Background:Knee osteoarthritis (OA) is an increasingly common and disabling problem in worldwide. Exercises are considered the cornerstone of non-surgical management of knee OA and is recommended in all current clinical guidelines. The diversity of exercise programs determines the need to compare their efficiency, in order to recommend the best option for the patient.Objectives:The aim of the present study was to compare the effect on knee functionality of conventional exercises program and combinate with manual therapy in patients with knee osteoarthritis.Methods:164 patients that fulfilled the ACR classification criteria for knee osteoarthritis (127 females and 37 males) ranging in age from 42 to 84 years (mean 62,2 SD 8,76), participated in a 10 days two-arm randomized trial. One group (Gr.1) received an exercises program, the other group additionally manual therapy methods (Gr.2). Pain and function were measured with a Visual Analogue Scale (VAS, mm) and Knee Injury and Osteoarthritis Outcomes Score (KOOS) with 5 domains (Pain, Symptoms, Activity in Daily Living (ADL), Sport and recreation (Sport/rec.) and Quality of life (QoL)).Results:In the Gr.1 were 82 patients mean age 61,8±9,2 years and in Gr.2 – 82 patients 62,7±8,3 years (p>0.05). The initial level of pain (63,4±14,2 vs 60,2±18,8mm) and knee functionality according to KOOS (Tab1.) were similar in both groups, p>0.05. After 10 days rehabilitation program, VAS in Gr.1 was 39,6±14,8 mm, in Gr.2- 28,5±11,6 mm, (p<0.01). The KOOS results at the end of the rehabilitation program were with improvement, statistically significative in the Gr.2 (p<0,05).Table 1.The KOOS results at baseline and after 10 days of rehabilitation program.KOOS scales(M±SD), %Group 1Group 2BaselineAfter 10 daysBaselineAfter 10 daysPain55,5 ±13,863,4±13,653,0±22,364,3±19,1Symptoms59,0±18,765,6±18,156,6±19,069,0±15,9ADL46,3±15,554,5±16,043,0±19,955,1±18,2Sport/rec15,6±17,323,1±19,616,0±24,330,5±23,6QoL29,3±22,236,5± 22,934,8±23,950,6±18,9Conclusion:The reduction of pain and recovery of function were found in both groups, with better results in patients who received manual therapy and exercises program. This study supports the routine manual therapy in rehabilitation program in patients with knee osteoarthritis.Disclosure of Interests:None declared.

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Background:Systemic lupus erythematosus is an autoimmune disease with a major impact on patient’s quality of life.Objectives:To evaluate patient’s attitude toward early disease and factors that influence it.Methods:Performed case-control study included SLE patients that fulfilled SLICC, 2012 classification criteria. The research included two groups of patients: early SLE – 1stgroup (disease duration ≤24 months) and non-early SLE – 2ndgroup control (disease duration >24 months). The pattern of the disease activity was assessed by patient global assessment (PGA), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus Activity Measure (SLAM), for SLE activity, SLICC/ACR Damage Index (DI) for disease irreversible changes and SF-8 for the Quality of Life (QoL).Results:A total of 101 SLE patients with 34 in the 1stgroup (early SLE) and 67 in the 2ndgroup (non-early SLE) was analyzed. The disease activity showed high disease activity in both groups by SLEDAI (7,02±4,16 and 6,26±4,43 points, p>0,05) and SLAM (7,47±4,40 and 7,31±4,10 points, p>0,05) such as (46,97±19,39 vs 47,98±22,41 points). The QoL was appreciated as low, by both components (mental and physical), in groups. The damage index was higher in the 2nd group (0,23±0,43 and 1,07±1,29, p<0,001), which can be explained by the development of irreversible changes with the increase of disease duration.The PGA in early SLE was influenced by subjective symptoms contained in SLAM index (r=0,48, p<0,05), such as fatigue and depression, and the level of the quality of life (r=0,65, p<0,001). Meantime, PGA in patients with longer disease duration (>2 years), was influenced by the presence of organ damage by SLICC/ACR DI (0,23, p<0,05) and objective findings of the disease activity contained in SLEDAI (r=0,33, p<0,005) and SLAM (0,44, p<0,001).Conclusion:The disease recognition in patients with early SLE was determined by subjective and psycho-emotional signs, while in patients with longer disease duration it was influenced by organ damage and complications.References:no referencesDisclosure of Interests:None declared

Background:Physical rehabilitation is proposed as a method of non-pharmacological treatment of knee osteoarthritis (OA) by the EULAR and OARSI recommendations. At the same time, presence of concomitant diseases could influence the condition of patients and the outcomes of the rehabilitation program.Objectives:To evaluate the frequency of comorbidities in OA patients and to appreciate their impact on outcomes of the physical rehabilitation program.Methods:A prospective control case study was conducted in the University Rehabilitation Center. The patients underwent clinical examination, VAS scale was used to assess level of pain, and Knee Injury and Osteoarthritis Outcome Score (KOOS) with 5 domains (Pain, Symptoms, ADL, Sport, QoL) for joint function assessment. These parameters were evaluated at the onset of the program (T0) and at the end of the 10th day (T1). Medical data records, general clinical exam and Charlson Comorbidities Index (CCI) assessed the comorbidities.Results:48 patients with OA were included in the study, 37 patients of them were found with comorbidities. The most frequent associated diseases were: cardiovascular- 76.6%, obesity-59.9%, and endocrine - 12.9% cases. At T0, significantly lower levels in the group with comorbidities were identified on the domains Pain, Sport and QoL. The CCI in patients with comorbidities was 3.29 ± 0.14 points (82.1% for 1-year survival rate). At the T1 moment, we found an improvement in joint functionality in both groups. The mean value of the VAS score group of patients without comorbidities decreased from 48,18 mm to 21,36 mm (p <0.05) and for the group of patients with comorbidities – 64,2 at / 36,2 mm (p<0.001). Significant improvement in joint function in the comorbidities group was in Pain (p <0.01), Sport (p <0.05) and Qol (p <0.01) domains, at the same in patients without comorbidities, the improvement was significant in all 5 domains.Conclusion:Comorbidities are highly associated to knee osteoarthritis and prove to have a negative influence on the results of the physical rehabilitation program; therefore, we would recommend to apply individualized rehabilitation programs adapted to the associated conditions of each patient.Disclosure of Interests:None declared