The predictors to self-reported and performance-based physical function in knee osteoarthritis patients: a cross-sectional study.

Background: Osteoarthritis (OA) knee patients have limited ability in physical function, or difficulties with physical tasks and activities may develop disability. This study aimed to observe the predictors of self-reported and performance-based physical function in patients with knee OA by analyzing the impacts of demographic, pathological, and muscle impairment factors. Methods: 135 knee OA patients participated in this study to complete self-reported questionnaires using Knee Injury and Osteoarthritis Outcome Score (KOOS). When measuring performance-based physical function, a 6-meter gait speed (6MGS) test was measured to evaluate their mobility, and a 5-time Sit-to-Stand test (5STS) was assessed to evaluate their balance. Pain intensity, knee extensor and flexor muscle strength, age, body mass index (BMI), durations of symptoms, and radiographic severity were also collected. Spearman correlation and stepwise multiple linear regression were used to explore the association and predictors in self-reported and performance-based physical function. Results: BMI and durations of symptoms did not indicate any significant correlation with either self-reported or performance-based physical function. Age is significantly negatively associated with 6MGS (r 2 = -0.383, p < 0.01), while knee extensor muscle strength has a moderate correlation with 5STS (r 2 = -0.528, p < 0.01). In the stepwise multiple linear regression models, pain intensity (ß = 0.712, p < 0.001), knee flexor muscle strength (ß = 0.112, p = 0.042) were significantly associated with self-reported physical function in daily activities and contributed to 55.0% of the variance in KOOS-PF score. Knee muscle strength, including knee extensor (5STS: ß = -0.428, p < 0.001) and flexor muscle strength (6MGS: ß = 0.367, p < 0.001), were the main predictors with performance-based physical function. Conclusion: Pain intensity was the leading risk factor of self-reported physical function, and knee flexor muscle strength contributed as well. The severity of knee OA, durations of symptoms and BMI did not contribute to physical function. However, knee extensor and flexor muscle strength were the main predictors of performance-based performance. Our results show that strengthening of weak knee muscles in both quadriceps and hamstring muscle strength should be considered a priory consideration in knee OA no matter if people are in the early or end-stage of knee OA.

Cross-Cultural Adaptation of Chinese Victorian Institute of Sports Assessment-Achilles (VISA-A) Questionnaire for Achilles Tendinopathy.

Background: Victorian Institute of Sports Assessment (VISA-A) is a patient-reported outcome for assessing symptoms severity associated with Achilles tendinopathy (AT). It is a valid and reliable tool that has been used widely for measuring and monitoring treatment outcomes for AT. This clinical measurement study aims to develop a Chinese version of the VISA-A questionnaire. The study objective is to adapt the VISA-A questionnaire cross-culturally and assess its psychometric property for Chinese-speaking individuals. Methods: VISA-A was translated and adapted cross-culturally according to international guidelines for self-reported questionnaires. During the establishment of Chinese VISA-A, there are 5 stages involved in the creation process, including translation, synthesis, reverse translation, review, and pretesting, which are performed by professionals in various fields, including orthopaedic surgeons, physiotherapists, and professional translators. Results: A total of 60 participants were recruited to complete the Chinese VISA-A and 36-Item Short Form Health Survey (SF-36) questionnaires. The overall test-retest reliability was 0.98 (intraclass correlation coefficient = 0.97-0.99). The correlation between Chinese VISA-A and physical function subscale (r = 0.70) was strong and statistically significant. There were moderate correlations between Chinese VISA-A, limitations to role of physical function subscale (r = 0.30), and bodily pain subscale (r = 0.42), which were also statistically significant. There were statistically significant differences in Chinese VISA-A scores between healthy control and pathologic group (P < .001), at-risk group, and pathologic group (P < .001) respectively. Conclusion: Chinese VISA-A demonstrated good reliability and validity for measuring symptom severity in patients with AT. Chinese VISA-A can be recommended as a self-reported measure for monitoring symptoms severity and treatment progress of patients with Achilles tendinopathy.Level of Evidence: Level II, cohort study.

Decreased passive muscle stiffness of vastus medialis is associated with poorer quadriceps strength and knee function after anterior cruciate ligament reconstruction.

BACKGROUND: Muscle deficits of the quadriceps and hamstrings are common after anterior cruciate ligament reconstruction, and increase the risk of knee reinjury. Muscle stiffness is an important factor for dynamic joint stability. However, the changes in quadriceps and hamstring muscle stiffness and its influence after anterior cruciate ligament reconstruction remain unclear. METHOD: Twenty-five male subjects with anterior cruciate ligament reconstruction and twenty-one matched healthy subjects participated in this study. The passive muscle stiffness of the quadriceps and hamstrings was assessed by shear modulus using ultrasound shear wave elastography. The isokinetic muscle strengths of the quadriceps and hamstrings were tested. Knee function was evaluated by the International Knee Documentation Committee and Lysholm score. Muscle stiffness was compared between limbs via non-parametric tests. Correlation analysis was used to detect the relationship between muscle stiffness, isokinetic muscle strength and knee functional scores. FINDINGS: The involved limb exhibited significantly decreased shear modulus in the vastus medialis compared to the dominant limbs(z = -3.585;P = 0.001;ES = 1.13) and non-dominant limbs(z = -3.551;P = 0.002;ES = 1.24) of healthy controls. The shear modulus of ST was also significantly lower in the involved limb when compared with the contralateral limbs(z = -3.996;P < 0.001;ES = 1.33), dominant limbs(z = -4.477;P < 0.001;ES = 1.65) and non-dominant limbs(z = -4.234;P = 0.001;ES = 1.43) of healthy controls. The shear modulus of the vastus medialis was associated with quadriceps peak torque at 60°/s(r = 0.470; p < 0.001) and knee functional score(r = 0.459; p = 0.021). INTERPRETATION: The passive muscle stiffness of the vastus medialis decreased after anterior cruciate ligament reconstruction, which is associated with poorer quadriceps strength and knee function. The effect of modulation of muscle stiffness on improving knee function warrants future investigation.

[The hypoglycemic effects of crude polysaccharides extract from Momordica charantia in mice].

OBJECTIVE: In order to study the hypoglycemic effects of crude polysaccharides extract from Momordica charantia in normal and diabetic mice. METHODS: Oral glucose tolerance test was carried out in 24 normal mice, CPS was orally administered in experiment group at 1 g/kg BW. 80 diabetic mice (type 1 and type 2 diabetic model) were divided into two groups randomly, CPS was administered at ad lib and fasted condition in experiment group at 1 g/kg BW, blood glucose was measured at different time. RESULTS: In normal mice, after administered glucose (3g/kgBW) the blood glucose level of experiment group at 0.5, 1 h was significantly lower than that of control group (16.4% and 16.5% lower than control group respectively, P < 0.05 and P < 0.01). In diabetic mice, the fasted and ad lib blood glucose after administering CPS orally 2h, 4h were lower than that of control group (P < 0.05 and P < 0.01 respectively). CONCLUSION: CPS can improve OGTT in normal mice, and has significant hypoglycemic effect in two types diabetic mice.