Arthritis care and research : the official journal of the Arthritis Health Professions Association

To evaluate the efficacy of operant pain treatment for fibromyalgia syndrome (FMS) in an inpatient setting.
Sixty‐one patients who fulfilled the American College of Rheumatology criteria for FMS were randomly assigned to the operant pain treatment group (OTG; n = 40) or a standardized medical program with an emphasis on physical therapy (PTG; n = 21). Pain assessments were performed before, immediately after, 6 months after, and 15 months after treatment.
The OTG patients reported a significant and stable reduction in pain intensity, interference, solicitous behavior of the spouse, medication, pain behaviors, number of doctor visits, and days at a hospital as well as an increase in sleeping time. Sixty‐five percent of the OTG compared with none of the patients in the PTG showed clinically significant improvement.
These results suggest that operant pain treatment provided in an inpatient setting is an effective treatment for FMS, whereas a purely somatically oriented program may lead to a deterioration of the pain problem.

Kati Thieme

Erika Gromnica‐Ihle

Herta Flor

Arthritis Care &amp; Research

Arthritis &amp; Rheumatism

Operant behavioral treatment of fibromyalgia: A controlled study

纤维肌痛的操作性行为治疗：一项对照研究

By magnetic resonance imaging (MRI), subchondral bone attrition (SBA) can be seen in early osteoarthritis (OA), but the significance of this is unknown. We therefore evaluated whether SBA was associated with cartilage loss within the same subregion of the knee.
The Multicenter Osteoarthritis Study is a cohort of individuals who have or are at high risk for knee OA. At baseline and 30 months, participants' knee MRIs were graded using the Whole‐Organ Magnetic Resonance Imaging Score in the 10 subregions of the tibiofemoral joint for cartilage morphology and SBA. We conducted analyses within a knee to eliminate between‐person confounding, using an M:N (cases:controls) matched case–control approach with the 10 subregions of a person's knee forming a matched set. Cases within a knee were defined as subregions with cartilage loss, while controls were subregions in that same knee without cartilage loss. We evaluated the association of cartilage loss over 30 months with the presence of baseline SBA in the same subregion within that knee using conditional logistic regression.
SBA was associated with an odds ratio of 7.5 (95% confidence interval 5.6–9.9,P< 0.0001) for cartilage loss in the same subregion compared with subregions without any baseline SBA in our sample of 459 knees from participants, 64% of whom were women, with a mean age of 63 years and a mean body mass index of 30.5 kg/m2.
SBA is strongly associated with cartilage loss within the same subregion of a knee. SBA may directly influence overlying cartilage loss or serve as a marker of an area undergoing great compressive stress and in which cartilage loss is inevitable.

T. Neogi

D. Felson

J. Niu

J. Lynch

M. Nevitt

A. Guermazi

F. Roemer

C. E. Lewis

B. Wallace

Y. Zhang

Cartilage loss occurs in the same subregions as subchondral bone attrition: A within‐knee subregion‐matched approach from the multicenter osteoarthritis study

软骨丢失与软骨下骨磨损发生在相同亚区域：多中心骨关节炎研究中的膝关节内亚区域匹配方法

To determine the effect of joint protection and home exercises on hand function of patients with hand osteoarthritis (OA).
Randomized, controlled, 3‐month trial with a blinded assessor. Primary outcome parameter was grip strength; secondary parameters were Health Assessment Questionnaire and visual analog scales (VAS) for pain and global hand function. Forty patients with hand OA were randomly assigned to 2 groups: One group received instruction for joint protection and home hand exercises (JPE group), the control group received an information session about hand OA.
Grip strength improved by 25% in the JPE group (right hand,P< 0.0001; left hand,P= 0.0005), but not in the control group. Global hand function (by VAS) improved in a larger proportion (65%) of patients in the JPE group (P< 0.05).
Joint protection and hand home exercises, easily administered and readily acceptable interventions, were found to increase grip strength and global hand function.

Tanja Alexandra Stamm

Klaus Peter Machold

Josef Sebastian Smolen

Sabine Fischer

Kurt Redlich

Winfried Graninger

Wolfgang Ebner

Ludwig Erlacher

Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: A randomized controlled trial

联合保护与家庭手部锻炼改善手部骨关节炎患者手部功能：一项随机对照试验

To examine thigh muscle strength, functional performance, and self‐reported outcome in patients with nontraumatic meniscus tears 4 years after operation, and to study the impact of a strength deficit on self‐reported outcome and evaluate the feasibility of 3 performance tests in this patient group.
The study group comprised 45 patients (36% women, mean age 46.7) who had an arthroscopic partial meniscectomy a mean of 4 years (range 1–6 years) previously. Main outcome measures included isokinetic strength of knee extensors and flexors, functional performance (1‐leg hop, 1‐leg rising, and square‐hop tests), and a self‐reported questionnaire (Knee Injury and Osteoarthritis Outcome Score).
We found lower knee extensor strength and worse 1‐leg rising capacity in the operated leg, but no difference between operated and nonoperated leg for knee flexors (P≤ 0.004 andP> 0.3, respectively). Patients with a stronger quadriceps of the operated leg compared with the nonoperated leg had less pain and better function and quality of life (r = 0.4–0.6,P≤ 0.010). We found the 1‐leg rising and 1‐leg hop tests to be suitable performance tests in middle‐aged meniscectomy patients.
Quadriceps strength is reduced in the meniscectomized leg compared with the nonoperated leg 4 years after surgery. This relative quadriceps weakness significantly affects objective and self‐reported knee function, pain, and quality of life, indicating the importance of restoring muscle function after meniscectomy in middle‐aged patients.

Ylva B. Ericsson

Ewa M. Roos

Leif Dahlberg

Muscle strength, functional performance, and self‐reported outcomes four years after arthroscopic partial meniscectomy in middle‐aged patients

中年患者关节镜下部分半月板切除术后四年肌肉力量、功能表现及自我报告结果

To characterize the distribution of error in knee joint proprioception, quadriceps force accuracy and steadiness, and muscle strength in patients with knee osteoarthritis (OA). Special attention was paid to eccentric strength.
We compared knee OA patients (n = 20: 15 women, 5 men) with age‐ and sex‐matched, symptom‐free adults. Knee pain and mobility were assessed with standard tests. Knee joint proprioception was measured with a repositioning test. Quadriceps force accuracy and steadiness were determined during a force target‐tracking task. Maximal voluntary quadriceps force was measured during eccentric, isometric, and concentric contractions.
OA patients had knee pain, needed 67% more time to complete 4 functional tasks, and produced 82% more proprioception errors (allP< 0.05). About 80% of this error was due to overshooting the target and 68% of the overshooting error occurred at 2 of the 5 least flexed knee joint positions. OA patients had 89% more errors in accurately matching target forces during submaximal quadriceps contractions and in the same tasks, OA patients also produced these forces with 155% more variability (allP< 0.05). OA patients had especially weakened ability to produce maximal voluntary eccentric strength.
Quadriceps dysfunction in knee OA includes impaired proprioception, especially in the more extended knee joint positions; impaired ability to accurately and steadily control submaximal force; and impaired eccentric strength. These results have implications for designing exercise and rehabilitation programs for patients with knee OA.

Tibor Hortobágyi

Joseph Garry

Donald Holbert

Paul Devita

Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis

膝关节骨性关节炎患者股四头肌肌力控制的异常

To investigate the movement and muscle activation strategies during walking of individuals with medial knee osteoarthritis (OA) to determine the influence of quadriceps strength, medial knee laxity, limb alignment, and self‐reported knee instability on knee motion.
Twenty‐eight persons with medial knee OA and 26 control subjects participated. Quadriceps strength, medial knee laxity, and limb alignment were measured. Knee instability (IKOSscore) was assessed with the Activities of Daily Living Scale of the Knee Outcome Survey. Knee motion and muscle activation patterns were measured with motion analysis. Group differences were detected with independent samplest‐tests and predictive relationships were determined with linear and hierarchical regression analyses.
Individuals with OA were weaker, had greater medial knee laxity, and had more varus alignment. The OA group used less knee motion and higher muscle co‐contraction during weight acceptance and single‐limb support. Quadriceps strength and IKOSscore significantly strengthened the prediction of knee motion during weight acceptance and single‐limb support, whereas limb alignment and medial laxity did not.
The knee stiffening and higher muscle co‐contraction used by the OA group may be detrimental to joint integrity. IKOSscores predicted knee motion after accounting for quadriceps strength, underscoring the importance of addressing knee instability with appropriate rehabilitation strategies in persons with medial knee OA in order to promote long‐term joint integrity.

Laura C. SchmitT

Katherine S. Rudolph

Influences on knee movement strategies during walking in persons with medial knee osteoarthritis

内侧膝关节骨性关节炎患者行走时膝关节运动策略的影响因素

To test the hypotheses that poor knee joint proprioception is related to limitations in functional ability, and poor proprioception aggravates the impact of muscle weakness on limitations in functional ability in osteoarthritis (OA) of the knee.
Sixty‐three patients with symptomatic OA of the knee were tested. Proprioceptive acuity was assessed by establishing the joint motion detection threshold (JMDT) in the anteroposterior direction. Muscle strength was measured using a computer‐driven isokinetic dynamometer. Functional ability was assessed by the 100‐meter walking test, the Get Up and Go (GUG) test, and the Western Ontario and McMaster Universities Osteoarthritis Index physical function (WOMAC‐PF) questionnaire. Correlation analyses were performed to assess the relationship between proprioception, muscle strength, and functional ability. Regression analyses were performed to assess the impact of proprioception on the relationship between muscle strength and functional ability.
Poor proprioception (high JMDT) was related to more limitation in functional ability (walking time r = 0.30,P< 0.05; GUG time r = 0.30,P< 0.05; WOMAC‐PF r = 0.26,P<0.05). In regression analyses, the interaction between proprioception and muscle strength was significantly related to functional ability (walking time,P< 0.001 and GUG time,P< 0.001) but not to WOMAC‐PF score (P= 0.625). In patients with poor proprioception, reduction of muscle strength was associated with more severe deterioration of functional ability than in patients with accurate proprioception.
Patients with poor proprioception show more limitation in functional ability, but this relationship is rather weak. In patients with poor proprioception, muscle weakness has a stronger impact on limitations in functional ability than in patients with accurate proprioception.

M. van der Esch

M. Steultjens

J. Harlaar

D. Knol

W. Lems

J. Dekker

Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee

膝关节骨性关节炎患者本体感觉、肌肉力量与功能能力的联合研究

Individuals with medial compartment knee osteoarthritis (OA) and genu varum use different movement and muscle activation patterns to increase joint stability during gait. The purpose of this study was to ascertain whether opening‐wedge high‐tibial osteotomy (OW‐HTO) corrected pathomechancial abnormalities associated with the progression of knee OA.
Fifteen patients diagnosed with medial knee OA and genu varum who were scheduled for OW‐HTO were tested prior to and 1 year following OW‐HTO. Fifteen age‐ and sex‐matched controls were also tested. Frontal plane laxity was measured from stress radiographs. All participants underwent quadriceps strength testing with a burst superimposition technique and gait analysis with surface electromyography to calculate knee joint kinematics and kinetics and muscle co‐contraction during the stance phase of gait. Participants rated their knee function and instability using a self‐report questionnaire.
Static alignment improved following the surgery. Medial laxity (P= 0.003) and instability (P= 0.002) significantly improved, and statistical reductions in the adduction moment resulted in lower levels of vastus medialis‐medial gastrocnemius muscle co‐contractions (P= 0.089). Despite improvements in global rating of knee function (P= 0.001), the OA group's ratings remained significantly lower than those of the healthy controls (P= 0.001). Quadriceps strength deficits and knee flexion impairments persisted.
Persistent quadriceps weakness and impaired knee kinematics after realignment suggest that the movement strategy may perpetuate joint destruction and impede the long‐term success of realignment. Rehabilitation should focus on quadriceps strength and improving joint mobility to improve the long‐term function of individuals with medial knee OA.

Dan K. Ramsey

Lynn Snyder‐Mackler

Michael Lewek

William Newcomb

Effect of anatomic realignment on muscle function during gait in patients with medial compartment knee osteoarthritis

解剖重建对内侧间室膝骨关节炎患者步态中肌肉功能的影响

To evaluate the long‐term effect of recreational exercise on the development of knee osteoarthritis (OA) in a community‐based cohort of older adults, many of whom were overweight or obese.
Subjects were asked about recreational activities including walking or jogging for exercise and working up a sweat, and were asked to compare their activity levels with others. Subjects were then asked about knee pain and weight‐bearing anteroposterior and lateral knee radiographs were obtained. Approximately 9 years later, subjects were reexamined for OA. Radiographs were read for OA features in both tibiofemoral and patellofemoral compartments and were scored for tibiofemoral joint space narrowing. To evaluate incident OA, we excluded knees with OA at baseline for all analyses and focused on 3 knee‐specific outcomes: incident radiographic OA, symptomatic OA, and tibiofemoral joint space loss. After adjusting for age, sex, body mass index (BMI), knee injury history, and correlation between knees, we evaluated the association of each recreational activity with OA development.
A total of 1,279 subjects underwent both baseline and followup examinations (mean age at baseline 53.2 years). Neither recreational walking, jogging, frequent working up a sweat, nor high activity levels relative to peers were associated with a decrease or increase in risk of OA. Joint space loss was also unaffected by activity. Persons with BMI above the median (27.7 kg/m2for men and 25.7 kg/m2for women; mean BMI >30 kg/m2for both) had no increases in risk of OA by different type of activity.
Among middle‐aged and elderly persons without knee OA, many of whom were overweight, recreational exercise neither protects against nor increases risk of knee OA.

David T. Felson

Jingbo Niu

Margaret Clancy

Burton Sack

Piran Aliabadi

Yuqing Zhang

Effect of recreational physical activities on the development of knee osteoarthritis in older adults of different weights: The Framingham Study

不同体重老年人休闲体育活动对膝关节骨性关节炎发展的影响：弗雷明汉研究

+5d/bs	e+/GRg: Elsevier USA，uzYam8: ，dxwaWB: journal，8x2mMQ: TY4X7V
ak9yM6	A7IHrH: 1996，sQJ/D8: ，sE9og+:， wzlKC/:

Arthritis care and research : the official journal of the Arthritis Health Professions Association

uM3Gfz

sZFHBm

sZFHBm

sZFHBm

sZFHBm

Hi2Sc4

e7MLUV

XjnQ+b

Kq5Kd6

LB2xFn

XmiM++

Operant behavioral treatment of fibromyalgia: A controlled study

Cartilage loss occurs in the same subregions as subchondral bone attrition: A within‐knee subregion‐matched approach from the multicenter osteoarthritis study

Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: A randomized controlled trial

Muscle strength, functional performance, and self‐reported outcomes four years after arthroscopic partial meniscectomy in middle‐aged patients

Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis

Cartilage loss occurs in the same subregions as subchondral bone attrition: A within‐knee subregion‐matched approach from the multicenter osteoarthritis study

Influences on knee movement strategies during walking in persons with medial knee osteoarthritis

Joint proprioception, muscle strength, and functional ability in patients with osteoarthritis of the knee

Effect of anatomic realignment on muscle function during gait in patients with medial compartment knee osteoarthritis

Effect of recreational physical activities on the development of knee osteoarthritis in older adults of different weights: The Framingham Study