Association between tibial subchondral bone structure from plain radiographs and cartilage composition from quantitative MRI in postmenopausal women with mild osteoarthritis

Neuromuscular performance and body mass as indices of bone loading in premenopausal and postmenopausal women.

The strong association between body mass and skeletal robusticity has been attributed to increasing skeletal loading with increasing mass. However, it is unclear whether body mass is merely a coarse substitute for bone loading rather than a true independent predictor of bone strength. As indices of neuromuscular performance, impulse and peak power were determined from vertical ground reaction force during a maximal counter movement jump test in 221 premenopausal and 82 postmenopausal women. Bone compressive (BSI(d) g(2)/cm(4)) and bending (SSImax(mid) mm(3)) strength indices were measured with peripheral quantitative computed tomography (pQCT) at the distal ((d)) and midshaft ((mid)) sites …

Reproducibility of imaging human knee cartilage by delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) at 1.5 Tesla

Summary Objective The purpose of this study was to investigate the day-to-day reproducibility of the delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) measurement at different knee joint surfaces in healthy subjects at 1.5 Tesla (T). Methods The dGEMRIC experiment was repeated for 10 asymptomatic volunteers three times with an average interval of 5 days between scans. The measurement was performed from a single sagittal slice through the center of the lateral femoral condyle and from the center of the patella in the axial plane. Cartilage was manually segmented into superficial, deep and full-thickness regions of interests (ROIs) at different topographical locations of the femur, tibia…

Exercise for bone and cartilage in postmenopausal women with mild knee osteoarthritis

The purpose of this study was to investigate the effects of high-impact exercise on bone mineral mass and strength, and on knee cartilage composition in postmenopausal women with mild knee osteoarthritis (OA). In addition, the association between knee OA and femoral neck bone structural characteristics in women with mild knee radiographic OA and those without radiographic knee OA was studied. Also, the reproducibility of measuring human knee joint cartilage by the delayed gadolinium-enhanced MRI (dGEMRIC) technique was determined in healthy asymptomatic subjects. Data from a 12-month randomized controlled trial (RCT) was used to assess the effects of exercise on bones and cartilages. The tr…

Reliability and Validity of The Finnish Version of The Boston Carpal Tunnel Questionnaire among Surgically Treated Carpal Tunnel Syndrome Patients

Background and Aims: The Boston Carpal Tunnel Questionnaire is the most commonly used outcome measure in the assessment of carpal tunnel syndrome. The purpose of this study was to translate the original Boston Carpal Tunnel Questionnaire into Finnish and validate its psychometric properties. Materials and Methods: We translated and culturally adapted the Boston Carpal Tunnel Questionnaire into Finnish. Subsequently, 193 patients completed the Finnish version of the Boston Carpal Tunnel Questionnaire, 6-Item CTS Symptoms Scale, and EuroQol 5 Dimensions 12 months after carpal tunnel release. The Boston Carpal Tunnel Questionnaire was re-administered after a 2-week interval. We calculated cons…

Effects of a progressive aquatic resistance exercise program on the biochemical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods A minimum of 80 volunteers who meet the inclusion criteria will b…

Associations of neck muscle strength and cervical spine mobility with future neck pain and disability: a prospective 16-year study.

Abstract Background Neck pain has been associated with weaker neck muscle strength and decreased cervical spine range of motion. However, whether neck muscle strength or cervical spine mobility predict later neck disability has not been demonstrated. In this 16-year prospective study, we investigated whether neck muscle strength and cervical spine mobility are associated with future neck pain and related disability in women pain-free at baseline. Methods Maximal isometric neck muscle strength and passive range of motion (PROM) of the cervical spine of 220 women (mean age 40, standard deviation (SD) 12 years) were measured at baseline between 2000 and 2002. We conducted a postal survey 16 ye…

Cross-cultural adaptation and validation of the Kerlan-Jobe Orthopaedic Clinic shoulder and elbow score in Finnish-speaking overhead athletes

Background The Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) is developed to evaluate the shoulder and elbow function in overhead athletes. To date, the score has not been adapted into Finnish language. The aim of this study was to perform a cross-cultural adaptation of the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score (KJOC) into Finnish language and evaluate its validity, reliability, and responsiveness in overhead athletes. Methods Forward–backward translation method was followed in the cross-cultural adaptation process. Subsequently, 114 overhead athletes (52 males, 62 females, mean age 18.1 ± 2.8 years) completed the Finnish version of KJOC score, Disabilitie…

Structural validity of the Boston Carpal Tunnel Questionnaire and its short version, the 6-Item CTS symptoms scale : a Rasch analysis one year after surgery

Abstract Background: The Boston Carpal Tunnel Questionnaire (BCTQ) and its shorter version, the Six-Item Carpal Tunnel Symptoms Scale (CTS-6), are widely used for assessing function and/or symptoms in patients with carpal tunnel syndrome. This study examined the structural validity of the BCTQ and CTS-6 among patients who had undergone surgery for treatment of carpal tunnel syndrome. Methods: The data for this cross-sectional analysis were obtained from 217 adult patients who had undergone carpal tunnel release surgery one year earlier. All patients completed the CTS-6, Symptom Severity Scale (SSS) and Functional Status Scale (FSS) of the BCTQ at 12 months after surgery. The Rasch Measureme…

Enhanced rehabilitation guidance after arthroscopic capsulolabral repair of the shoulder : a randomized controlled trial

Objective: To compare the effects of a 12-month home-based exercise program to usual care in patients after arthroscopic capsulolabral repair of the shoulder. Design: Randomized controlled trial. Setting: Outpatient physical and rehabilitation medicine clinic. Subjects: Forty-five patients (mean age: 35 years; standard deviation (SD): 10 years) who underwent arthroscopic capsulolabral repair due to labral lesion were randomized into an exercise group (EG) or a control group (CG). Intervention: The EG received a 12-month home-based additional exercise program with four physiotherapy follow-up visits, while the CG received standard postoperative exercise instructions. Main measures: Self-repo…

Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score

Background The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a commonly used knee assessment and outcome tool in both clinical work and research. However, it has not been formally translated and validated in Finnish. The purpose of this study was to translate and culturally adapt the KOOS questionnaire into Finnish and to determine its validity and reliability among Finnish middle-aged patients with knee injuries. Methods KOOS was translated and culturally adapted from English into Finnish. Subsequently, 59 patients with knee injuries completed the Finnish version of KOOS, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Short-Form 36 Health Survey (SF-36) and Numeric Pai…

Effects of Exercise on Patellar Cartilage in Women with Mild Knee Osteoarthritis

AB Purpose: This study aims to investigate the effects of exercise on patellar cartilage using T2 relaxation time mapping of magnetic resonance imaging in postmenopausal women with mild patellofemoral joint osteoarthritis (OA). Methods: Eighty postmenopausal women (mean age, 58 (SD, 4.2) yr) with mild knee OA were randomized to either a supervised progressive impact exercise program three times a week for 12 months (n = 40) or a nonintervention control group (n = 40). Biochemical properties of cartilage were estimated using T2 relaxation time mapping, a parameter sensitive to collagen integrity, collagen orientation, and tissue hydration. Leg muscle strength and power, aerobic capacity, and…

Additional file 1: of Construct validity and reliability of the Finnish version of the Knee Injury and Osteoarthritis Outcome Score

The back-translation of the Finnish version of the KOOS questionnaire “KOOS KNEE QUESTIONNAIRE”. (PDF 87 kb)

Association between radiography-based subchondral bone structure and MRI-based cartilage composition in postmenopausal women with mild osteoarthritis

Summary Objective Our aim was to investigate the relation between radiograph-based subchondral bone structure and cartilage composition assessed with delayed gadolinium enhanced magnetic resonance imaging of cartilage (dGEMRIC) and T 2 relaxation time. Design Ninety-three postmenopausal women (Kellgren–Lawrence grade 0: n  = 13, 1: n  = 26, 2: n  = 54) were included. Radiograph-based bone structure was assessed using entropy of the Laplacian-based image ( E Lap ) and local binary patterns ( E LBP ), homogeneity indices of the local angles (HI Angles,mean , HI Angles,Perp , HI Angles,Paral ), and horizontal (FD Hor ) and vertical fractal dimensions (FD Ver ). Mean dGEMRIC index and T 2 relax…

Effects of High-Impact Training on Bone and Articular Cartilage: 12-Month Randomized Controlled Quantitative MRI Study

Osteoarthritis and osteoporosis often coexist in postmenopausal women. The simultaneous effect of bone-favorable high-impact training on these diseases is not well understood and is a topic of controversy. We evaluated the effects of high-impact exercise on bone mineral content (BMC) and the estimated biochemical composition of knee cartilage in postmenopausal women with mild knee osteoarthritis. Eighty women aged 50 to 66 years with mild knee osteoarthritis were randomly assigned to undergo supervised progressive exercise three times a week for 12 months (n = 40) or to a nonintervention control group (n = 40). BMC of the femoral neck, trochanter, and lumbar spine was measured by dual-energ…

Impact or No Impact for Women With Mild Knee Osteoarthritis: A Bayesian Meta‐Analysis of Two Randomized Controlled Trials With Contrasting Interventions

Objective We aim to predict the probability of a benefit from two contrasting exercise programs for a woman with a new diagnosis of mild knee osteoarthritis (OA). The short and long-term effects of aquatic resistance training (ART) and high-impact aerobic land training (HLT) compared with the control will be estimated. Methods Original data sets from two previously conducted randomised controlled trials (RCT) were combined and used in a Bayesian meta-analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms and quality of l…

Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia : a randomized controlled study

Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100mm), and functional status was assessed by the Fibromyalgia Impact Questio…

Effects of a progressive aquatic resistance exercise program on the biomechanical composition and morphology of cartilage in women with mild knee osteoarthritis: protocol for a randomised controlled trial

Background. Symptoms associated with osteoarthritis of the knee result in decreased function, loss of working capacity and extensive social and medical costs. There is a need to investigate and develop effective interventions to minimise the impact of and even prevent the progression of osteoarthritis. Aquatic exercise has been shown to be effective at reducing the impact of osteoarthritis. The purpose of this article is to describe the rationale, design and intervention of a study investigating the effect of an aquatic resistance exercise intervention on cartilage in postmenopausal women with mild knee osteoarthritis. Methods. A minimum of 80 volunteers who meet the inclusion criteria will…

Effect of biomechanical footwear on upper and lower leg muscle activity in comparison with knee brace and normal walking

Abstract Aim To evaluate the activity of knee stabilizing muscles while using custom-made biomechanical footwear (BF) and to compare it when walking barefoot and with a knee brace (Unloader®). Methods Seventeen healthy working-aged (mean age: 29 years; standard deviation: 8 years) individuals participated. The knee brace was worn on the right knee and BF in both legs. Surface electromyography (sEMG) data was recorded bilaterally from vastus medialis (VM), semitendinosus (ST), tibialis anterior (TA) and lateral gastrocnemius (LG) muscles during walking, and repeated-measures ANOVA with a post-hoc t-test was used to determine differences between the different walking modalities (barefoot, bra…

Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women

The separate effects of 18 weeks of intensive strength and endurance training on isometric knee extension (KE) and flexion (KF) strength and walking speed were studied in 76- to 78- year-old women. Maximal voluntary isometric force for both KE and KF was measured in a sitting position on a custom-made dynamometer chair at a knee angle of 60 degrees from full extension. Maximal walking speed was measured over a distance of 10 m. The endurance-trained women increased KE torque and KE torque/body mass after the first 9 weeks of training when compared with the controls. when comparing the baseline, 9 week and 18 week measurements within the groups separately, both the endurance- and strength-tr…

Maternal risk factors of urinary incontinence during pregnancy and postpartum: A prospective cohort study

Highlights • Urinary incontinence after delivery affects every fifth woman. • Urinary incontinence before pregnancy is a risk factor of postpartum incontinence. • Primiparous women are at a greater risk of urinary incontinence after birth.

Interactive multiobjective optimization for finding the most preferred exercise therapy modality in knee osteoarthritis

Abstract Background There are no explicit guidelines or tools available to support clinicians in selecting exercise therapy modalities according to the characteristics of individual patients despite the apparent need. Objective This study develops a methodology based on a novel multiobjective optimization model and examines its feasibility as a decision support tool to support healthcare professionals in comparing different modalities and identifying the most preferred one based on a patient’s needs. Methods Thirty-one exercise therapy modalities were considered from 21 randomized controlled trials. A novel interactive multiobjective optimization model was designed to characterize the effic…

Strength training in treatment of chronic neck pain

Background: Chronic non-specific neck pain is common in modern industrialized countries causing suffering, disability and considerable economical losses for individuals and society. Treatment is commonly advice for stretching and strength exercises in primary health care. However, if improvements are not satisfactory, patients may seek specialist care. The purpose of this study was to evaluate the effectiveness of multimodal rehabilitation in treatment of chronic neck pain. Methods: The study group comprised of 56 patients with chronic neck pain, who participated rehabilitation for three weeks and one-week follow-up period after eight months at an inpatient rehabilitation facility. The aim …

Use of conservative therapy before and after surgery for carpal tunnel syndrome

Abstract Background Conservative therapies are typically offered to individuals who experience mild or intermittent symptoms of carpal tunnel syndrome (CTS) or postoperatively to subjects who have undergone carpal tunnel release. Although long-term studies report mostly positive results for carpal tunnel release, knowledge on the need for conservative treatments following surgery is scarce. The aim of this retrospective cohort study was to examine the use of conservative therapies before and after carpal tunnel releasing surgery. Methods Of 528 patients who underwent carpal tunnel release surgery in the study hospital during the study period, 259 provided sufficiently completed questionnair…

Pulsed electromagnetic field therapy in the treatment of pain and other symptoms in fibromyalgia: A randomized controlled study

Low-energy pulsed electromagnetic field (PEMF) therapy has been suggested as a promising therapy to increase microcirculation, which is of great concern in patients with fibromyalgia. This study evaluated the effectiveness of PEMF therapy on the treatment of fibromyalgia. A group of 108 women with fibromyalgia were allocated to a 12-week treatment period with an active Bio-Electro-Magnetic-Energy-Regulation (BEMER) device and a similar treatment period with an inactive device. Each patient received active and sham treatments in a random order. Pain and stiffness were assessed on a visual analog scale (VAS, scale 0-100 mm), and functional status was assessed by the Fibromyalgia Impact Questi…

Impact or No Impact for Women With Mild Knee Osteoarthritis : A Bayesian Meta-Analysis of Two Randomized Controlled Trials With Contrasting Interventions

Objective: We aim to predict the probability of a benefit from two contrasting exercise programs for a woman with a new diagnosis of mild knee osteoarthritis (OA). The short and long-term effects of aquatic resistance training (ART) and high-impact aerobic land training (HLT) compared with the control will be estimated. Methods: Original data sets from two previously conducted randomised controlled trials (RCT) were combined and used in a Bayesian meta-analysis. Group differences in multiple response variables were estimated. Variables included cardiorespiratory fitness, dynamic maximum leg muscle power, maximal isometric knee extension and flexion force, pain, other symptoms and quality of…

Interactive multiobjective optimization for finding the most preferred exercise therapy modality in knee osteoarthritis

There are no explicit guidelines or tools available to support clinicians in selecting exercise therapy modalities according to the characteristics of individual patients despite the apparent need. This study develops a methodology based on a novel multiobjective optimization model and examines its feasibility as a decision support tool to support healthcare professionals in comparing different modalities and identifying the most preferred one based on a patient’s needs. Thirty-one exercise therapy modalities were considered from 21 randomized controlled trials. A novel interactive multiobjective optimization model was designed to characterize the efficacy of an exercise therapy modality ba…