance (F479L and E167D) mutations in the MEFV gene. We hypothesised that the triad of FMF, chronic inflammatory seronegative arthropathy and PG might be linked to the V726A variant, while the presence of the other two variants may have amplified the clinical presentation. Further studies are warranted to confirm our observation.

Effectiveness of gait retraining interventions in individuals with hip or knee osteoarthritis: A systematic review and meta-analysis.

BACKGROUND: Osteoarthritis is a chronic synovial joint disease leading to pain, stiffness, and gait dysfunction, resulting in a significant health and economic burden. Gait retraining strategies and tools are used to address biomechanical gait dysfunction and symptoms in individuals with osteoarthritis. However, there is limited evidence relating to their effectiveness. QUESTION: Do gait retraining strategies and tools improve gait biomechanics and symptoms in individuals with hip or knee osteoarthritis compared to control or alternate intervention? METHODS: Seven databases were searched using key words relating to osteoarthritis, gait retraining, and biomechanics. A best evidence synthesis was conducted on included studies. Where available, a meta-analysis was performed, and the standardised mean difference (SMD) and 95% confidence internals (CI) were reported. RESULTS: Eighteen studies were included. One study investigated gait retraining in participants with hip osteoarthritis and demonstrated limited evidence for improving gait biomechanics. Seventeen studies on knee osteoarthritis were included in the best evidence synthesis with six included in the meta-analysis. Gait retraining strategies which incorporated a real-time biofeedback tool, appear to have strong evidence for effectively modifying walking biomechanics. Moderate evidence was identified to support kinesiology taping improving pain scores. The meta-analysis pooled effect demonstrated significant improvements for knee adduction moment [SMD, -1.10; 95% CI. -1.85, -0.35] and the Western Ontario and McMaster Osteoarthritis Index in favour of gait retraining than a control intervention [SMD, -0.86; 95% CI. -1.33, -0.39]. All other interventions demonstrated evidence that was conflicting, limited, or not in favour of gait retraining. CONCLUSION: Gait retraining may be beneficial for improving biomechanics and symptoms in knee osteoarthritis, however due to the high heterogeneity and limited studies in the analysis, further research is required. Further high quality randomised controlled trials for knee and especially hip osteoarthritis investigating the effects of gait retraining on biomechanics and symptoms are required.

Sports injury prevention programmes from the sports physical therapist's perspective: An international expert Delphi approach.

OBJECTIVE: To provide consensus on how to plan, organize and implement exercise-based injury prevention program (IPP) in sports. DESIGN: Delphi. SETTING: LimeSurvey platform. PARTICIPANTS: Experienced sports physical therapists from the International Federation of Sports Physical Therapy member countries. MAIN OUTCOME MEASURES: Factors related to sports IPP planning, organization and implementation. RESULTS: We included 305 participants from 32 countries. IPP planning should be based on an athlete's injury history, on pre-season screening results, and on injury rates (respectively, 98%, 92%, 89% agreement). In total 97% participants agreed that IPP organization should depend on the athlete's age, 93% on the competition level, and 93% on the availability of low-cost materials. It was agreed that IPP should mainly be implemented in warm-up sessions delivered by the head or strength/conditioning coach, with physical training sessions and individual physical therapy sessions (respectively, 94%, 92%, 90% agreement). CONCLUSION: Strong consensus was reached on (1) IPP based on the athlete's injury history, pre-season screening and evidence-based sports-specific injury rates; (2) IPP organization based on the athlete's age, competition level, and the availability of low-cost materials and (3) IPP implementation focussing on warm-up sessions implemented by the strength/conditioning coach, and/or individual prevention sessions by the physical therapist.

Profiles of Recruits Entering Army Basic Training in New Zealand.

INTRODUCTION: A high incidence of musculoskeletal injuries is sustained by army recruits during basic training. Describing recruits' personal, lifestyle, and physical performance characteristics at the entry to training can help identify existing intrinsic risk factors that may predispose some recruits to injury. Identifying modifiable and preventable intrinsic risk factors may contribute to lower recruit injury and associated burdens during the course of basic training. The aim of this study was to therefore describe the profile of New Zealand Army recruits upon entry to basic training using personal, lifestyle, and physical performance characteristics. METHODS: New Zealand Army male and female recruits from two intakes in the same year were invited to participate. Recruits' data on personal (sex, age, height, and weight), lifestyle (self-reported responses to the Military Pre-training Questionnaire comprising physical and injury history, diet, alcohol, and smoking status) and physical performance characteristics (2.4-km timed run, weight-bearing dorsiflexion lunge test, and the Y Balance TestTM for lower limb dynamic stability) were collected and analyzed. RESULTS: Participants included 248 New Zealand Army recruits: 228 males (91.9%), 20 females (8.1%), average age of 20.3 ± 2.8 years. Findings indicated 30.9% of recruits reported injury in the 12 months prior to training commencing, with 44.8% of those injuries in the lower limbs. Pre-entry alcohol consumption was higher than recommended and 20.1% of recruits identified as current smokers. Recruits who passed the 2.4-km timed run included 53.8% of males and 28.6% of females. Weight-bearing dorsiflexion lunge test performance was within a normal range (right = 10.3 ± 3.3 cm), however limb asymmetry (>1.5 cm) was present with 30.9% of recruits. For the Y Balance TestTM for dynamic lower limb stability, 70% of female recruits had high posterolateral reach asymmetry (8.1 ± 6.0 cm), while normalized composite reach scores were low (right) for male (92.2 ± 8.1%) and female recruits (89.0 ± 7.5%). CONCLUSIONS: New Zealand Army recruits entering basic training were predominantly active young males, reported few injuries in the previous year, had higher than recommended alcohol consumption and a minority were smokers. The majority of recruits had low aerobic fitness, average ankle dorsiflexion range, and low dynamic lower limb stability. While a number of adverse characteristics identified are potentially modifiable, more research is required to identify an association to musculoskeletal injury risk in New Zealand Army recruits. Describing the profile of recruits entering training, particularly recruits at risk of injury is one of the first steps in injury prevention.

Prevalence of Musculoskeletal Injuries in New Zealand Army Recruits as Defined by Physical Therapy Service Presentations.

INTRODUCTION: Army recruit injuries occurring during basic training can lead to high personal and organizational burdens potentially threatening deployment capability. Previous military surveillance describing recruit injury as defined by physical therapy presentations is limited to 1-year duration or includes only male infantry recruits or trained personnel. Research describing injury incidence and trends specific to New Zealand Army basic training recruits over a longer period will better inform future injury prevention programs. AIMS: To identify the incidence and patterns of injuries reported from physical therapy presentations for New Zealand Army recruits undertaking basic training over a 4-year period. MATERIALS AND METHODS: This retrospective observational study identified injuries from physical therapy service presentations in New Zealand Army recruits from 2008 to 2011. All male and female New Zealand Army recruits who presented to physical therapy, following medical triage, were included. Recruit physical therapy presentations for injury and respiratory and other conditions were collated. Injury incidence was grouped by body region (upper limbs, lower limbs, and combined spinal regions) and site (joint or segment), and cumulative and injury incidence rates were calculated. RESULTS: One thousand eight hundred and ninety-six (1,697 males and 199 females) New Zealand Army recruits commenced basic training between 2008 and 2011. One thousand six hundred and eighty-three physical therapy presentations occurred for recruit injury during New Zealand Army basic training over 4 years. Lower limb injuries accounted for over 75% (n = 1,285) of the overall demand for physical therapy service during recruit basic training. Injuries sustained at the knee and below accounted for 67% of all reported injury presentations. CONCLUSION: Four years of injury surveillance using physical therapy presentations identified the lower limb, with the knee and below as the most commonly injured regions in New Zealand Army recruits. Injury prevention interventions for New Zealand Army recruits should aim to reduce lower limb injuries. Future research on injury surveillance would benefit from incorporating clear injury and severity definitions, established injury classification systems, and standardized incidence calculations.

Immune Dysregulation in Patients With Chromosome 18q Deletions-Searching for Putative Loci for Autoimmunity and Immunodeficiency.

Introduction: Autoimmune disorders, IgA deficiency, and allergies seem to be common among individuals with 18q deletion syndrome [OMIM 601808]. We aimed to determine the prevalence, mechanism, and genetic background of autoimmunity, immune deficiency, and allergy in a cohort of patients with 18q deletions. Material and Methods: Medical registries and social media were used to recruit the patients. Microarray oligonucleotide comparative genomic hybridization (aCGH) (Agilent, Santa Clara, CA, USA) was performed in all patients to identify size and location of chromosome 18 deletion. Clinical evaluation and medical record collection were performed in each of the study participants. The history of autoimmune disorders, severe and/or recurrent infections, and symptoms of allergy were noted. Total immunoglobulin IgG, IgA, IgM, IgE, and IgG1-4 serum levels were measured using nephelometry and ELISA methods. Lymphocyte T subset phenotyping was performed in 24 subjects from 18q del cohort. To predict the most promising candidate genes, we used the ENDEAVOUR-a free web resource for gene prioritization. Results: 18q deletion was confirmed by means of array CGH analysis in 27 individuals, 15 (55.6%) females and 12 males, referred to the project by specialists in medical genetics, diabetology, or pediatric endocrinology between May 2015 and December 2019. The mean age at examination was 11.8 years (min-max: 4.0-33.5). Autoimmune disorders were present in 14/27 (51.8%) of the cohort. In eight of patients, symptoms of immune deficiency coexisted with autoimmunity. Allergy was reported in nine of 27 (33.4%) patients. Over 89% of patients presented with at list one type of immunoglobulin (IgA, IgM, IgG, IgE, and IgG1-4) deficiency and eight of 25 (32%) had abnormalities in at least two major immunoglobulin (IgG, IgA, IgM) measurements (CVID-like phenotype). Patients with 18q del exhibited a significantly decreased CD4, Treg FOXP3+, TregFOXP3+Helios+, and TemCD4 cell numbers in comparison with the control groups of 24 T1DM patients and 28 healthy controls. Conclusions: Patients with 18q deletions frequently suffer from autoimmune disorders, recurrent infections, and allergy due to immune dysregulation presenting with variable antibody deficiencies and T-regulatory cell deficiency (CD4+CD25+CD127lowFOXP3+). The spectrum of speculations regarding which gene might be responsible for such phenotype ranges from single gene haploinsufficiency to deletion of a cluster of immunogenes located distally to 18q21.

Remitting seronegative symmetrical synovitis with pitting oedema following BNT162b2 mRNA COVID-19 vaccination.

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) is a rare inflammatory condition that occurs in older adults. Here, we report a case of an 80-year-old man with no history of rheumatic disease who presented with acute onset of bilateral hand pain, pitting oedema and synovitis after the second dose of the BNT162b2 mRNA C0VID-19 vaccine. Laboratory workup revealed elevated inflammatory markers and negative autoantibodies. Significant improvement was noted with prednisolone. This is the first reported case of RS3PE in an elderly patient with no previous rheumatic disease following mRNA COVID-19 vaccination.

Method validation for the determination of 314 pesticide residues using tandem MS systems (GC-MS/MS and LC-MS/MS) in raisins: Focus on risk exposure assessment and respective processing factors in real samples (a pilot survey).

A multi-residue method for the simultaneous analysis of a wide range of pesticides in raisins using liquid and gas chromatography-tandem mass spectrometry (LC-MS/MS and GC-MS/MS) has been validated. Pesticides are extracted from raisins with ethyl acetate, followed by centrifugation. The validation study was in accordance with DG SANTE guidelines. Validation experiments have been performed in both analytical instruments. A total number of 314 pesticides were spiked in raisins of organic farming at two spiking levels for GC-MS/MS (0.025 and 0.1 mg/kg), and at three spiking levels for LC-MS/MS (0.005, 0.05, and 0.1 mg/kg) with 6 replicates at each concentration. The scope of validation included linearity, limits of quantification (LOQ), accuracy, precision, and matrix effects (%) for each pesticide. The validated method was then applied for the analysis of 37 commercial raisin samples purchased from the market. For the evaluation of the results, processing factors (PFs) have been applied to derive the amount of residue in raisins, from the maximum residue levels (MRLs) of grapes, and which in this paper will be referred as to the MRL expressed in raisins. In all conventional samples, pesticides were detected at concentrations above the LOQ. In total, 55 different pesticides were detected. All conventional samples contained multiple pesticides ranging from 2 to 24. On the other hand, samples from organic farming were found to be free of the analysed pesticides. The 13.5% of the examined samples were considered as violations. The exposure assessment for the acute risk of the violating samples indicated that no potential risk derives from the detected and approved in the EU pesticides, while the detection of not approved pesticides in the EU, and the lack of toxicological reference values for certain pesticides raise concerns for the human health, especially for children. The results of the survey study indicate the need to include processed samples, and in particular dry fruits with a high consumption rate such as raisins, in the official controls of pesticide residues in food.

A Pilot Study of Short-course Nivolumab and Low-dose Ipilimumab for Adjuvant Treatment of Melanoma: Brown University Oncology Research Group Trial, BrUOG 324.

BACKGROUND: Combined cytotoxic T-lymphocyte-associated antigen 4 and programmed death 1 inhibitor blockade is a promising strategy in advanced melanoma and other solid tumors. This pilot study assessed the safety and toxicity of nivolumab plus low-dose ipilimumab in patients with high-risk completely resected melanoma. PATIENTS AND METHODS: Patients received ipilimumab, 1 mg/kg every 6 weeks, and nivolumab, 3 mg/kg every 2 weeks, for a total of 24 weeks (4 cycles). The primary objective was to assess the toxicity of the combined regimen. RESULTS: Twenty-one patients with resected melanoma were enrolled. One patient was stage IIC, 16 patients were stage III and 4 patients had resected stage 4 disease. Ten of 21 (48%) had grade 3 treatment-related toxicities but there was no grade 4 or grade 5 toxicities. The rate of grade 3 nonhematologic toxicities exceeded the toxicity limits defined by the study. Fifteen of 21 patients (71%) completed all 4 cycles of therapy. The median follow-up is 41 months. The 2-year recurrence-free survival is 85.7% and the 2-year overall survival is 90.5%. CONCLUSION: A 6-month course of nivolumab and low-dose ipilimumab may be a promising adjuvant treatment for patients with resected melanoma. Further studies of this regimen are indicated.

Association between hip muscle cross-sectional area and hip pain and function in individuals with mild-to-moderate hip osteoarthritis: a cross-sectional study.

BACKGROUND: To examine the associations between hip muscle cross-sectional area and hip pain and function in community-based individuals with mild-to-moderate hip osteoarthritis. METHODS: This study included 27 participants with mild-to-moderate hip osteoarthritis. Cross-sectional area of hip muscles, including psoas major, rectus femoris, gluteus maximus, gluteus medius and minimus, adductor longus and magnus, obturator internus, and obturator externus, were measured from magnetic resonance images. Hip pain and function were evaluated using the Hip Disability and Osteoarthritis Outcome Score (HOOS) categorised into 5 subscales: pain, symptoms, activity of daily living, sport and recreation function, and hip-related quality of life (for each subscale 0 representing extreme problems and 100 representing no problems). RESULTS: Mean age of the 27 participants was 63.2 (SD 7.6) years and 66.7% (n = 18) were female. After adjusting for age and gender, greater cross-sectional area of adductor longus and magnus was associated with a higher HOOS score in quality of life (regression coefficient 1.4, 95% confidence interval (CI) 0.2-2.7, p = 0.02), activity of daily living (regression coefficient 1.3, 95% CI 0.1-2.6, p = 0.04) and sport and recreation function (regression coefficient 1.6, 95% CI 0.1-3.0, p = 0.04). There was a trend towards an association between greater cross-sectional area of psoas major and a higher quality of life score (regression coefficient 3.6, 95% CI - 0.5 to 7.7, p = 0.08). The cross-sectional area of hip muscles was not significantly associated with HOOS pain or symptom score. CONCLUSION: Greater cross-sectional area of hip adductors was associated with better function and quality of life in individuals with mild-to-moderate hip osteoarthritis. Greater cross-sectional area of hip flexors might be associated with better quality of life. These findings, while need to be confirmed in longitudinal studies, suggest that targeting the hip adductor and flexor muscles may improve function and quality of life in those with mild-to-moderate hip osteoarthritis.

A 12-month prospective exploratory study of muscle and fat characteristics in individuals with mild-to-moderate hip osteoarthritis.

BACKGROUND: Reductions in lower extremity muscle strength, size and quality and increased fat content have been reported in advanced hip osteoarthritis (OA). Whether these differences are also evident at earlier stages of the disease and the extent to which they might develop over time is unclear. The main purpose of this 12-month exploratory prospective study was to compare changes in muscle and fat characteristics in individuals with mild-to-moderate hip OA and healthy controls. METHODS: Fourteen individuals with mild-to-moderate symptomatic and radiographic hip OA (n = 9 unilateral; n = 5 bilateral), and 15 healthy controls similar in age and sex without symptoms or radiographic hip OA were assessed at baseline and at 12-month follow-up. Maximal voluntary isometric strength of the hip and knee muscle groups was assessed using an isokinetic dynamometer. Lower extremity lean and fat mass were assessed using dual-energy x-ray absorptiometry, and thigh muscle and fat areas and thigh muscle density were assessed using peripheral quantitative computed tomography. RESULTS: Knee extension (p = 0.01), hip extension (p < 0.01), hip flexion (p = 0.03), and hip abduction (p < 0.01) strength, lower extremity lean mass (p < 0.01), thigh muscle area (p = 0.03), and thigh muscle density (p < 0.01) were significantly lower in hip OA compared to controls. Hip extension (p < 0.05), hip flexion (p = 0.03), and hip abduction (p = 0.03) strength significantly declined over the follow-up period in the hip OA group. CONCLUSIONS: Pre-existing deficits in hip muscle strength in individuals with mild-to-moderate hip OA were accentuated over 12-months, though no changes in symptoms or joint structure were observed. A longer follow-up period is required to establish whether strength deficits drive clinical and structural decline in these patients. Interventions to prevent or slow declines in strength may be relevant in the management of mild-to-moderate hip OA.

Individuals with mild-to-moderate hip osteoarthritis exhibit altered pelvis and hip kinematics during sit-to-stand.

BACKGROUND: Performance of the sit-to-stand (STS) task is compromised in individuals with advanced hip osteoarthritis (OA). Understanding how STS performance is altered in individuals with mild-to-moderate hip OA may inform interventions to improve function and slow disease progression. RESEARCH QUESTION: Do trunk, pelvis, and hip biomechanics differ during a STS task between individuals with mild-to-moderate hip OA and a healthy, age-matched control group? METHODS: Thirteen individuals with mild-to-moderate symptomatic and radiographic hip OA and seventeen healthy, age-matched controls performed a standardized STS task. Data were acquired using a three-dimensional motion capture system. The primary outcome measures were task duration, sagittal and frontal plane trunk, pelvis, and hip joint angles, and sagittal and frontal plane trunk and hip joint moments. Comparisons of lower-limb measures were between the most affected side in the hip OA group and a randomly chosen limb for the control group, termed the index limb, prior to and following lift-off from the chair. RESULTS: Participants with mild-to-moderate hip OA took longer to perform the STS task compared to controls. Prior to lift-off, the hip OA group exhibited greater posterior pelvic tilt, greater pelvic rise on the index side and less hip joint flexion relative to controls. Following lift-off, the hip OA group exhibited greater pelvic rise on the index side compared to controls. SIGNIFICANCE: Individuals with mild-to-moderate hip OA exhibit subtle alterations in movement strategy compared to healthy controls when completing a STS task similar, to a small extent, to adaptations reported in advanced stages of the disease. Interventions to target these features and prevent further decline in physical function may be warranted in the management of mild-to-moderate hip OA while the opportunity remains.

Individuals with mild-to-moderate hip osteoarthritis have lower limb muscle strength and volume deficits.

BACKGROUND: Individuals with advanced hip osteoarthritis (OA) exhibit generalized muscle weakness of the affected limb and so clinical practice guidelines recommend strength training for the management of hip OA. However, the extent and pattern of muscle weakness, including any between-limb asymmetries, in early stages of the disease are unclear. This study compared hip and knee muscle strength and volumes between individuals with mild-to-moderate symptomatic and radiographic hip OA and a healthy control group. METHODS: Nineteen individuals with mild-to-moderate symptomatic and radiographic hip OA (n = 12 unilateral; n = 7 bilateral) and 23 age-matched, healthy controls without radiographic hip OA or hip pain participated. Isometric strength of the hip and knee flexors and extensors, and hip abductors and adductors were measured. Hip and thigh muscle volumes were measured from lower limb magnetic resonance images. A full-factorial, two-way General Linear Model was used to assess differences between groups and between limbs. RESULTS: Participants in the hip OA group demonstrated significantly lower knee flexor, knee extensor, hip flexor, hip extensor and hip abductor strength compared to controls and had significantly lower volume of the adductor, hamstring and quadriceps groups, and gluteus maximus and gluteus minimus muscles, but not tensor fasciae latae or gluteus medius muscles. There were no between-limb strength differences or volume differences within either group. CONCLUSIONS: Atrophic, bilateral hip and knee muscle weakness is a feature of individuals with mild-to-moderate hip OA. Early interventions to target muscle weakness and prevent the development of strength asymmetries that are characteristic of advanced hip OA appear warranted.

Hip joint mechanics during walking in individuals with mild-to-moderate hip osteoarthritis.

The purpose of this case-control study was to characterise hip joint kinematics and moments during gait in people with mild-to-moderate hip osteoarthritis (OA). Eligible participants were allocated to the hip OA group (n=27) or the age-matched control group (n=26) based on radiographic and symptomatically defined inclusion criteria. Participants walked barefoot along a 10-m walkway at their self-selected gait speed. Trajectories of 43 markers attached to the trunk, pelvis, upper and lower limbs were recorded using a 12-camera motion capture system. Ground reaction force data were simultaneously collected. Individuals in the hip OA group had a 10% higher body mass, 13% slower self-selected walking speed, 10% shorter step length, 2% and 9% longer relative stance and double support duration (% stride) respectively, 41% lower sagittal plane hip range of motion, and 28% and 45% lower peak sagittal and transverse plane hip joint moments respectively during gait compared to controls (p<0.05). The finding that individuals with mild-to-moderate hip OA experienced less net hip joint loading over a reduced range of hip motion for a longer proportion of the gait cycle when walking at their preferred gait speed suggest that the mechanics of the hip joint are altered in hip OA, and could have implications for disease progression through altered mechano-biological processes within the joint.