- Email: [email protected]
A randomised clinical trial of targeted physiotherapy for patellofemoral osteoarthritis
Friday 2 November Papers / Journal of Science and Medicine in Sport 15 (2012) S188–S264
international experts will be combined to provide a comprehensive guide for physiotherapists when treating PFPS.
S245
592
http://dx.doi.org/10.1016/j.jsams.2012.11.593
Effects of menstrual cycle phase on salivary ␣-amylase activity following 2 hours of cycling exercise in recreationally active eumenorrheic women
591
N. Yasuda 1,∗ , T. Tanioka 2 , N. Iwashita 1 , K. Yamamoto 1
A randomised clinical trial of targeted physiotherapy for patellofemoral osteoarthritis
1
K. Crossley 1,∗ , B. Vicenzino 1 , M. Pandy 2 , A. Schache 2 , R. Hinman 2
Introduction: Clarifying how the menstrual cycle phase influences various aspects of salivary responses is necessary to provide a comprehensive understanding of human responses to physically and psychologically stressful events in women. The purpose of this study was to determine the effects of menstrual cycle phase on salivary ␣-amylase activity following 2 h of prolonged cycling exercise in women. Methods: Twelve recreationally active eumenorrheic women served as the subjects [age: 20.9 ± 0.3 year; height: 160.1 ± 5.6 cm; body weight: 54.7 ± 5.8 kg; Body mass index: 21.3 ± 1.8 kg/m2 ; Body fat: 21.9 ± 3.1%; peak oxygen uptake (VO2 peak): 44.4 ± 5.0 ml/kg/min (mean ± SD)]. All subjects performed an incremental cycling exercise until volitional exhaustion to determine their peak oxygen uptake. At the 10-min period before and after 2 h of cycling exercise corresponding to constant power output at 60%VO2 peak, salivary ␣-amylase activity was determined with a biosensor qualified by Yamaguchi et al. (J Int Med Res, 34: 152–159, 2006). All subjects performed the same exercise protocol during the follicular (F: 5∼8 days after the onset of the menses) and luteal (L: 22∼25 days after the onset of the menses) phase. During each 2 h of exercise protocol, carbohydrateelectrolyte solution (glucose: 62 g/L; Na+ : 49 mg/dL; K+ : 20 mg/dL; Ca2+ : 2 mg/dL; Mg2+ : 0.6 mg/dL) were consumed every twenty minutes (2 ml/kg body mass) in order to delay fatigue and prevent hypoglycemia and dehydration Results: In terms of the salivary ␣-amylase activity, two-way (time x phase) analysis of variances (ANOVA) showed significant main effects for time (Pre: 38.6 ± 13.4, Post: 46.5 ± 18.0 for F; Pre: 37.9 ± 8.6, Post: 49.3 ± 27.3 kIU/L for L, p < 0.05). In contrast, there were no significant main effects for phase or interaction. With regard to the percent increase of salivary ␣-amylase activity, there was a trend for the luteal phase to be higher than the follicular phase although no menstrual cycle differences were found. Discussion and Conclusions: Salivary ␣-amylase activity regulated by the sympathetic-adrenomedullary system and hypothalamic- pituitary-adrenal axis has been suggested as a potential marker for exercise intensity. However, effects of menstrual cycle phase on salivary ␣-amylase activity following prolonged exercise remained to be elucidated. The findings of the present study indicate that the menstrual cycle phase appears not to influence salivary ␣-amylase activity following 2 h of cycling exercise equivalent to power output at 60%VO2 peak. Supported partly by funds from the Grant-in-Aid for Scientific Research (C) in Applied Health Sciences (Grant No.23500867) of Japan Society for the Promotion of Science.
1 2
University of Queensland University of Melbourne
Introduction: The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJOA. Therefore, this project aimed to evaluate whether a physiotherapy treatment, targeted to the PFJ, resulted in greater improvements in pain and physical function than a physiotherapy education treatment. Methods: 92 people with PFJOA (PFJ-specific history, signs and symptoms ad radiographic evidence of PFJOA) were recruited from the community. A randomised controlled trial, adhering to CONSORT guidelines evaluated the efficacy of physiotherapy (8 individual sessions over 12 weeks and a home exercise program) compared to a physiotherapy-delivered education program. Primary outcomes, evaluated by a blinded assessor, included: i) patient perceived change in pain and function; ii) pain during aggravating activities on a visual analogue scale; and iii) physical function subscale of the Western Ontario and MacMasters Universities osteoarthritis index (WOMAC) at 3 and 9 months. All analyses were conducted on an intention-to-treat basis, using linear regression models, including age, gender, body mass index, radiographic OA severity and baseline score as co-variates Results: The two treatment groups were matched at baseline for demographic characteristics. Targeted physiotherapy resulted in greater improvements in the targeted physiotherapy group than the education group for perceived pain (p < 0.001) and function (p = 0.002) at 3 months. These results were maintained at 9 months for pain (p < 0.001) and function (p = 0.003). At 3 months, these results were reflected in the between-group differences in pain score (12 mm, 95% confidence intervals 0 to 24) and WOMAC physical function (out of 68) (4.1 points; 95% confidence interval 0 to 8.2). Discussion: A physiotherapy treatment, targeted to the PFJ, resulted in superior outcomes than a physiotherapy-led education treatment for PFJOA. Treatments for knee OA may be enhanced by targeting treatments to the compartment most affected by the disease. http://dx.doi.org/10.1016/j.jsams.2012.11.594
2
International Pacific University Showa University
http://dx.doi.org/10.1016/j.jsams.2012.11.595
international experts will be combined to provide a comprehensive guide for physiotherapists when treating PFPS.
S245
592
http://dx.doi.org/10.1016/j.jsams.2012.11.593
Effects of menstrual cycle phase on salivary ␣-amylase activity following 2 hours of cycling exercise in recreationally active eumenorrheic women
591
N. Yasuda 1,∗ , T. Tanioka 2 , N. Iwashita 1 , K. Yamamoto 1
A randomised clinical trial of targeted physiotherapy for patellofemoral osteoarthritis
1
K. Crossley 1,∗ , B. Vicenzino 1 , M. Pandy 2 , A. Schache 2 , R. Hinman 2
Introduction: Clarifying how the menstrual cycle phase influences various aspects of salivary responses is necessary to provide a comprehensive understanding of human responses to physically and psychologically stressful events in women. The purpose of this study was to determine the effects of menstrual cycle phase on salivary ␣-amylase activity following 2 h of prolonged cycling exercise in women. Methods: Twelve recreationally active eumenorrheic women served as the subjects [age: 20.9 ± 0.3 year; height: 160.1 ± 5.6 cm; body weight: 54.7 ± 5.8 kg; Body mass index: 21.3 ± 1.8 kg/m2 ; Body fat: 21.9 ± 3.1%; peak oxygen uptake (VO2 peak): 44.4 ± 5.0 ml/kg/min (mean ± SD)]. All subjects performed an incremental cycling exercise until volitional exhaustion to determine their peak oxygen uptake. At the 10-min period before and after 2 h of cycling exercise corresponding to constant power output at 60%VO2 peak, salivary ␣-amylase activity was determined with a biosensor qualified by Yamaguchi et al. (J Int Med Res, 34: 152–159, 2006). All subjects performed the same exercise protocol during the follicular (F: 5∼8 days after the onset of the menses) and luteal (L: 22∼25 days after the onset of the menses) phase. During each 2 h of exercise protocol, carbohydrateelectrolyte solution (glucose: 62 g/L; Na+ : 49 mg/dL; K+ : 20 mg/dL; Ca2+ : 2 mg/dL; Mg2+ : 0.6 mg/dL) were consumed every twenty minutes (2 ml/kg body mass) in order to delay fatigue and prevent hypoglycemia and dehydration Results: In terms of the salivary ␣-amylase activity, two-way (time x phase) analysis of variances (ANOVA) showed significant main effects for time (Pre: 38.6 ± 13.4, Post: 46.5 ± 18.0 for F; Pre: 37.9 ± 8.6, Post: 49.3 ± 27.3 kIU/L for L, p < 0.05). In contrast, there were no significant main effects for phase or interaction. With regard to the percent increase of salivary ␣-amylase activity, there was a trend for the luteal phase to be higher than the follicular phase although no menstrual cycle differences were found. Discussion and Conclusions: Salivary ␣-amylase activity regulated by the sympathetic-adrenomedullary system and hypothalamic- pituitary-adrenal axis has been suggested as a potential marker for exercise intensity. However, effects of menstrual cycle phase on salivary ␣-amylase activity following prolonged exercise remained to be elucidated. The findings of the present study indicate that the menstrual cycle phase appears not to influence salivary ␣-amylase activity following 2 h of cycling exercise equivalent to power output at 60%VO2 peak. Supported partly by funds from the Grant-in-Aid for Scientific Research (C) in Applied Health Sciences (Grant No.23500867) of Japan Society for the Promotion of Science.
1 2
University of Queensland University of Melbourne
Introduction: The patellofemoral joint (PFJ) is one compartment of the knee that is frequently affected by osteoarthritis (OA) and is a potent source of symptoms. However, there is a dearth of evidence for compartment-specific treatments for PFJOA. Therefore, this project aimed to evaluate whether a physiotherapy treatment, targeted to the PFJ, resulted in greater improvements in pain and physical function than a physiotherapy education treatment. Methods: 92 people with PFJOA (PFJ-specific history, signs and symptoms ad radiographic evidence of PFJOA) were recruited from the community. A randomised controlled trial, adhering to CONSORT guidelines evaluated the efficacy of physiotherapy (8 individual sessions over 12 weeks and a home exercise program) compared to a physiotherapy-delivered education program. Primary outcomes, evaluated by a blinded assessor, included: i) patient perceived change in pain and function; ii) pain during aggravating activities on a visual analogue scale; and iii) physical function subscale of the Western Ontario and MacMasters Universities osteoarthritis index (WOMAC) at 3 and 9 months. All analyses were conducted on an intention-to-treat basis, using linear regression models, including age, gender, body mass index, radiographic OA severity and baseline score as co-variates Results: The two treatment groups were matched at baseline for demographic characteristics. Targeted physiotherapy resulted in greater improvements in the targeted physiotherapy group than the education group for perceived pain (p < 0.001) and function (p = 0.002) at 3 months. These results were maintained at 9 months for pain (p < 0.001) and function (p = 0.003). At 3 months, these results were reflected in the between-group differences in pain score (12 mm, 95% confidence intervals 0 to 24) and WOMAC physical function (out of 68) (4.1 points; 95% confidence interval 0 to 8.2). Discussion: A physiotherapy treatment, targeted to the PFJ, resulted in superior outcomes than a physiotherapy-led education treatment for PFJOA. Treatments for knee OA may be enhanced by targeting treatments to the compartment most affected by the disease. http://dx.doi.org/10.1016/j.jsams.2012.11.594
2
International Pacific University Showa University
http://dx.doi.org/10.1016/j.jsams.2012.11.595