Background Exercise is recommended as a principal treatment for individuals with knee osteoarthritis (KOA). However, the best choice for an optimal exercise program able to promote long-term compliance in KOA patients is not clear. This study aims to compare the effect of combined exercise (CE: quadriceps strengthening exercises (QSE) and Baduanjin qigong training (BDJ)) versus QSE alone and BDJ alone on older adults with KOA. Methods A three-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from three community centers were assigned respectively to QSE group, BDJ group and CE group. We assessed pain intensity, physical function, self-efficacy, and health-related quality-of-life (HRQoL) using standardized instruments at baseline, 3 months and 6 months follow-up. Results One hundred and twenty-eight participants with KOA aged over 60 completed the study. Over the 6 months, there were significant group interaction effects on pain intensity (F = 28.888, P < 0.001), physical function (F = 26.646, P < 0.001), and self-efficacy (F = 22.359, P < 0.001), and, based on a short form-12 item health survey questionnaire (SF-12), physical component summary (F = 7.470, P < 0.001), and mental component summary (F = 10.207, P < 0.001). Overall, the CE group exhibited significantly greater improvement in all outcomes when compared to the QSE group and the BDJ group. Conclusions CE treatment is more effective than QSE and BDJ in pain relief, increasing physical function, improving self-efficacy, and raising quality-of-life in community-dwelling KOA older adults. Moreover, it promotes long-term compliance in KOA community patients. Trial registration Chinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020.

BackgroundExercise is recommended as a core treatment for individuals with KOA. However, the optimal exercise program to promote long-term compliance for KOA patients is not clear. The aim of this study is to compare the effects of the combination exercise program (quadriceps strengthening exercises (QSE) plus Baduanjin qigong) versus QSE alone on older adults with knee osteoarthritis (KOA). MethodsA two-arm, quasi-experimental trial with repeated measurements was used. As a cluster randomized trial, participants from one community center were assigned to combination exercise group while participants from the other center were assigned to QSE group. We assessed pain intensity, physical function, self-efficacy, and HRQoL with standardized instruments at baseline, 3 and 6 months. Results87 participants with KOA who aged above 60 completed the study. Over the 6 months, There were significant time by group interaction effects on pain intensity (F = 44.419, p < 0.001), physical function (F = 46.904, p < 0.001) and self-efficacy (F = 49.754, p < 0.001), as well as in the physical component summary (F = 15.205, p < 0.001) and mental component summary of SF-12 (F = 19.205, p < 0.001), with the combination exercise group exhibiting significantly greater improvements in all outcomes than QSE group. ConclusionsCombination exercise treatment is more effective than QSE for relieving pain, increasing physical functioning, and improving self-efficacy, and quality of life in community-dwelling KOA older adults. Also, it could promote long-term compliance for KOA community patients.Trial registrationChinese Clinical Trails Registry number ChiCTR2000033387 (retrospectively registered). Registered 30 May 2020

Acute heart failure (AHF) is life-threatening medical condition requiring hospital admission and appropriate oxygen therapy. High flow nasal cannula oxygen therapy (HFNC) has gained its popularity in treatment of AHF, however, there were less studies have demonstrated the physiological efficacy of HFNC. Purpose of this study was to evaluated the physiological responses and clinical outcomes of HFNC by comparing with noninvasive positive pressure ventilation (NPPV) therapy. A retrospective cohort investigation was conducted at emergency intensive care unit (EICU) and cardiovascular center of our hospital from June 2019 to March 2022, AHF patients with hypoxemia were reviewed. According to the received oxygen therapy model, patients were divided into HFNC and NPPV groups. Demographic data, arterial blood gas (ABG) parameter, echocardiography findings, complications and other related variables were extracted and collected from the electronic medical records (EMRs) by well-trained investigators. Physiological responses and clinical outcomes within and between 2 groups were analyzed. Finally, 156 patients with a mean age of 69.3 ± 7.1 years were reviewed, there were 82 (52.6%) male and 74 (47.4%) female patients in the sample and 70 (44.9%) and 86 (55.1%) patients classified III and IV score were included in this study, 80 patients received HFNC and 76 underwent NPPV oxygen therapy. There were no significant differences of baseline characteristics for the 2 groups patients. Changes of left ventricular function parameters, ABG and clinical outcomes were all improved satisfactorily after 24 h medical interventions in both group, what's more, patients underwent HFNC therapy could acquire a better amelioration when compared with NPPV groups (P < .05). HFNC may be an ideal model for patients with AHF, particularly those with hypoxemia. HFNC therapy could significantly improve several objective parameters of physiological responses and clinical outcomes. Abbreviations: ABG = arterial blood gas, AHF = acute heart failure, APACHE II = physiology and chronic health evaluation-II, FiO 2 = inspired oxygen concentration, HF = heart failure, HFNC = high flow nasal cannula, HR = heart rate, LVEDV = left ventricular end diastolic volume, LVEF = left ventricular ejection fraction, LVESD = left ventricular and systolic diameter, LVESV = left ventricular end systolic volume, NPPV = noninvasive positive pressure ventilation, NT-proBNP = N-terminal pro-B-type natriuretic peptide, PaO 2 = arterial partial pressure of oxygen, RR = respiratory rate, SpO 2 = blood oxygen saturation.