This study supports the importance of a combined self-management and exercise intervention to improve functional lower limb strength and aerobic capacity in a Portuguese sample. Additionally, pain and other symptoms have improved clinically.

Biomedical techniques and applications are being developed and placed at the service of clinicians. An example is medical thermography, which is being used more often in the detection of certain diseases and also in pain distribution. Current thermography processing software has some limitations mainly because it is developed for general applications and does not allow the identification of a Region Of Interest (ROI) with a specific anatomic shape. Current commercial software usually uses regular prismatic shapes for the definition of these regions, such as, rectangles, squares, circles and/or ellipse that poorly define complex geometric regions. These shapes present limitations when they do not fit with the complex geometric shape of the area that is to be characterized, either by the exclusion or the inclusion of irrelevant data in the evaluation of the thermal images. This particular limitation is observed no matter how accurate the definition of the ROI is. In order to improve characterization of thermal images, a computational application was developed. The limitations of existing software applications was overcome by designing an application that allows choosing any ROI, independently of its geometric shape and optimize it for further processing. This research work presents several segmentation algorithms and a comparison of untreated and optimized ROI's.

BackgroundAquatic exercise is recommended by the Osteoarthritis Research Society (OARSI), by the American College of Rheumatology (ACR) and by the European League Against Rheumatism (EULAR) as a nonpharmacological method of controlling the knee osteoarthritis (KOA) symptoms. Moreover, given that weight loss results in a reduction of the load that is exerted upon the knee during daily activities, obesity is also considered to be a modifiable risk factor for the development and or exacerbation of KOA. The implementation of an exercise based weight loss program may, however, itself be limited by the symptoms of KOA. The aquatic program against osteoarthritis (termed “PICO” in Portuguese) prioritizes the control of symptoms and the recovery of functionality, with an attendant increase in the patient’s physical activity level and, consequently, metabolic rate. Our laboratory is assessing the effectiveness of 3 months of PICO on the symptoms of KOA, on physical function, on quality of life and on gait. In addition, PICO shall examine the effects of said exercise intervention on inflammatory biomarkers, psychological health, life style and body composition.Methods/DesignThe trial is a prospective, single-blinded, randomized controlled trial, and involves 50 overweight and obese adults (BMI = 28–43.5 kg/m2; age 40–65 yrs) with radiographic KOA. The participants are randomly allocated into either an educational attention (control) group or an aquatic (exercise program) group. This paper describes the experimental protocol that is used in the PICO project.DiscussionThe PICO program shall provide insight into the effectiveness of an aquatic exercise program in the control of KOA symptoms and in the improvement of the quality of life. As such, they are likely to prove a useful reference to health professionals who intend to implement any kind of therapeutic intervention based around aquatic exercise.Trial registrationNCT01832545.

Traditional locomotion studies emphasize an optimization of the desired movement trajectories while ignoring sensory feedback. We propose an information based theory that locomotion is neither triggered nor commanded but controlled. The basis for this control is the information derived from perceiving oneself in the world. Control therefore lies in the human-environment system. In order to test this hypothesis, we derived a mathematical foundation characterizing the energy that is required to perform a rotational twist, with small amplitude, of the instantaneous axes of the knee (IAK). We have found that the joint’s perception of the ground reaction force may be replaced by the co-perception of muscle activation with appropriate intensities. This approach generated an accurate comparison with known joint forces and appears appropriate in so far as predicting the effect on the knee when it is free to twist about the IAK.