ORCID Profile
0000-0001-6660-9183
Current Organisations
National Ageing Research Institute
,
Southern Cross University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Oxford University Press (OUP)
Date: 25-08-2012
DOI: 10.1093/RHEUMATOLOGY/KES222
Abstract: Foot orthoses are commonly used in the management of knee OA, although the relationship between foot function and knee OA is still unclear. The purpose of the study was to examine foot function during walking in people with and without medial compartment knee OA. Motion of the tibia, rearfoot and forefoot in 32 patients with medial compartment knee OA and 28 age-matched control subjects was investigated. Multivariate analysis was used to compare the groups. The knee OA group contacted the ground with a more everted rearfoot, demonstrated greater peak rearfoot eversion and exhibited reduced rearfoot frontal plane range of motion and reduced rearfoot peak inversion. The tibia was more internally rotated and laterally tilted throughout the gait cycle, with reduced peak external rotation. People with medial compartment knee OA exhibit altered foot kinematics during gait that are indicative of a less mobile, more everted foot type. The presence and degree of tibial malalignment and the available rearfoot range of motion during walking may affect in idual responses to load-altering interventions, such as foot orthoses and footwear modifications. Australian New Zealand Clinical Trials Registry, www.anzctr.org.au/, ACTRN12608000116325.
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.GAITPOST.2009.07.109
Abstract: Development of patellofemoral pain syndrome (PFPS) is considered to be multifactorial. The aims of this systematic review were to (i) summarise and critique the body of literature addressing kinematic gait characteristics associated with PFPS and (ii) provide recommendations for future research addressing kinematic gait characteristics associated with PFPS. A comprehensive search of MEDLINE, EMBASE, CINAHL, and Current Contents revealed 561 citations for review. Each citation was assessed for inclusion and quality using a modified version of the 'Quality Index' and a novel inclusion/exclusion criteria checklist by two independent reviewers. A total of 24 studies were identified. No prospective studies with adequate data to complete effect size calculations were found. Quality of included case-control studies varied, with a number of methodological issues identified. Heterogeneity between studies made meta-analysis inappropriate. Reductions in gait velocity were indicated during walking, r negotiation, and stair negotiation in in iduals with PFPS. Findings indicated delayed timing of peak rearfoot eversion and increased rearfoot eversion at heel strike transient during walking and delayed timing of peak rearfoot eversion, increased rearfoot eversion at heel strike, reduced rearfoot eversion range, greater knee external rotation at peak knee extension moment, and greater hip adduction during running in in iduals with PFPS. There is a clear need for prospective evaluation of kinematic gait characteristics in a PFPS population to distinguish between cause and effect. Where possible, future PFPS case-control studies should consider evaluating kinematics of the knee, hip and foot/ankle simultaneously with larger participant numbers. Completing between sex comparisons when practical and considering spatiotemporal gait characteristics during methodological design and data analysis is also recommended.
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.GAITPOST.2010.11.022
Abstract: Patellofemoral pain syndrome (PFPS) development is considered to be multifactorial with various knee, hip and foot/ankle kinematic factors thought to be involved. A paucity of research evaluating kinematic factors throughout the lower limb kinematic chain simultaneously in in iduals with PFPS was identified in a recent systematic review. The objective of this study was to compare kinematics at the knee, hip and foot/ankle in a group of in iduals with PFPS to a group of asymptomatic controls. Twenty-six in iduals with PFPS and 20 controls aged between 18 and 35 were recruited. Between-group comparisons were made for magnitude and timing of peak angles, and range of motion at the forefoot (dorsiflexion, abduction and supination), rearfoot (dorsiflexion, internal rotation and eversion), knee (flexion, abduction and internal rotation) and hip (adduction and internal rotation) during walking. The PFPS group demonstrated less peak hip internal rotation (7.0° versus 11.8°, p=0.024, p=0.024), earlier peak rearfoot eversion relative to the laboratory (30.4% versus 35.3% of the gait cycle, p=0.010) and tibia (32.7% versus 36.5% of the gait cycle, p=0.030), and greater rearfoot dorsiflexion range of motion relative to the laboratory (72.3° versus 68.2°, p=0.007). Additionally, a trend toward reduced gait velocity (p=0.070) was found in the PFPS group. Reduced peak hip internal rotation and gait velocity in in iduals with PFPS may indicate compensation to reduce PFJ load during walking. However, earlier peak rearfoot eversion may be a factor related to the pathomechanical development of the condition.
Publisher: Elsevier BV
Date: 12-2012
DOI: 10.1016/J.KNEE.2012.05.002
Abstract: In iduals with knee osteoarthritis (OA) have flatter/more pronated feet than those without OA, but it is unclear whether altered foot posture and function are a cause or consequence of knee OA. The purpose of this study was to examine whether changes in foot posture and function occur after realignment of the knee following total knee replacement (TKR). Nineteen patients with predominantly medial compartment knee OA were tested prior to and 12 months after TKR. The Foot Posture Index (FPI) and Arch Index (AI) were measured as well as motion of the tibia, rearfoot and forefoot using a 3D motion analysis system incorporating a multisegment foot model. There were no significant changes in FPI or AI following TKR, however gait analysis revealed significant increases in tibial external rotation (-18.7 ± 7.0° vs -22.5 ± 8.7°, p=0.002), tibial transverse plane range of motion (-9.1 ± 4.6° vs -11.4 ± 6.1°, p=0.0028) and rearfoot range of motion in the frontal plane (8.6 ± 2.6° vs 10.4 ± 2.7°, p=0.002), and a decrease in rearfoot transverse plane range of motion (8.7 ± 5.3° vs 5.9 ± 4.1°, p=0.038) following the procedure. TKR produces no change in static foot posture, but results in significant changes in rearfoot kinematics during gait. These findings suggest that rearfoot motion compensates for changes in the alignment of the knee, highlighting the ability of the foot to accommodate for proximal skeletal malalignment.
Publisher: Springer Science and Business Media LLC
Date: 11-07-2019
Publisher: Springer Science and Business Media LLC
Date: 24-06-2015
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.JOCA.2013.08.003
Abstract: To determine the proportion of people with hip and knee osteoarthritis that meet physical activity guidelines recommended for adults and older adults. Systematic review with meta-analysis of studies measuring physical activity of participants with hip and knee osteoarthritis using an activity monitor. Physical activity levels were calculated using the mean average [95% confidence interval (CI)] weighted according to s le size. Meta-analyses determined the proportion of people meeting physical activity guidelines and recommendations of (1) ≥150 min per week of moderate to vigorous physical activity (MVPA) in bouts of ≥10 min (2) ≥150 min per week of MVPA in absence of bouts (3) ≥10,000 steps per day and ≥7000 steps per day. The Grades of Research, Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of the evidence. For knee osteoarthritis, 21 studies involving 3266 participants averaged 50 min per week (95% CI = 46, 55) of MVPA when measured in bouts of ≥10 min, 131 min per week (95% CI = 125, 137) of MVPA, and 7753 daily steps (95% CI = 7582, 7924). Proportion meta-analyses provided high quality evidence that 13% (95% CI = 7, 20) completed ≥150 min per week of MVPA in bouts of ≥10 min, low quality evidence that 41% (95% CI = 23, 61) completed ≥150 min per week of MVPA in absence of bouts, moderate quality evidence that 19% (95% CI = 8, 33) completed ≥10,000 steps per day, and low quality evidence that 48% (95% CI = 31, 65) completed ≥7000 steps per day. For hip osteoarthritis, 11 studies involving 325 participants averaged 160 min per week (95% CI = 114, 216) of MVPA when measured in bouts of ≥10 min, 189 min per week (95% CI = 166, 212) of MVPA, and 8174 daily steps (95% CI = 7670, 8678). Proportion meta-analyses provided low quality evidence that 58% (95% CI = 18, 92) completed ≥150 min per week of MVPA in absence of bouts, low quality evidence that 30% (95% CI = 13, 50) completed ≥10,000 steps per day, and low quality evidence that 60% (95% CI = 47, 73) completed ≥7000 steps per day. A small to moderate proportion of people with knee and hip osteoarthritis met physical activity guidelines and recommended daily steps. Future research should establish the effects of increasing physical activity in this population to meet the current physical activity guidelines.
Publisher: IEEE
Date: 08-2007
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.GAITPOST.2016.04.031
Abstract: People with knee osteoarthritis (OA) are at twice the risk of falling compared to older people without knee OA, however the mechanism for this is poorly understood. This study investigated the biomechanical response of the trunk and lower limb joints during a forward induced fall under different task conditions in people with and without knee OA. Twenty-four participants with OA (68.6±6.2 years) and 15 asymptomatic controls (72.4±4.8 years) participated in the study. Forward fall was induced by releasing participants from a static forward leaning position. Participants were required to recover balance during three conditions: normal, physical (obstacle clearance) and cognitive dual tasks (counting backwards). Spatiotemporal parameters, lower limb joint kinematics and kinetics of the recovery limb were compared between the two groups and across the three task conditions. The OA group demonstrated slower spatio-temporal characteristics and reduced hip and knee flexion angles, joint moments owers and reduced muscle negative work at the knee and ankle (p<0.05). Cognitive dual task resulted in reduced centre of mass velocity and step length (p=0.03) compared to the physical dual task condition. Reduced knee (p=0.02) and hip joint powers (p=0.03) were demonstrated in the OA group in the physical task condition. When simulating a forward fall, participants with OA demonstrated difficulty in absorbing the impact and slowing down the forward momentum of the body during a recovery step. Moreover, poor dynamic postural control was demonstrated as task complexity increased.
Publisher: Human Kinetics
Date: 06-2023
Abstract: Background : The Exercise interveNtion outdoor proJect in the cOmmunitY (ENJOY) Seniors Exercise Park program uses specialized outdoor equipment and a physical activity program to engage older people in physical activity, with multiple health benefits. We determined the cost-effectiveness of the ENJOY program. Methods : The economic evaluation compared health care utilization costs 6 months prior to and 6 months post ENJOY program participation. Incremental cost-utility analysis for the primary aim (quality of life) and incremental cost-effectiveness analysis for the secondary aim (falls) were used. Analyses took a societal perspective inclusive of Australian government-funded health care and pharmaceuticals in addition to hospitalizations, community-based nursing and allied health, and community services. Productivity costs were also calculated. Results : Fifty participants (average age 72.8 y [SD 7.4] and 78.0% [n = 39/50] women) were included. Participation in the ENJOY program reduced health care costs in the 6 months following the program: preintervention, $9764.49 (SD $26,033.35) postintervention, $5179.30 (SD $3826.64) observed postintervention reduction −$4.585.20 (95% confidence interval, −$12,113.99 to $2943.59 P = .227) without compromising quality of life (mean difference [MD] 0.011 95% confidence interval, −0.034 to 0.056 P = .631) or increasing the likelihood of a fall (−0.5 95% confidence interval, 0.00 to −0.50 P = .160). The ENJOY intervention is likely cost-effective. Conclusions : Planning for shared community spaces should consider the benefits of a Seniors Exercise Park as part of the built environment.
Publisher: Wiley
Date: 27-04-2016
DOI: 10.1002/ACR.22743
Publisher: SAGE Publications
Date: 09-08-2017
Abstract: Objective: To investigate the feasibility, effectiveness, and short-term effects of an exercise intervention using a novel exercise park in improving seniors’ balance, physical function, and quality of life. Method: Randomized controlled trial with pre- and post-intervention design (baseline and 18-week intervention) was used. Outcome measures included measures of balance, strength, and function, as well as quality of life and fear of falling. MANCOVA was used to assess differences between groups (control and exercise intervention) over time. Results: Intervention group showed significant improvement on single leg stance ( p = .02, 95% confidence interval [CI] = [−8.35, −0.549]), knee strength ( p .01, 95% CI = [−29.14, −5.86]), 2-min walk ( p = 0.02, 95% CI = [−19.13, −0.859]), and timed sit to stand ( p = .03, 95% CI = [−2.26, −0.143]) tests. Discussion: The exercise park program improved physical function and had high adherence and participation rate. Such intervention has been shown to be safe and therefore might enhance participation in exercise programs for older adults.
Publisher: Elsevier BV
Date: 08-2012
DOI: 10.1016/J.CLINBIOMECH.2012.02.007
Abstract: Excessive rearfoot eversion is thought to be a risk factor for patellofemoral pain syndrome development, based on theoretical rationale linking it to greater tibial internal rotation and hip adduction. This study aimed to establish the relationship of rearfoot eversion with tibial internal rotation and hip adduction during walking in in iduals with and without patellofemoral pain syndrome. Twenty-six in iduals with patellofemoral pain syndrome and 20 controls (18-35years) participated. Each underwent instrumented three-dimensional motion analysis during over-ground walking. Pearson's correlation coefficients (r) were calculated to establish the relationship of rearfoot eversion with tibial internal rotation and hip adduction (peak and range of motion). Greater peak rearfoot eversion was associated with greater peak tibial internal rotation in the patellofemoral pain syndrome group (r=0.394, P=0.046). Greater rearfoot eversion range of motion was associated with greater hip adduction range of motion in the patellofemoral pain syndrome (r=0.573, P=0.002) and control (r=0.460, P=0.041) groups and greater peak hip adduction in the control group (r=0.477, P=0.033). Associations between greater rearfoot eversion and greater hip adduction indicate that interventions targeted at the foot or hip in in iduals with patellofemoral pain syndrome may have similar overall effects on lower limb motion and clinical outcomes. The relationship between rearfoot eversion and tibial internal rotation identified in the patellofemoral pain syndrome group may be related to aetiology. However, additional prospective research is needed to confirm this.
Publisher: Springer Science and Business Media LLC
Date: 14-03-2011
Publisher: Springer Science and Business Media LLC
Date: 22-06-2021
DOI: 10.1186/S12889-021-11224-7
Abstract: The physical environment has been shown to have a positive effect on the promotion of physical activity of older people. Outdoor environments that incorporate specialised exercise equipment suitable for older people are uniquely placed to promote physical activity and social connectedness amongst older people. The ENJOY project included the installation of specialised outdoor exercise equipment (the Seniors Exercise Park) and the delivery of a physical and social activity program for older people as part of a prospective pre-post research design. The installation of the specialised equipment in public sites and an aged care facility was also aimed at increasing usage of the equipment by older people from the wider community and to increase physical and social activities. A conceptual framework for implementation and several engagement methods were utilised to guide the research and to support the participating partners throughout the project. This paper is a reflective narrative describing the collaborative process and approach utilised to engage local governments and community, and reports the challenges and the lessons learnt to inform future strategies for implementation. The conceptual framework for the implementation process that guided the conduct and delivery of the ENJOY project included the core elements of the Interactive Systems Framework and the ecologic framework. These models incorporate elements of research-to-practice and community-centred implementation to accommodate the unique perspectives of a range of stakeholders. Partner characteristics such as local governments’ structure and policy as well as community factors can impact on implementation. Partnership with local governments with effective communication, strategic planning and community and seniors engagement approaches are recommended for successful implementation. The lessons learnt can further assist public health research design around changes to the built environment to positively impact on older people’s physical activity levels. Trial registration number ACTRN12618001727235. Date of registration 19th October 2018, www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375979
Publisher: Springer Science and Business Media LLC
Date: 31-05-2019
Publisher: Journal of Orthopaedic & Sports Physical Therapy (JOSPT)
Date: 05-2010
Abstract: Case-control and reliability study. To compare foot and ankle characteristics between in iduals with and without patellofemoral pain syndrome (PFPS) and to identify reliable weight-bearing foot and ankle measurements for use in future research on PFPS. PFPS is a common presentation to sports medicine and orthopaedic clinics. Characteristics of the foot and ankle are often linked with PFPS development, although evidence to support this link is equivocal and there is a lack of consensus on how best to evaluate these characteristics. A variety of weight-bearing foot and ankle measurements were evaluated by 3 raters of varying experience in 20 in iduals with PFPS and 20 controls matched by age, sex, height, and body mass. Between-group comparisons were made for each measurement using data from an experienced podiatrist blinded to group assignment of the participants. Intrarater and interrater reliability was compared between all measurements using the first 15 participants from each group. Between-group comparisons showed that the in iduals in the PFPS group had a more pronated foot posture when assessed by the foot posture index and longitudinal arch angle, and for all measurements relative to subtalar joint neutral. Foot posture index, normalized navicular drop, and calcaneal angle relative to subtalar joint neutral measurements also possessed high reliability in both groups when used by experienced raters. Reliability was not influenced by rater experience or the presence of PFPS for relaxed-stance foot posture measurements. Both tester inexperience and the presence of PFPS reduced reliability for all measurements of foot posture relative to subtalar joint neutral and measurement of weight-bearing ankle dorsiflexion. The foot posture index, normalized navicular drop, and calcaneal angle relative to subtalar joint neutral are all reliable and sensitive to group differences when used in a population with PFPS. In iduals with PFPS possess a more pronated foot posture and increased foot mobility compared to controls. Prospective evaluation of these measurements is now required to determine whether they contribute to the development of PFPS. J Orthop Sports Phys Ther 2010 (5):286-296, Epub 12 April 2010. doi:10.2519/jospt.2010.3227.
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.GAITPOST.2013.01.010
Abstract: Variations in foot posture, such as pes planus (low-arched foot) or pes cavus (high-arched foot), are thought to be an intrinsic risk factor for injury due to altered motion of the lower extremity. Hence, the aim of this systematic review was to investigate the relationship between foot posture and lower limb kinematics during walking. A systematic database search of MEDLINE, CINAHL, SPORTDiscus, Embase and Inspec was undertaken in March 2012. Two independent reviewers applied predetermined inclusion criteria to selected articles for review and selected articles were assessed for quality. Articles were then grouped into two broad categories: (i) those comparing mean kinematic parameters between different foot postures, and (ii) those examining associations between foot posture and kinematics using correlation analysis. A final selection of 12 articles was reviewed. Meta-analysis was not conducted due to heterogeneity between studies. Selected articles primarily focused on comparing planus and normal foot postures. Five articles compared kinematic parameters between different foot postures - there was some evidence for increased motion in planus feet, but this was limited by small effect sizes. Seven articles investigated associations between foot posture and kinematics - there was evidence that increasing planus foot posture was positively associated with increased frontal plane motion of the rearfoot. The body of literature provides some evidence of a relationship between pes planus and increased lower limb motion during gait, however this was not conclusive due to heterogeneity between studies and small effect sizes.
Publisher: Springer Science and Business Media LLC
Date: 18-10-2012
DOI: 10.1007/S00167-011-1710-Y
Abstract: Knee pain and disability can persist following knee replacement surgery which may place patients at increased risk of falls. This study investigated the falls risk and the occurrence of falls of people with knee osteoarthritis (OA) before and at 12 months following knee replacement surgery. Thirty-five patients with knee OA were tested prior to undergoing knee replacement surgery and at 12 months following surgery using the short form Physiological Profile Assessment, which incorporates tests of vision, lower limb proprioception, knee extension strength, reaction time and postural sway. Physical activity, number of falls, fear of falling, pain, disability and health-related quality of life were also assessed. No significant differences were found between the number of falls pre- and post-surgery (n.s.), with 48.5 and 40% reporting at least one fall in the 12 months before and following the surgery, respectively. Improvements in knee strength, reaction time and fear of falling were evident following surgery, with no improvement in lower limb proprioception. Self-reported pain, function and stiffness were significantly improved, but health-related quality of life deteriorated following the surgery. The number of falls experienced following knee replacement surgery remained relatively high, which may be attributed to the persistence of impaired lower limb proprioception. Although knee replacement surgery improves function and alleviates pain, people who undergo this procedure may need to engage in rehabilitation following the surgery to reduce the risk of falling. Therapeutic study investigating the result of treatment on patient outcomes, Level IV.
Publisher: IEEE
Date: 12-2008
Publisher: Elsevier BV
Date: 09-2014
Publisher: Elsevier BV
Date: 12-2016
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.GAITPOST.2015.10.017
Abstract: This systematic review evaluated the available evidence for the effects of Masai Barefoot Technology (MBT) footwear on lower limb biomechanics during gait. Electronic databases (MEDLINE, EMBASE, CINAHL, SPORTDiscus, and PubMed) were searched in January 2015. Methodological quality of included studies was evaluated using the Quality Index. Standardised mean differences and 95% confidence intervals were calculated, and meta-analysis was conducted where possible. 17 studies satisfied the inclusion criteria 16 cross-sectional studies and one randomised control trial (RCT). Quality Index scores ranged from 7 to 12 (out of 15). All 17 studies investigated walking gait only. Evidence showed that MBT footwear caused asymptomatic in iduals to walk with a shorter stride length, reduced peak hip flexion, increased peak knee extension, and reduced hip and knee range of motion throughout gait. All kinematic effects occurred in the sagittal plane. There was a trend towards a decrease in internal and external joint moments and power, except for the foot, where increases in force were observed. There were only a small number of changes to lower limb muscle litude and timing. No statistically significant effects were observed in symptomatic in iduals with knee osteoarthritis or following total knee replacement, but there was an increase in cadence and a decrease in step length in in iduals following tibiotalar arthrodesis. These findings suggest that MBT footwear does change lower limb biomechanics in both asymptomatic and symptomatic in iduals during gait. However, further clinical trials need to be undertaken to determine whether these changes are therapeutically beneficial.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2013
Publisher: Wiley
Date: 20-06-2021
DOI: 10.1002/HPJA.367
Abstract: Outdoor exercise equipment has become popular as important environmental infrastructure to provide opportunities for physical activity and social connectedness in public settings. With higher sedentary behaviour and physical inactivity reported among older people, infrastructure changes and safe environments that promote older peoples’ health and mobility are required. Due to ageing‐related functional decline and health conditions associated with ageing, older adults may have special physical needs that require careful consideration when choosing outdoor equipment. However, limited information is available regarding the suitability of the types of exercise equipment for older people. This commentary provides further information on the type of equipment available, its functionality and suitability for older age populations and key considerations for the decision‐maker involved in selecting, installing and supporting community use of outdoor exercise equipment. Recommendations on what is required to maximise usability from a system or organisational‐based approach using research evidence is also discussed. Older people are more susceptible to the negative influences of their local environment and outdoor neighbourhood conditions. Consequently, the age‐friendliness and suitability of the outdoor exercise equipment characteristics, location and settings may facilitate older adults’ engagement in physical and social activities.
Publisher: Human Kinetics
Date: 08-2016
Abstract: The forward-step-down (FSD) test may be used to identify underlying pathologies related to lower-extremity injuries. However, research on its interrater reliability is limited. To assess the interrater reliability of the FSD test with a broad cohort of clinicians and to compare the level of agreement with an expert panel. Single-measure, interrater reliability. Annual conference of the Israeli Physical Therapy Society. 15 healthy subjects who performed the FSD test and 142 physical therapists (PTs) who evaluated performance. Each subject performed the FSD while being videoed. Six videos were selected by an expert panel for analysis. After viewing the videos, FSD performance was rated by 142 PTs, as well as by the expert panel, using a 3-level scale. Interrater reliability determined by intraclass correlation coefficient (ICC) and percentage of agreement with the expert panel. Fair to good reliability and acceptable agreement were found for the entire s le of raters (ICC –.61, agreement 74%). The percentage of agreement was greater in the subgroup of raters who were familiar with the FSD than in those who were not (78.08% vs 69.32%, respectively, P = .004). Years of work experience did not affect the percentage of agreement ( P = .141). Fair to good interrater reliably of the FSD test was demonstrated by a broad cohort of PTs. The findings support the clinical utility of the FSD test as an assessment tool for quality of movement.
Publisher: Wiley
Date: 28-10-2022
DOI: 10.1111/AJAG.13004
Abstract: Falls and fall‐related injuries amongst older people continue to be a long‐term public health issue. Access to specialist services that target fall prevention has been shown to improve outcomes. This project aimed to develop an online directory of public outpatient and ambulatory falls and balance clinics and programs in Victoria. Environmental scan of existing services and survey of service providers between January and August 2020. Forty‐seven community‐based and 53 hospital‐based falls and balance services across metropolitan (46%) and regional (54%) Victoria registered. The majority of services were programs (70%) targeting exercise and/or education, as opposed to clinics (30%), which focus on diagnosis and developing management plans. Survey responses were collated to develop an online service directory: www.nari.net.au/victorian‐falls‐directory The Victorian Falls and Balance Service Directory provides a centralised and accessible reference for clinicians and community members regarding available outpatient and ambulatory services that target fall prevention.
Publisher: Springer Science and Business Media LLC
Date: 15-03-2014
Publisher: Springer Science and Business Media LLC
Date: 24-11-2011
DOI: 10.1007/S00167-010-1325-8
Abstract: Knee osteoarthritis (OA) is a major cause of disability and a risk factor for falls in older people. The purpose of this study was to assess the falls risk of people with knee OA before surgery and at 4 months following surgery and to compare this to a control group. Thirty-five patients with knee OA prior to undergoing knee replacement surgery and 27 asymptomatic age-matched controls participated in the study. The surgical group were tested prior to their surgery and at 4 months post-surgery. The short form of the Physiological Profile Assessment was used to assess falls risk and included tests of vision, lower limb proprioception, knee extension strength, reaction time and postural sway. Physical activity, quality of life, fear of falls and disability before and after surgery were also documented. At least one fall in the previous 12 months was reported for 48% of the surgical group compared with 30% of the control group. Following the surgery, there was a reduction in fear of falling and pain, and improvements in function for the surgical group. However, compared to the control group, the surgical group exhibited a greater fear of falling and reduced lower limb proprioception and knee extension strength both pre- and post-surgery. People who undergo knee replacement surgery may be at increased risk of falls both prior to and 4 months following their surgery, primarily due to deficits in knee extension strength and lower limb proprioception. Therefore, interventions to reduce the risk of falls should be implemented early after the surgery.
Publisher: Springer Science and Business Media LLC
Date: 24-11-2015
Publisher: Springer Science and Business Media LLC
Date: 23-09-2017
DOI: 10.1007/S11657-017-0378-4
Abstract: The association between vitamin D and muscle function associated with balance recovery and falls in people with knee osteoarthritis is unclear. Those with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function. Low vitamin D status in people with knee osteoarthritis (OA) is often reported to be associated with increased pain and locomotor dysfunction. However, despite the growing evidence of the effect of vitamin D on the pathogenesis of knee OA, its role remains conflicting. Importantly, muscle function is important for knee joint health however, the association between vitamin D levels and muscle function associated with balance recovery and falls is unclear. This study investigated the effect of circulating 25-hydroxyvitamin D (25 (OH) D) on pain, quadriceps strength, lower limb muscle mass and knee power function during balance recovery in people with knee OA. Twenty-four participants with clinical symptoms of knee OA (68.6 ± 6.2 years) participated in the study. Serum levels of 25 (OH) D were assessed and participants were classified as follows: vitamin D insufficiency ≤ 50 nmol/L and vitamin D sufficiency > 50 nmol/L. The groups were compared on knee function during balance recovery tasks, lower limb strength and muscle mass as well as perceived pain and function. Seven patients (29.1%) were classified as vitamin D-insufficient. Vitamin D insufficiency was associated with reduced knee muscle function during the balance recovery task, increased pain (Western Ontario and McMasters University Osteoarthritis Index (WOMAC) subscore), dysfunction (WOMAC subscore) and total WOMAC score (p < 0.05). People with knee OA with vitamin D insufficiency demonstrated poorer knee function during balance recovery, greater pain and locomotor dysfunction. Vitamin D insufficiency may have an adverse effect on muscle power function.
Publisher: Human Kinetics
Date: 2023
Publisher: Elsevier BV
Date: 08-2008
DOI: 10.1016/J.APMR.2007.11.058
Abstract: To examine the physical function, gait, and quality of life of patients after total hip replacement (THR) randomly assigned to either a targeted home- or center-based exercise program. Randomized controlled trial. Rehabilitation research center in Australia. Twenty-three patients with unilateral THR were randomly assigned to a supervised center-based exercise group (n=11) or an unsupervised home-based exercise group (n=12). The center-based group completed an 8-week targeted exercise program while under the direct supervision of a physiotherapist. After initial instruction, the home-based group completed the 8-week targeted exercise program at home without further supervision. Quality of life, physical function, and spatiotemporal measures of gait. No significant interaction (group by time) or main effects of grouping were found. Within each group, quality of life, and stair climbing improved significantly (P<.05) as did Timed Up & Go test and 6-minute walk test performances (P<.05). Walking speed increased by 16 cm/s (P<.01), cadence by 8 steps/min (P<.05), step length by 4.7 cm (P<.05), and double-support time reduced by a factor of 16%. Step length symmetry showed significant improvement (P<.05) over time. Step length differential between the affected and unaffected limbs reduced from 4.0 to 2.7 cm. The targeted strengthening program was effective for both the home- and center-based groups. No group differences were found in the majority of the outcome measures. This finding is important because it shows that THR patients can achieve significant improvements through a targeted strengthening program delivered at a center or at home.
Publisher: Wiley
Date: 02-2015
DOI: 10.14814/PHY2.12294
Publisher: Springer Science and Business Media LLC
Date: 11-2017
DOI: 10.1038/NATURE24621
Abstract: Our growing awareness of the microbial world’s importance and ersity contrasts starkly with our limited understanding of its fundamental structure. Despite recent advances in DNA sequencing, a lack of standardized protocols and common analytical frameworks impedes comparisons among studies, hindering the development of global inferences about microbial life on Earth. Here we present a meta-analysis of microbial community s les collected by hundreds of researchers for the Earth Microbiome Project. Coordinated protocols and new analytical methods, particularly the use of exact sequences instead of clustered operational taxonomic units, enable bacterial and archaeal ribosomal RNA gene sequences to be followed across multiple studies and allow us to explore patterns of ersity at an unprecedented scale. The result is both a reference database giving global context to DNA sequence data and a framework for incorporating data from future studies, fostering increasingly complete characterization of Earth’s microbial ersity.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.CLINBIOMECH.2015.03.014
Abstract: Foot posture has been postulated as a risk factor for overuse injuries of the knee, however the link between foot posture and knee joint function is unclear. The aims of this study were to: (i) compare knee adduction moment and knee joint rotations between normal, planus and cavus foot posture groups, and (ii) to determine the relationship between rearfoot and midfoot joint rotations and knee adduction moment magnitude. Rotation of the knee, rearfoot and midfoot was evaluated in 97 healthy adults that were classified as normal (n=37), cavus (n=30) or planus (n=30) for the Foot Posture Index, Arch Index and normalised navicular height. One way analyses of variance were used to compare tri-planar knee joint rotation, knee adduction moment peak variables and knee adduction angular impulse between foot posture groups. Pearson's correlation coefficient was used to investigate the association between rearfoot and midfoot joint rotation during initial contact phase and the magnitude of 1st knee adduction moment peak. The planus group displayed significantly greater external rotation angle at heel contact compared to both normal and cavus groups. The planus groups also displayed greater extension at heel contact and sagittal plane flexion range of motion during propulsion and early swing compared to the cavus group. Otherwise, differences between groups were characterised by small effect sizes. There was no association between rearfoot or midfoot joint rotations and knee adduction moment. These findings suggest that in healthy in iduals, foot posture and foot joint rotations do not substantially influence knee joint rotations and knee adduction moment while walking at a comfortable pace.
Publisher: Springer Science and Business Media LLC
Date: 08-10-2019
DOI: 10.1007/S00167-018-5210-1
Abstract: Patients undergoing total knee arthroplasty often have unfulfilled expectations from the surgery that can lead to dissatisfaction. This study aimed to examine the discrepancy between patients' expectations and actual functional abilities prior to undergoing knee replacement surgery, and at 6 and 12 months following the surgery. A survey was undertaken of patients before, and 6 and 12 months post-surgery. The survey included the Knee Surgery Perception Questionnaire (KSPQ) to assess patients' current perception of their level of function and pain, their desired outcomes, and the discrepancy between the two. Pain, function and quality of life were also assessed. Repeated measure ANOVAs were used to assess differences between pre- and post-surgery. A total of 176 patients were surveyed. Significant differences in the KSPQ discrepancy scores (subscale and total scores) were demonstrated between the three assessment point times (p < 0.01). Paired t tests identified significant differences between the pre-surgery and 6-month KSPQ discrepancy scores, (p < 0.01) indicative of substantial improvement in physical function and slight reduction in expectations. Overall significant improvement (p < 0.01) was reported over time across all measures: physical function, pain and stiffness and quality of life. The discrepancy between patients' current abilities and their expectation changes following surgery, especially in the first 6 months post-surgery. Patients' goals might change as their function and pain improve post-surgery. Combining education programmes and discussion with the treating orthopaedic surgeons pre-operatively is important for the development of realistic, achievable expectations. III.
Publisher: Elsevier BV
Date: 05-2005
Publisher: Institute of Electrical and Electronics Engineers (IEEE)
Date: 09-2009
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.PTSP.2017.06.001
Abstract: Self-efficacy is positively associated with adherence behaviours and rehabilitation outcomes following Anterior Cruciate Ligament (ACL) reconstruction. An internet resource can be an effective way to provide information, goal setting, patient monitoring and hence support overall self-management. This study examined the feasibility of a three month 'internet-based intervention' (mobile-oriented site) to enhance recovery for patients following ACL reconstruction. The potential effect of the internet-based intervention on knee pain, function, self-efficacy and fear of pain were also assessed. This was a pilot randomised controlled trial (RCT) with pre and post intervention design (assessments at one week and three months following ACL reconstruction) comparing: (1) a control group and (2) an intervention group (internet-based intervention). A set of qualitative and quantitative assessments were included to evaluate potential improvements in self-efficacy, pain and function and perception of the internet intervention. Seventeen participants were available for analysis (n = 10 intervention and n = 7 control group). Participants reported the internet-based intervention to be a useful tool for information, reminder and reinforcement for performing their exercise rehabilitation with 30.3% (±35.3%) adherence to the internet-based intervention. No differences were observed between the groups over time on the outcome questionnaires (p > 0.05). Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12616001379404.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2022
DOI: 10.1186/S12889-022-13335-1
Abstract: Physical activity is important to maintain health in older age, with physical activity in the outdoors providing mental and physical health benefits for all age groups. One way by which older people can engage in physical activity in the outdoors is through using suitable age-friendly outdoor exercise equipment, the Seniors Exercise Park. The ENJOY MAP for HEALTH aims to evaluate the effect of the Seniors Exercise Park installation and associated capacity building activities on park visitation, park-based physical activity by older people and delivery of community physical activity programs. This study is a quasi-experimental (natural experiment) with pre and post study design evaluating the effect of age-friendly outdoor spaces with specialised outdoor exercise equipment on older people’s physical activity and wellbeing in six Victorian municipalities (local governments/councils). Each council will undergo four stages (site construction and development, promotion and marketing, capacity building and training, evaluation and sustainability). Several activities and methods will be employed from stage one through stage four to evaluate the potential impact of the age-friendly outdoor spaces on physical activity and wellbeing and will comprise the following elements: site observation and equipment utilisation, face to face intercept surveys, development of an online access monitor and community building activities. The project is expected to result in a significant change in the physical outdoor environment for the participating councils and communities whereby older people and other community members will be able to engage in safe physical and social activity programs, socialise more and hence improve the overall wellbeing of older people. This trial is retrospectively registered with the Australian New Zealand Clinical Trials Registry. Trial registration number ACTRN12621000965808 . Date registered 23/07/2021.
Publisher: BMJ
Date: 16-11-2010
Abstract: There is growing evidence for the provision of foot orthoses when treating in iduals with patellofemoral pain syndrome (PFPS), and prescription is frequently based on the assessment of foot posture/function. However, evaluation of the link between abnormal foot posture/function and foot orthoses outcomes has previously been limited to static alignment measures and has produced inconsistent findings. In this study, the ability of baseline foot kinematics associated with pronation to predict marked improvement 12 weeks following foot orthoses prescription in in iduals with PFPS was evaluated. 26 in iduals with PFPS were issued with prefabricated foot orthoses, and patient-reported level of improvement was documented at 12 weeks. Potential predictors of marked improvement at 12 weeks were measured during walking at baseline and included forefoot dorsiflexion and abduction, and rearfoot eversion. Of the 25 participants who completed the study, seven (28%) reported marked improvement with the foot orthoses after 12 weeks. Discriminant function analysis revealed a greater peak rearfoot eversion to be the only significant independent predictor of marked improvement. These findings provide preliminary evidence that greater peak rearfoot eversion is predictive of marked improvement 12 weeks following prefabricated foot orthoses prescription in in iduals with PFPS. Therefore, foot orthoses may be most effective in the subgroup of people with PFPS and increased dynamic foot pronation.
Publisher: IEEE
Date: 2007
Publisher: Wiley
Date: 09-2012
DOI: 10.1002/JOR.21545
Abstract: An abnormal flexor moment pattern is often evident following total knee replacement (TKR) surgery. We investigated whether such a pattern at 12 months post-surgery could be predicted using biomechanical gait measures assessed before surgery and at 4 months post-surgery. Thirty two TKR patients were evaluated and classified as normal (biphasic pattern) or abnormal (flexor moment pattern) at each time point. Biomechanical parameters collected before surgery and at 4 months post-surgery were then explored for their ability to predict gait patterns at 12 months post-surgery. The gait pattern at 4 months was significantly associated with the 12 month post-surgery gait pattern, with over half of those with a flexor moment pattern at 4 months retaining this pattern at 12 months. Discriminant function analysis indicated that peak knee flexion during early stance, peak knee extension, and peak knee extension moment at 4 months post-surgery were independent predictors of the gait pattern at 12 months. Thus, an abnormal knee flexor moment pattern at 12 months post-surgery can be predicted by biomechanical analysis 4 months after surgery. Therefore, interventions aimed at improving active extension may need to be implemented early after surgery to restore a normal gait pattern.
Publisher: Elsevier BV
Date: 11-2007
Publisher: Informa UK Limited
Date: 30-11-2017
DOI: 10.1080/09638288.2017.1408710
Abstract: To explore the perceptions of people with severe knee osteoarthritis and increased cardiovascular risk about participating in a walking program. Qualitative study using semistructured interviews for people with severe knee osteoarthritis and increased cardiovascular risk who participated in a 12-week walking program. Interviews were audiotaped, transcribed verbatim, member-checked, coded and themes developed using thematic analysis. Findings were triangulated with quantitative data including pain, function and cardiovascular risk factors from previously reported data. Twenty-one participants were interviewed after the completion of the walking program. The main theme identified was the preoccupation with the knee including pain, damage and the view that surgery was required. Three subthemes to emerge were (i) the perception of functional, cardiovascular and psychosocial benefits with the walking program (ii) that supervision, monitoring and commitment were important enablers and (iii) external factors such as ill-health, weather and the environment were key barriers. The perceived functional and cardiovascular benefits converged with results from quantitative data. Even when patients with severe osteoarthritis of the knee report other benefits from participating in a walking program, the core theme to emerge was their preoccupation with knee pain, knee damage and the view that they needed a knee replacement. Implications for Rehabilitation Patients with severe osteoarthritis of the knee and moderate cardiovascular risk reported functional, cardiovascular and psychosocial benefits from participating in a walking program. Despite patients reporting functional, cardiovascular and psychosocial benefits, the core theme to emerge was their preoccupation with knee pain, knee damage and the view that they needed a knee replacement. The core theme highlights the challenges in promoting physical activity for patients with severe knee osteoarthritis.
Publisher: Wiley
Date: 20-06-2016
Publisher: Springer Science and Business Media LLC
Date: 18-08-2017
Publisher: Elsevier BV
Date: 06-2016
DOI: 10.1016/J.JOCA.2015.12.008
Abstract: Using a mouse surgical model of post-traumatic osteoarthritis (OA), we sought to determine if muscle function is altered following acute joint injury and whether this relates to OA progression. Male C57BL/6 mice underwent surgical transection of the medio-meniscal tibial ligament destabilisation of the medial meniscus (DMM) or sham surgery on one knee. Tibialis anterior (TA) muscle function was assessed in situ at 1, 4 and 8 weeks post-surgery. Cartilage damage and joint inflammation were assessed by histologic scoring. Muscle mRNA expression was quantified by qRT-PCR. Tetanic and twitch force production between DMM and sham muscle did not differ at 1 week post-surgery. Muscle function improved in both groups with time, but specific force production in DMM muscles was 18% and 22% lower than sham muscles at 4 and 8 weeks post-surgery respectively. At 8 weeks post-surgery, DMM muscles had a 40% slower relaxation rate and reduced expression of sarcoplasmic/endoplasmic reticulum Ca(2+) ATPase (Serca) pump mRNA compared to sham muscles both observations indicate likely alterations in muscle Ca(2+) handling. There were no histologic signs of muscle atrophy or inflammation in DMM TA muscles. Specific force production in both sham and DMM mice showed a negative correlation with the severity of joint inflammation. Acute knee injury in the DMM model of post-traumatic OA leads to a persistent deficit in TA muscle function that occurs in the absence of muscle atrophy. This study highlights that the impact of acute knee injury is unlikely to be limited to the muscles controlling knee movement.
Publisher: Springer Science and Business Media LLC
Date: 02-09-2012
DOI: 10.1007/S11556-011-0086-9
Abstract: Chronic musculoskeletal conditions in the lower extremities, particularly arthritis, and the chronic pain associated with them, are independent risk factors for falls, with approximately 50% of people with arthritis reporting one or more falls. Despite this, few studies have specifically addressed balance dysfunction, falls risk and falls incidence in people with arthritis. This review aimed to identify potential factors contributing to the increased risk of falls in people with lower limb osteoarthritis or rheumatoid arthritis and to summarise the evidence base for effective exercise interventions targeted to reduce their risk of falls. A systematic search of the literature was conducted in February 2010 and included the following databases: MEDLINE (Ovid), EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Cochrane Library and PsycINFO. Only three studies that investigated exercise programmes for people with lower limb arthritis met all inclusion criteria, but none used falls as an outcome measure. To broaden the review, systematic reviews that assessed the effectiveness of exercise interventions for fall prevention in older people were also included. The presence of any form of lower limb arthritis and the associated consequences including pain, balance impairment, reduced muscle strength and reduced function are all associated with increased risk of falling. Due to the link between musculoskeletal pain and the increased risk of falls, further research needs to investigate which type of exercise programme will be effective in reducing the risk of falls in populations with arthritis in the lower limbs.
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.ARTH.2012.10.018
Abstract: We investigated the biomechanical changes that occur in the lower limb following total knee arthroplasty (TKA). Lower limb joint kinematics and kinetics were evaluated in 32 patients before and 12 months following TKA and 28 age-matched controls. Analysis of variance with Bonferroni-adjusted post-hoc tests showed no significant changes in knee joint kinematics and kinetics following TKA despite significant improvements in pain and function. Significant increases in peak ankle plantarflexion and dorsiflexion moments and ankle power generation were observed which may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Differences in knee gait parameters may arise as a result of the presence of osteoarthritis and mechanical changes associated with TKA as well as retention of the pre-surgery gait pattern.
Publisher: Elsevier BV
Date: 06-2015
DOI: 10.1016/J.GAITPOST.2015.03.004
Abstract: Variations in foot posture are associated with the development of some lower limb injuries. However, the mechanisms underlying this relationship are unclear. The objective of this study was to compare foot kinematics between normal, pes cavus and pes planus foot posture groups using a multi-segment foot model. Ninety-seven healthy adults, aged 18-47 were classified as either normal (n=37), pes cavus (n=30) or pes planus (n=30) based on normative data for the Foot Posture Index, Arch Index and normalised navicular height. A five segment foot model was used to measure tri-planar motion of the rearfoot, midfoot, medial forefoot, lateral forefoot and hallux during barefoot walking at a self-selected speed. Angle at heel contact, peak angle, time to peak angle and range of motion was measured for each segment. One way ANOVAs with post-hoc analyses of mean differences were used to compare foot posture groups. The pes cavus group demonstrated a distinctive pattern of motion compared to the normal and pes planus foot posture groups. Effect sizes of significant mean differences were large and comparable to similar studies. Three key differences in overall foot function were observed between the groups: (i) altered frontal and transverse plane angles of the rearfoot in the pes cavus foot (ii) Less midfoot motion in the pes cavus foot during initial contact and midstance and (iii) reduced midfoot frontal plane ROM in the pes planus foot during pre-swing. These findings indicate that foot posture does influence motion of the foot.
Publisher: Wiley
Date: 29-11-2011
DOI: 10.1002/ACR.20625
Abstract: Patients with knee osteoarthritis (OA) are characterized by increased muscle inflammation and altered gait. We investigated the association between proinflammatory mediators in the vastus lateralis and physical function and gait in patients with knee OA. Nineteen patients with knee OA underwent gait analysis, assessment of self-reported pain and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and a muscle biopsy that was taken during their knee replacement surgery. Muscle was analyzed for cellular protein inflammatory mediators, interleukin-6, monocyte chemotactic protein 1 (MCP-1), p65 NF-κB, signal transducer and activator of transcription 3 (STAT-3), and JNK-1. Sagittal plane knee function, including early stance knee range of motion (ROM) and knee sagittal plane impulse, was measured using a motion analysis system. Pearson's correlation was used to assess relationships between selected variables. Significant positive correlations were found between MCP-1 and self-perceived stiffness, physical function, and the total WOMAC score (P < 0.05). MCP-1 was also negatively correlated with early stance knee ROM (r = -0.52, P = 0.023). Reduced velocity was associated with elevated levels of p65 NF-κB and STAT-3 (P < 0.05). Knee sagittal plane impulse was negatively correlated with JNK-1 (P = 0.02), indicating reduction in knee impulse with an increased level of JNK-1. Increased levels of several proinflammatory mediators were correlated with altered knee function during walking as well as greater physical disability and slower gait velocity. Identification of the cellular and molecular mechanisms associated with muscle inflammation is important to better understand the underlying mechanism responsible for altered gait and function in patients with knee OA.
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.GAITPOST.2018.03.005
Abstract: Variations in foot posture, such as pes planus (low medial longitudinal arch) or pes cavus (high medial longitudinal arch) are associated with some lower limb injuries. However, the mechanism that links foot posture to injury is not clear. Research question The aim of this study was to compare plantar pressure between healthy in iduals with normal, planus or cavus feet. Ninety-two healthy volunteers (aged 18 to 45) were classified as either normal (n = 35), pes planus (n = 31) or pes cavus (n = 26) based on the Foot Posture Index, Arch Index and normalised navicular height truncated. Barefoot walking trials were conducted using an emed Overall, the largest differences were between the planus and cavus foot groups in forefoot pressure and force. In particular, peak pressures at the 4th and 5th MTPJs in the planus foot group were lower compared to the normal and cavus foot groups, and displayed the largest effect sizes. Significance This study confirms that foot posture does influence plantar pressures, and that each foot posture classification displays unique plantar pressure characteristics.
Publisher: Springer Science and Business Media LLC
Date: 10-05-2017
DOI: 10.1007/S00421-017-3639-4
Abstract: The aim of the study was to determine whether higher fibrosis markers in skeletal muscle of older adults are accompanied by increased expression of components of the canonical TGF-β signal transduction pathway. Fourteen healthy young (21-35 years 9 males and 5 females) and seventeen older (55-75 years 9 males and 8 females) participants underwent vastus lateralis biopsies to determine intramuscular mRNA and protein expression of fibrogenic markers and TGF-β signaling molecules related to TGF-β1 and myostatin. Expression of mRNA encoding the pro-fibrotic factors axin 2, collagen III, β-catenin and fibronectin, were all significantly higher (all p < 0.05) in the older participants (350, 170, 298, and 641%, respectively). Furthermore, axin 2 and β-catenin mRNA were significantly higher in older females than older males (p < 0.05). Gene expression of ActRIIB, myostatin, and TGF-β1 were higher in older adults compared to younger adults (all p 0.05), whereas Smad3 protein phosphorylation was 48% lower (p < 0.05) in muscle from older adults. Increased abundance of mRNA of fibrotic markers was observed in muscle from older adults and was partly accompanied by altered abundance of pro-fibrotic ligands in a sex specific manner.
Publisher: Springer Science and Business Media LLC
Date: 20-09-2017
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.GAITPOST.2015.05.014
Abstract: Falls during walking reflect susceptibility to balance loss and the in idual's capacity to recover stability. Balance can be recovered using either one step or multiple steps but both responses are impaired with ageing. To investigate older adults' (n=15, 72.5±4.8 yrs) recovery step control a tether-release procedure was devised to induce unanticipated forward balance loss. Three-dimensional position-time data combined with foot-ground reaction forces were used to measure balance recovery. Dependent variables were margin of stability (MoS) and available response time (ART) for spatial and temporal balance measures in the transverse and sagittal planes lower limb joint angles and joint negative ositive work and spatio-temporal gait parameters. Relative to multi-step responses, single-step recovery was more effective in maintaining balance, indicated by greater MoS and longer ART. MoS in the sagittal plane measure and ART in the transverse plane distinguished single step responses from multiple steps. When MoS and ART were negative (<0), balance was not secured and additional steps would be required to establish the new base of support for balance recovery. Single-step responses demonstrated greater step length and velocity and when the recovery foot landed, greater centre of mass downward velocity. Single-step strategies also showed greater ankle dorsiflexion, increased knee maximum flexion and more negative work at the ankle and knee. Collectively these findings suggest that single-step responses are more effective in forward balance recovery by directing falling momentum downward to be absorbed as lower limb eccentric work.
Publisher: Elsevier BV
Date: 2009
DOI: 10.1016/J.GAITPOST.2008.07.004
Abstract: Knee osteoarthritis (OA) is one of the leading causes of disability among the elderly which, depending on severity, may require surgical intervention. Knee replacement surgery provides pain relief and improves physical function including gait. However gait dysfunction such as altered spatio-temporal measures may persist after the surgery. In this paper, we investigated the application of support vector machines (SVM) to classify gait patterns indicative of knee OA before surgery based on 12 spatio-temporal gait parameters and investigated whether SVMs could be used to predict gait improvement 2 and 12 months following knee replacement surgery. Test results for the pre-operative data indicated that the SVM could successfully identify in iduals with OA gait from the healthy using all of the spatio-temporal parameters with a maximum leave one out accuracy of 100% for the training set and 88.89% for the test set. Findings indicated that three patients still had altered gait patterns 2 months post-knee replacement surgery, but all in iduals showed improvement in gait 12 months following surgery. Consequently, the SVM detected improvement in gait function due to surgical intervention at 2 and 12 months following knee replacement which coincided with clinical assessment of the knee. This suggests that spatio-temporal parameters contain important discriminative information which may be used for the identification of pathological gait using an SVM classifier.
Publisher: Springer Science and Business Media LLC
Date: 12-2010
Publisher: Springer Science and Business Media LLC
Date: 12-05-2017
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1016/J.KNEE.2008.06.002
Abstract: Increased load on the knee joint by excessive levels of impact forces during initial contact has been suggested to lead to knee osteoarthritis (OA). Asymmetric loading after knee replacement may also relate to the development of OA in the contralateral limb, therefore this study investigated the heel strike transient vertical force and subsequent lower extremity kinematic, kinetic and spatio-temporal parameters during level walking between the operated and the contralateral limbs in patients 12 months following unilateral knee replacement. A six camera motion analysis system with a force plate was used to investigate the differences between limbs in the heel strike transient vertical GRF and its relative timing, and hip, knee and ankle angles and moments at initial contact, as well as spatio-temporal parameters during the stance phase of walking in 19 subjects with unilateral knee replacement. Paired t tests showed a significant difference in the contralateral limb relative to the operated limb in the heel strike transient magnitude (p=0.03), hip moment (p=0.01), knee moment (p=0.02) and ankle moment (p=0.03). No significant differences were found for the joint angles at heel contact or the spatio-temporal parameters (p>0.05). The heel strike transient magnitude was lower for the operated limb with no differences in the spatio-temporal parameters or the joint angles at initial contact between the limbs. Differences in the hip, knee and ankle moments were also found indicating an asymmetric loading of the impact force at initial contact on the lower extremity. The current findings may indicate an asymmetric loading on the knee joint and therefore may be clinically relevant in patients undergoing unilateral knee replacement.
Publisher: Springer Science and Business Media LLC
Date: 13-01-2016
DOI: 10.1007/S00198-015-3473-7
Abstract: The molecular regulation of muscle function in knee osteoarthritis is unclear. Elevated muscle atrophy regulation marker expression was associated with reduced muscle strength in knee osteoarthritis. The level of protein expression appears to be different between muscle, knee joint and serum, suggesting that inflammation is regulated differently within these tissues. Impaired muscle function is common in knee osteoarthritis (OA). Numerous biochemical molecules have been implicated in the development of OA however, these have only been identified in the joint and serum. We compared the expression of interleukin-15 (IL-15) and Forkhead box protein-O1 (FoxO1) in muscle of patients with knee OA and asymptomatic in iduals and examined whether IL-15 was also present in the joint and serum. Muscle and blood s les were collected from 19 patients with knee OA and 10 age-matched asymptomatic in iduals. Synovial fluid and muscle biopsies were collected from the OA group during knee replacement surgery. IL-15 and FoxO1 were measured in the skeletal muscle. IL-15 abundance was also analysed in the serum of both groups and synovial fluid from the OA group. Knee extensor strength was measured and correlated with IL-15 and FoxO1 in the muscle. FoxO1 protein expression was higher (p = 0.04), whereas IL-15 expression was lower (p = 0.02) in the muscle of the OA group. Strength was also lower in the OA group and was inversely correlated with FoxO1 expression. No correlation was found between IL-15 in the joint, muscle or serum. Skeletal muscle, particularly the quadriceps, is affected in people with knee OA where elevated FoxO1 protein expression was associated with reduced muscle strength. While IL-15 protein expression in the muscle was lower in the knee OA group, no correlation was found between the expression of IL-15 protein in the muscle, joint and serum, which suggests that inflammation is regulated differently within these tissues. Australian Clinical Trials Registry (ACTR) number: ACTRN12613000467730 ( www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN12613000467730&isBasic=True ).
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.JSBMB.2017.01.022
Abstract: Muscle function is often impaired in patients with knee osteoarthritis (OA), with reduced strength and increased pain. The role of vitamin D and the vitamin D-endocrine pathway in muscle health has recently been placed in the spotlight, with various groups reporting positive effects on muscle development, function and health. Recently, it has been shown that uptake into muscle of the specialized vitamin D binding protein (DBP) is dependent on the endocytic receptor, megalin. Here we analyse circulating vitamin D, and muscle DBP, megalin and the cognate vitamin D receptor (VDR) in patients with knee OA and compare them to asymptomatic controls. Muscle and blood s les were collected from 19 patients with end-stage OA of the knee and 10 age-matched controls. Muscle biopsies from the OA group were performed during knee replacement surgery and a needle biopsy was used on control volunteers. Immunoblots performed with specific antibodies were used to detect the presence of DBP, megalin, VDR (using the specific D-6 antibody) and albumin in the muscle biopsies. Results were correlated with FoxO1, a key regulator of the ubiquitin-proteasome degradation pathway in muscle. There were no differences in circulating levels of 25 (OH) vitamin D3 between the groups, and no subjects were vitamin D deficient. We found increased VDR, DBP and albumin protein in the muscle from patients with OA compared to controls, with no change in muscle megalin expression. Furthermore, DBP levels in the muscle correlated with FoxO1, suggesting an association between muscle protein breakdown and the activation of the vitamin D-endocrine pathway in muscle surrounding an OA affected joint. We show, for the first time, that the factors involved in the vitamin D-endocrine-pathway are present at higher levels in muscles from OA patients compared to asymptomatic controls. This is despite no differences in circulating 25 (OH) vitamin D levels between the groups. These findings indicate the activation of vitamin D pathway in these muscles that may provide a beneficial compensatory stimulation of the repair process in muscles that are subject to inflammatory and proteolytic processes.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2012
DOI: 10.1007/S00421-012-2458-X
Abstract: Older adults have an increase in circulating markers of inflammation. The current study examined whether there is an increase in the expression of inflammatory markers within the vastus lateralis, a major locomotive muscle, of older adults, and if so, whether the reduction in muscle strength and aerobic capacity in older adults is related to increased muscle inflammation. Skeletal muscle biopsies were taken from older adults (n = 17, 67 ± 1.6 years) and young in iduals (n = 16, 24 ± 0.6 years) under resting and fasting conditions. Muscle was analyzed for mRNA levels of intracellular inflammatory molecules (MCP1, TNFα and IL-1β) and total cellular protein abundance of cytokines, chemokines and kinases (IL-6, IL-8, MCP1, TNFα, p65 (NF-κB), JNK1/2 and STAT3). MCP1 expression was significantly higher (p < 0.05 50 %, mRNA and 40 %, protein) in elderly than younger participants, as was IL-8 (4 %). No detectable difference in kinase protein expression was observed for STAT3, JNK or p65 (NF-κB), TNFα or IL-6. Muscle strength was lower in the elderly compared to the young group (1.55 ± 0.17 vs. 2.56 ± 0.13 Nm/kg, p < 0.001). The elderly group also had a significantly lower VO(2peak) compared to the young group (24.9 ± 1.9 vs. 39.3 ± 1.9, p < 0.001), but muscle strength and VO(2peak) were not correlated with the examined inflammatory markers. Older adults have increased MCP1 (mRNA and protein abundance) and IL-8 (protein abundance) and also reduced muscle strength and VO(2peak). However, the reduction in muscle strength and VO(2peak) was not related to the increase in muscle inflammatory markers in this cohort.
Publisher: Frontiers Media SA
Date: 08-05-2014
Publisher: Springer Science and Business Media LLC
Date: 08-06-2017
DOI: 10.1007/S00402-017-2727-6
Abstract: Pain and disability often persist following hip (THR) and knee replacement (TKR) surgery predisposing patients to increased risk of falling. This study identified pre-operative predictors for post-operative falls in TKR and THR patients, and the incidence and circumstances of falls in the 12 months post-surgery. A survey was undertaken of patients before THR and TKR, and was repeated 12 months post-operation. The survey included (1) medical history and medications usage, (2) pain and function, (3) health-related and physical activity and (4) fear of falls and history of falls questionnaires. Patients were classified as 'fallers' (≥1 fall) or 'non-fallers' based on prospectively documented falls in the 12 months post-surgery. Binary logistic regression was conducted to identify independent pre-operative predictors of incident falls status. Eighty-two of the 243 participants (33.7%) reported ≥1 fall in the 12 months post-operatively [60 (34.1%) patients following TKR and 22 (32.8%) following THR]. The logistic regression model was statistically significant, χ People awaiting hip or knee joint replacement surgery might present with complex conditions that predispose them to greater risk of falling post-operation. Review of general health and history of falling is recommended pre-operatively to identify patients at risk.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.JOCA.2015.04.001
Abstract: To determine how much physical activity, in the form of walking, can be safely and feasibly tolerated for people with severe knee osteoarthritis (OA). Phase I dose response trial with escalating walking doses of 10, 20, 35, 50, 70, and 95 min over 1 week, were prescribed non-randomly to people with severe knee OA. The primary stopping rule was a substantial increase in knee pain. The primary outcomes were an estimation of the maximum tolerated dose of walking and the proportion of people who did not complete the dose for feasibility reasons. The secondary outcomes were pain, stiffness and activity limitation Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Twenty-four participants (13 women) aged 53-83 years, and average body mass index (BMI) of 34 kg/m(2) (SD 9) were recruited. Three participants were assigned to each dose between 10 and 70 min, and nine participants assigned to the 95-min dose. The trial was stopped at 95 min due to the maximum number of adverse events occurring at this dose. Therefore, the maximum tolerated dose was 70 min. No participant stopped due to reasons related to feasibility. There was a moderate association between dose and increased activity (linear R(2) = 0.31, cubic R(2) = 0.69) and reduced stiffness (linear R(2) = 0.20, cubic R(2) = 0.52), with increased benefits at moderate to higher doses. There is preliminary evidence that 70 min per week of moderate intensity supervised walking was safe and feasible for people with severe OA of the knee for higher doses there was a risk of exacerbating knee pain levels.
Publisher: IEEE
Date: 08-2007
Publisher: American Physiological Society
Date: 15-11-2012
DOI: 10.1152/JAPPLPHYSIOL.01032.2011
Abstract: Aging is associated with reduced muscle mass, weakness, and increased fatigability. In skeletal muscle, the Na + -K + pump (NKA) is important in regulating Na + -K + gradients, membrane excitability, and thus contractility, but the effects of aging on muscle NKA are unclear. We investigated whether aging is linked with reduced muscle NKA by contrasting muscle NKA isoform gene expression and protein abundance, and NKA total content in 17 Elderly (66.8 ± 6.4 yr, mean ± SD) and 16 Young adults (23.9 ± 2.2 yr). Participants underwent peak oxygen consumption assessment and a vastus lateralis muscle biopsy, which was analyzed for NKA α 1 -, α 2 -, α 3 -, β 1 -, β 2 -, and β 3 -isoform gene expression (real-time RT-PCR), protein abundance (immunoblotting), and NKA total content ([ 3 H]ouabain binding sites). The Elderly had lower peak oxygen consumption (−36.7%, P = 0.000), strength (−36.3%, P = 0.001), NKA α 2 - (−24.4%, 11.9 ± 4.4 vs. 9.0 ± 2.7 arbitrary units, P = 0.049), and NKA β 3 -protein abundance (−23.0%, P = 0.041) than Young. The β 3 -mRNA was higher in Elderly compared with Young ( P = 0.011). No differences were observed between groups for other NKA isoform mRNA or protein abundance, or for [ 3 H]ouabain binding site content. Thus skeletal muscle in elderly in iduals was characterized by decreased NKA α 2 - and β 3 -protein abundance, but unchanged α 1 abundance and [ 3 H]ouabain binding. The latter was likely caused by reduced α 2 abundance with aging, preventing an otherwise higher [ 3 H]ouabain binding that might occur with a greater membrane density in smaller muscle fibers. Further study is required to verify reduced muscle NKA α 2 with aging and possible contributions to impaired exercise capability and daily living activities.
Publisher: Elsevier BV
Date: 2007
DOI: 10.1016/J.GAITPOST.2005.12.015
Abstract: Abnormal subtalar joint function and the consequent rotation of the tibia during walking are thought to contribute to patellofemoral pain syndrome (PFPS). The purpose of this study was to measure rearfoot and tibia motion, and the ground reaction force (GRF) during the stance phase of walking in subjects with PFPS and compare them to healthy subjects. A four camera motion analysis system with a single force plate was used to investigate rearfoot motion relative to the tibia in three planes, the tibial transverse plane rotation and the GRF during the stance phase of walking in 13 female subjects diagnosed with PFPS and 14 healthy females. Analysis showed significantly delayed peak rearfoot eversion (p=0.02), and earlier occurrence of peak dorsiflexion (p=0.02) for the PFPS group. Furthermore, significantly lower peak medial GRF (p=0.03), minimum vertical GRF trough (p=0.02) and the second vertical GRF peak (p=0.01) were found in the PFPS group. Tibial transverse rotation was not shown to be different in PFPS subjects. However, there was prolonged rearfoot eversion during the stance phase of walking. The earlier appearance of rearfoot dorsiflexion as well as the lower GRFs indicate altered propulsive function of the foot during supination.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JOCA.2016.12.017
Abstract: The primary aim was to evaluate the effect of a dosed walking program on knee pain for patients with severe knee osteoarthritis (OA). Secondary aims evaluated the effects on cardiovascular health, function and quality of life. Participants with severe knee OA and increased cardiovascular risk were randomly assigned to a 12-week walking program of 70 min/week of at least moderate intensity, or to usual care. The primary outcome was knee pain (0-10). Secondary outcomes were of cardiovascular risk including physical activity, blood pressure, blood lipid and glucose levels, body mass index and waist circumference WOMAC Index scores physical function and quality of life. Forty-six participants (23 each group) were recruited. Sixteen participants (70%) adhered to the walking program. Intention to treat analysis showed no between-group difference in knee pain. The walking group had increased odds of achieving a healthy systolic blood pressure (OR = 5.7, 95% CI 1.2-26.9), and a faster walking speed (Mean Difference (MD) = 0.12 m/s, 95% CI 0.02-0.23). Per protocol analysis based on participant adherence showed the walking group had more daily steps (MD = 1345 steps, 95% CI 365-2325) more time walking (MD = 18 min/day, 95% CI 5-31) reduced waist circumference (MD = -5.3 cm, 95% CI -10.5 to -0.03) and increased knee stiffness (MD = 0.9 units, 95% CI 0.07-1.8). Patients with severe knee OA prescribed a 12-week walking program of 70 min/week may have had cardiovascular benefits without decreasing knee pain. Australian New Zealand Clinical Trials Registry ACTRN12615000015549.
Publisher: Informa UK Limited
Date: 06-03-2014
DOI: 10.3109/09638288.2014.895428
Abstract: To determine if a pre-operative group rehabilitation programme can improve arthritis self-efficacy for people with severe hip and knee osteoarthritis. Single group, repeated measures design: 4-week baseline phase followed by a 6-week intervention phase of water exercise, and education with self-management strategies. The primary outcome was arthritis self-efficacy. The secondary outcomes were measures of pain (WOMAC), activity limitation (WOMAC), activity performance (30 s chair stand test, 10 m walk test) and health-related quality of life (EuroQol). Twenty participants (10 knee osteoarthritis and 10 hip osteoarthritis) with a mean age of 71 years (SD 7) attended 92% (SD 10%) of the scheduled sessions. All measures demonstrated baseline stability between two time points for measurements at week 1 and measurements at week 4. After the 6-week intervention programme there were no significant improvements for arthritis self-efficacy. There was a 12% increase for fast walking speed (mean increase of 0.14 m/s, 95% CI 0.07, 0.22). There were no significant improvements for other secondary outcomes. A pre-operative water-based exercise and educational programme did not improve arthritis self-efficacy, self-reported pain and activity limitation, and health-related quality of life for people with hip and knee osteoarthritis who were candidates for joint replacement. While there was a significant increase in one measure of activity performance (walking speed), these findings suggest the current programme may be of little value. Implications for Rehabilitation This pre-operative group rehabilitation programme for people with severe hip and knee osteoarthritis did not change arthritis self-efficacy, pain, activity limitation and health-related quality of life. This programme may have little value in preparing people for joint replacement surgery. The optimal pre-operative programme requires further design and investigation.
Publisher: Informa UK Limited
Date: 04-09-2015
DOI: 10.3109/17483107.2015.1080767
Abstract: This study aimed to develop a low-cost real-time biofeedback system to assist with rehabilitation for patients following total knee replacement (TKR) and to assess its feasibility of use in a post-TKR patient case study design with a comparison group. The biofeedback system consisted of Microsoft Kinect(TM) and Nintendo Wii balance board with a dedicated software. A six-week inpatient rehabilitation program was augmented by biofeedback and tested in a single patient following TKR. Three patients underwent a six weeks standard rehabilitation with no biofeedback and served as a control group. Gait, function and pain were assessed and compared before and after the rehabilitation. The biofeedback software incorporated real time visual feedback to correct limb alignment, movement pattern and weight distribution. Improvements in pain, function and quality of life were observed in both groups. The strong improvement in the knee moment pattern demonstrated in the case study indicates feasibility of the biofeedback-augmented intervention. This novel biofeedback software has used simple commercially accessible equipment that can be feasibly incorporated to augment a post-TKR rehabilitation program. Our preliminary results indicate the potential of this biofeedback-assisted rehabilitation to improve knee function during gait. Research is required to test this hypothesis. Implications for Rehabilitation The real-time biofeedback system developed integrated custom-made software and simple low-cost commercially accessible equipment such as Kinect and Wii board to provide augmented information during rehabilitation following TKR. The software incorporated key rehabilitation principles and visual feedback to correct alignment of the lower legs, pelvic and trunk as well as providing feedback on limbs weight distribution. The case study patient demonstrated greater improvement in their knee function where a more normal biphasic knee moment was achieved following the six-week biofeedback intervention.
Publisher: Elsevier BV
Date: 10-2010
DOI: 10.1016/J.GAITPOST.2010.07.013
Abstract: Foot posture is thought to influence predisposition to overuse injuries of the lower limb. Although the mechanisms underlying this proposed relationship are unclear, it is thought that altered foot kinematics may play a role. Therefore, this study was designed to investigate differences in foot motion between people with normal- and flat-arched feet using the Oxford Foot Model (OFM). Foot posture in 19 participants was documented as normal-arched (n=10) or flat-arched (n=9) using a foot screening protocol incorporating measurements from weightbearing antero-posterior and lateral foot radiographs. Differences between the groups in triplanar motion of the tibia, rearfoot and forefoot during walking were evaluated using a three-dimensional motion analysis system incorporating a multi-segment foot model (OFM). Participants with flat-arched feet demonstrated greater peak forefoot plantar-flexion (-13.7° ± 5.6° vs -6.5° ± 3.7° p=0.004), forefoot abduction (-12.9° ± 6.9° vs -1.8° ± 6.3° p=0.002), and rearfoot internal rotation (10.6° ± 7.5° vs -0.2°± 9.9° p=0.018) compared to those with normal-arched feet. Additionally, participants with flat-arched feet demonstrated decreased peak forefoot adduction (-7.0° ± 9.2° vs 5.6° ± 7.3° p=0.004) and a trend towards increased rearfoot eversion (-5.8° ± 4.4° vs -2.5° ± 2.6° p=0.06). These findings support the notion that flat-arched feet have altered motion associated with greater pronation during gait factors that may increase the risk of overuse injury.
Publisher: Elsevier BV
Date: 02-2012
DOI: 10.1016/J.GAITPOST.2011.09.020
Abstract: Knee osteoarthritis (OA) has been shown to be a risk factor for falls. Reductions in foot clearance during the swing phase of walking can cause a trip and potentially lead to a fall. This study examined the swing phase mechanics of people with and without knee OA during walking. Minimum toe clearance (MTC) height, joint angles at the time of MTC and the influence of the angular changes of the hip, knee and ankle of the swing leg on foot clearance using sensitivity analysis were investigated in 50 knee OA participants and 28 age-matched asymptomatic controls. Although both groups had a similar MTC height (controls: 12.8±6.7 mm, knee OA: 13.4±7.0 mm), the knee OA group used a different strategy to achieve the same foot clearance, as evidenced by greater knee flexion (52.5±5.3° vs 49.4±4.8°, p=0.007), greater hip abduction (-3.6±3.3° vs -1.8±3.3°, p=0.03) and less ankle adduction (2.8±1.9° vs 4.2±2.1°, p=0.01). MTC height was comparable between the groups, however a different swing phase mechanism was used by the knee OA. Although adequate MTC is an important component of safe locomotion, it does not appear to be impaired in people with knee OA. Other factors, such as inadequate responses to postural perturbation, may be responsible for falls in this group.
Publisher: Wiley
Date: 15-04-2018
DOI: 10.1002/HPJA.60
Abstract: Exercising outdoors provide beneficial effect on mental and physical health for all ages. However, few older people exercise outdoors other than walking. While outdoor gyms have become increasingly common in Australia, limited outdoor exercise equipment specifically designed for older people is available in public spaces. We have set up and evaluated a unique purpose-built outdoor exercise park for older people in the community setting and demonstrated positive physical and wellbeing outcomes associated with the provision of this unique exercise mode and social program. This study is a reflective narrative describing this innovative exercise approach and reports challenges associated with establishment of the exercise park, conducting the randomised trial, strategies adopted to address these challenges and recommendations for future implementation of this approach in the community. Many challenges were encountered, including securing appropriate land to locate the exercise park, control of environmental factors for safety (non-slippery ground and equipment) as well as logistics in running the exercise program itself. Several adjustments in the equipment were also required to ensure safe use by older people. The inclusion of outdoor equipment for older people in public spaces or urban parks is important and careful consideration needs to be taken by local ublic authorities to provide access, amenities and safety for all as well as activities to suit all ages. SO WHAT?: Seniors' exercise parks can be installed in public places and may provide an enjoyable and effective approach to engage older in iduals in a more active and healthier lifestyle.
Publisher: American Physiological Society
Date: 15-11-2013
DOI: 10.1152/JAPPLPHYSIOL.00789.2013
Abstract: Knee osteoarthritis (OA) is a debilitating disorder prevalent in older populations that is accompanied by declines in muscle mass, strength, and physical activity. In skeletal muscle, the Na + -K + pump (NKA) is pivotal in ion homeostasis and excitability and is modulated by disuse and exercise training. This study examined the effects of OA and aging on muscle NKA in 36 older adults (range 55–81 yr), including 19 with OA (69.9 ± 6.5 yr, mean ± SD) and 17 asymptomatic controls (CON, 66.8 ± 6.4 yr). Participants completed knee extensor strength testing and a physical activity questionnaire. A vastus lateralis muscle biopsy was analyzed for NKA content ([ 3 H]ouabain binding sites), α 1–3 - and β 1–3 -isoform protein abundance (immunoblotting), and mRNA (real-time RT-PCR). The association between age and NKA content was investigated within the OA and CON groups and in pooled data. The NKA content was also contrasted between subgroups below and above the median age of 68.5 yr. OA had lower strength (−40.8%, P = 0.005), but higher NKA α 2 - (∼34%, P = 0.006) and α 3 -protein (100%, P = 0.016) abundance than CON and performed more incidental physical activity ( P = 0.035). No differences were found between groups for NKA content, abundance of other NKA isoforms, or gene expression. There was a negative correlation between age and NKA content within OA ( r = −0.63, P = 0.03) and with both groups combined ( r = −0.47, P = 0.038). The NKA content was 25.5% lower in the older (69–81 yr) than in the younger (55–68 yr) subgroup. Hence older age, but not knee OA, was related to lowered muscle NKA content in older adults.
Publisher: Wiley
Date: 27-04-2016
DOI: 10.1002/ACR.22750
Publisher: Springer Science and Business Media LLC
Date: 05-02-2018
Publisher: Wiley
Date: 28-04-2011
DOI: 10.1002/ART.30287
Abstract: Increased inflammation and pain are inseparable parts of knee osteoarthritis (OA) that may lead to disuse of the affected limb. The aim of this study was to examine the effects of knee OA on inflammation- and atrophy-related genes and proteins in the vastus lateralis muscle of patients with knee OA. Nineteen patients with knee OA and 14 asymptomatic control subjects matched for age and body mass index underwent strength measurements and a muscle biopsy. Muscle was analyzed for the total cellular protein of inflammatory kinases (p65 NF-κB, JNK1/2, STAT-3, and suppressor of cytokine signaling 3 [SOCS-3]) and inflammatory intracellular molecules (interleukin-6 [IL-6], IL-8, monocyte chemoattractant protein 1 [MCP-1], tumor necrosis factor α [TNFα], IL-1β, and atrogin-1). Knee OA resulted in greater levels of IL-6 protein (34% P = 0.002). The levels of inflammatory kinases, including STAT-3 (187% P = 0.002), p65 NF-κB (156% P = 0.002), and JNK1 (179% P = 0.027), were also elevated. Furthermore, elevated expression of gene transcripts encoding MCP-1 (28% P = 0.023), TNFα (85% P < 0.001), and SOCS-3 (38% P = 0.055) was observed in patients with knee OA compared with control subjects. Patients with knee OA had reduced muscle strength compared with control subjects (mean ± SEM 84.7 ± 8.7 versus 143.1 ± 20.8 Nm P = 0.005). Negative correlations were observed between muscle strength and MCP-1 protein abundance (r = -0.37 [P = 0.042]) and the gene expression of TNFα and atrogin-1 messenger RNA (r = -0.46 [P = 0.012] and r = -0.36 [P = 0.040], respectively). Gene expression and the protein abundance of numerous muscle markers of inflammation and atrophy were elevated in patients with knee OA, and the increase in muscle inflammation was associated with a reduction in muscle strength. Given the role inflammation markers may play in muscle strength and atrophy, further studies are needed to investigate the effect of exercise intervention on skeletal muscle inflammation.
Publisher: Springer Science and Business Media LLC
Date: 26-11-2016
DOI: 10.1007/S00167-014-3432-4
Abstract: The discrepancy between patient-desired outcomes and achievable functional outcomes is a source of patient dissatisfaction. This paper reports development and validation of a questionnaire to assess this discrepancy in patients undergoing knee replacement surgery. The initial questionnaire (Knee Surgery Perception Questionnaire, KSPQ) comprised two parts. Part A, assessed patients' perception of their current level of function and pain, and Part B, assessed patients' desired outcomes of the surgery. Validation was carried out for Part A and then applied to Part B using a one-factor congeneric model and was tested in 185 patients preceding surgery. A discrepancy score between patients' expectations and desired outcome (Part B) and their perception of current function (Part A) was also calculated. Pearson correlations were used between the KSPQ total score and subscales and other knee-specific questionnaires to determine construct validity. The final best set of models included four items for each subscale with a Chi-square value of 7.3 (n.s). The subscales and the total KSPQ showed significant strong to moderate correlations with knee-specific questionnaires. The discrepancy score in each subscale and the overall score showed relatively large discrepancy between patients' expectations and their perception of current function with higher discrepancy score reported for pain and walking. The KSPQ is a valid questionnaire to assess patients' expected and desired outcomes of knee replacement surgery and their perception of their current abilities and function, and discrepancy between these. The KSPQ now requires further investigation at different stages of recovery following surgery. III.
No related grants have been discovered for Pazit Levinger.