Exercise therapy with or without other physical therapy interventions versus placebo interventions for osteoarthritis –Systematic review

Dean, Benjamin; Bennell, Kim L; Collins, Jenna; Thurley, Neal; Rombach, Ines

doi:10.1016/j.ocarto.2021.100195

Cited by 13 publications

(6 citation statements)

References 30 publications

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“…These joints are often affected by osteoarthritis, a degenerative condition that causes deterioration of the joint surfaces and eventual bone modeling. The consequence of such a condition is severe pain, leading to significant functional limitations and disability, as well as a significant social burden. − Patients with osteoarthritis represent the cohort of people with upper limb osteoarthritis most likely to undergo surgical intervention . However, previous studies evaluating the efficacy of surgical intervention have shown varying levels of benefit in terms of pain reduction and improved function and have reported adverse event rates ranging from 10 to 22%, depending on the procedure used .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of In Vivo Biocompatibility in Preclinical Studies of a Finger Implant Medical Device Correlated with Mechanical Properties and Microstructure

Major,

Grajoszek,

Byrski

et al. 2023

ACS Appl. Mater. Interfaces

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The aim of the experiment was to evaluate the biocompatibility of four 3D-printed biomaterials planned for use in the surgical treatment of finger amputees: Ti-6Al-4 V (Ti64), ZrO 2 −Al 2 O 3 ceramic material (ATZ20), and osteoconductive (anodized Ti64) and antibacterial (Hydroxyapatite, HAp) coatings that adhere well to materials dedicated to finger bone implants. The work concerns the correlation of mechanical, microstructural, and biological properties of dedicated materials. Biological tests consisted of determining the overall cytotoxicity of the organism on the basis of in vivo tests carried out in accordance with the ISO 10993-6 and ISO 10993-11 standards. Clinical observations followed by diagnostic examinations, histopathological evaluation, and biochemical characterization showed no significant differences between control and tested groups of animals. The wound healed without complication, and no pathological effects were found. The wear test showed the fragility of the hydroxyapatite thin layer and the mechanical stability of the zirconia-based ceramic substrate. Electron microscopy observations revealed the layered structure of tested substrates and coatings.

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Section: Introductionmentioning

confidence: 99%

Evaluation of In Vivo Biocompatibility in Preclinical Studies of a Finger Implant Medical Device Correlated with Mechanical Properties and Microstructure

Major,

Grajoszek,

Byrski

et al. 2023

ACS Appl. Mater. Interfaces

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“…[18][19][20] Perhaps given the lack of high-quality evidence to guide practice, the ladder approach makes sense by reserving the more invasive and risky interventions for after all else has failed. 21 This approach is also consistent with the cost-effectiveness of the NICE guideline development process, meaning that in the absence of high-quality evidence, less expensive interventions are generally preferred before considering the more invasive and expensive interventions. 22 Our interviews also demonstrated the highly malleable and adaptable role of the steroid injection as part of a package of care in people with CMCJ OA.…”

Section: Discussionmentioning

confidence: 74%

A qualitative study exploring clinicians’ views on clinical trials in thumb carpometacarpal joint osteoarthritis

Dean

Srikesavan

Horton³

et al. 2022

Bone & Joint Open

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Aims Osteoarthritis (OA) affecting the thumb carpometacarpal joint (CMCJ) is a common painful condition. In this study, we aimed to explore clinicians’ approach to management with a particular focus on the role of specific interventions that will inform the design of future clinical trials. Methods We interviewed a purposive sample of 24 clinicians, consisting of 12 surgeons and 12 therapists (four occupational therapists and eight physiotherapists) who managed patients with CMCJ OA. This is a qualitative study using semi-structured, online interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. Results A total of 14 themes were developed, six of which were developed relating to the clinical management of CMCJ OA: 1) A flexible ‘ladder’ approach starting with conservative treatment first; 2) The malleable role of steroid injection; 3) Surgery as an invasive and risky last resort; 4) A shared and collaborative approach; 5) Treating the whole person; and 6) Severity of life impact influences treatment. The remaining eight themes were developed relating to clinical trial barriers and facilitators: 1) We need to embrace uncertainty; 2) You are not losing out by taking part; 3) It is difficult to be neutral about certain treatments; 4) Difficult to recruit to ‘no treatment’ ; 5) Difficult to recruit to a trial comparing no surgery to surgery; 6) Patients are keen to participate in research; 7) Burden on staff and participants; and 8) A enthusiasm for a variety of potential trial arms. Conclusion Our findings contribute to a better understanding of how clinicians manage thumb CMCJ OA in their practice settings. Our study also provides useful insights informing the design of randomized clinical trials involving steroid injections and surgery in people with thumb CMCJ OA. Cite this article: Bone Jt Open 2022;3(4):321–331.

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“…A recent systematic review reported that current evidence displays that exercise therapy is superior to placebo in the short term for pain and function in OA [ 53 ].…”

Section: Discussionmentioning

confidence: 99%

Isometric Quadriceps Exercises for Patients with Knee Osteoarthritis: A Randomized Controlled Trial Comparing Knee Joint Position Flexion versus Extension

Sengul

Yavuzer

Keles

et al. 2022

Rehabilitation Research and Practice

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Objective. To compare the effect of quadriceps isometric exercises performed in two different positions in addition to the combined physical therapy program on pain, stiffness, and physical function in patients with knee osteoarthritis (OA). Methods. A total of 30 patients with OA (age range 45 to 70 years) who were admitted to Istanbul Private Ekotom Medical Center, Department of Physical Medicine and Rehabilitation Outpatient Clinic, were included. The patients were randomly divided into two groups according to the type of performing the quadriceps isometric exercises as group 1 (performing in knee extension, n = 14 ) and group 2 (performing in knee flexion, n = 15 ). All patients also received a combined physical therapy program. Exercise protocols were applied six days a week for four weeks. The pain was evaluated using a 10 cm visual analog scale for pain (VAS) in rest and activity; pain, joint stiffness, and physical function were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. A significant difference was found in the VAS and WOMAC scores of both groups in group comparisons ( p < 0.05 ). When the groups were compared in terms of change values, a significant difference was found in the WOMAC stiffness score in favor of group I ( p < 0.05 ). Discussion. It is possible to obtain positive results with quadriceps isometric exercises to reduce pain and joint stiffness and increase physical function in patients with knee OA. However, exercises performed in knee extension were found to be more effective in reducing joint stiffness.

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Exercise therapy with or without other physical therapy interventions versus placebo interventions for osteoarthritis –Systematic review

Cited by 13 publications

References 30 publications

Evaluation of In Vivo Biocompatibility in Preclinical Studies of a Finger Implant Medical Device Correlated with Mechanical Properties and Microstructure

Evaluation of In Vivo Biocompatibility in Preclinical Studies of a Finger Implant Medical Device Correlated with Mechanical Properties and Microstructure

A qualitative study exploring clinicians’ views on clinical trials in thumb carpometacarpal joint osteoarthritis

Isometric Quadriceps Exercises for Patients with Knee Osteoarthritis: A Randomized Controlled Trial Comparing Knee Joint Position Flexion versus Extension

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