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No. 377 Intrarater Reliability and Level of Agreement of the Visual Analogue Scale, Goniometry, Hand-Held Dynamometry and the Six-Minute Walk Test in Persons With Knee Osteoarthritis
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Methods: After baseline Doppler assessment of the arterial flow and diameter participants randomized into the DeLorme (DEL; n¼10; 5M/5F) or Oxford (OXF; n¼10; 5M/5F) resistance training (RT) protocols approved for the dominant arm. After completing the RT protocols participants underwent Doppler examination. Study was done in two different days in a cross-over design; ten individuals trained DEL protocol and the other 10 trained with OXF; second day RT protocol was cross changed to prevent bias. Main outcome measurements: baseline and post-exercise 1st, 3rd, 5th and 10th minute serial arterial diameter and BAFV were measured from the dominant and non-dominant brachial artery by using Doppler ultrasonography. Baseline and post-exercise arterial blood pressure heart rate and body temperature were measured in all participants. Sonographer and clinical assessor were blind to the exercise type. Level of Evidence: Level 1. Results: Baseline measurements were similar. There was a sudden increase and gradual decrease in the BAFT of dominant arm after DEL; however a relatively steady increase and gradual decrease after the OXF protocol. Area under the curve analysis revealed that post exercise BAFV was similar for both RT protocols on the dominant (p¼0.07) and non-dominant arm (p¼0.756). Post-exercise brachial artery diameter changes were similar between protocols. Conclusion: Although the timeflow pattern differs, both exercise protocols show similar changes in BAFV and diameter at the dominant and non-dominant arm in young healthy individuals.
No. 375 Effects of Prolotherapy on Patients With Primary Knee Osteoarthritis: A Prospective Uncontrolled Clinical Trial. Presno-Rubín Diana Helena; González-Sánchez Mariana; Aceves-Dávalos Ana Eloina; Gómez-Toledo Carmina (Hospital Civil De Guadalajara Faa Guad. Jal. Mex). Disclosure: None. Objective: To evaluate the short-term effects of prolotherapy with dextrose on knee pain, joint stiffness, and function in adults with symptomatic knee osteoarthritis (KOA). Design: Prospective uncontrolled clinical trial. Setting: Tertiary care general hospital (outpatient setting). Participants: Adults (45-70 years) with at least 6 months of symptomatic KOA recruited from clinical and community settings. Interventions: Participants received extra-articular injections of 15% dextrose and intra-articular prolotherapy injections of 25% dextrose at base-line, 4 and 8 weeks. Main Outcome Measures: The primary outcome measure was the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC) designed to evaluate quality of life according to pain, joint stiffness and function. The second outcome measure was the validated analog visual scale (AVS) on which patients grade from 1-10 their knee pain level. Third the measure of knee flexion by goniometry. We performed all these measures at base-line, 4 and 8 weeks. Evidence Level: level 2. Results: We studied fifteen patients (aged 58.27.89; 9 females and 6 males). On WOMAC we found lower scores on all subscales at both 4 and 8 week follow-ups (compared to base-line). (pain: baseline¼11.25.57, 4 weeks¼8.674.67 and 8 weeks¼6.84.93. Joint stiffness: base-line¼4.672.41, 4 weeks¼3.332.19 and 8 weeks¼2.51.72. Function: base-line¼38.1317.9, 4 weeks ¼27.4716.99 and 8 weeks¼ 22.6715.57). In all cases the differences were statistically significant: p<0.01. The AVS also showed a decrease score on each assessment (baseline¼81.8, 4 weeks¼6.32.58 and 8 weeks¼5.53.38) both with p<0.01 compared with base-line. Knee flexion range showed an increase on both follow-up measures with statistical significance (p<0.01) compared with base-line (base-line¼108.6711.56 , 4 weeks¼114.28.42 and 8 weeks¼1188.4 ). Conclusions: In this population prolotherapy resulted in clinically meaningful short-term improvement on all measured variables: pain, joint stiffness, function and knee flexion range on patients with knee osteoarthritis studies with larger populations and control groups are required for establishing definitive effectiveness.
PRESENTATIONS
No. 377 Intrarater Reliability and Level of Agreement of the Visual Analogue Scale, Goniometry, Hand-Held Dynamometry and the Six-Minute Walk Test in Persons With Knee Osteoarthritis. Rodriguez Eliana; Ramírez Carolina; Serrano Yannely (School of Physical Therapy Industrial University of Santanderbucaramanga Santander Colombia). Disclosure: None. Objective: To evaluate the intrarater reliability and agreement of visual analogue scale (VAS) (at rest palpation and after functional activities), goniometry of knee flexion and extension, the hand-held dynamometry (HHD) of quadriceps and hamstrings and the sixminute walk test (6-MWT) in persons with knee osteoarthritis (OA). Design: Evaluation of diagnostic technologies with cross-section sampling. The analysis included intraclass correlation coefficient (ICC 2K) the bland and Altman’s limits of agreement. Setting: School of Physical Therapy Bucaramanga Colombia. Participants: 11 subjects were included 1 male and 10 females (647 years old) with medical diagnosis of knee OA. Interventions: The measurements were standardized and then performed twice by examiner with an interval of 2 days between assessments. Before the first examination test each participant had a brief period of familiarization with the procedures. Main Outcome Measures: VAS (at rest palpation and after functional activities) for pain intensity, goniometric assessment of knee flexion and extension for the range of motion, HHD of quadriceps and hamstrings for muscle strength and 6-MWT for the functionality. Level of Evidence: Level 1. Results: The reliability of the goniometric measurements was good (ICC 0.96). The VAS at rest, palpation and after functional activities showed good reliability (ICC 0.93; 0.82; and 0.95, respectively). The reliability for the HHD assessment was good for quadriceps and hamstrings (ICC 0.97 and 0.93, respectively); and the 6-MWT showed good reliability (ICC 0.97). The agreement level was good for goniometry HHD and for VAS at rest and palpation and moderate after functional activities. Conclusions: The results indicate that the evaluated tests have good reliability and agreement level. Our findings support the use in controlled clinical trials. The measurement standardization and the familiarization are necessary to ensure confident results.
No. 378 The Effect of High Intensity Jumping Exercises on Bone Mineral Density in Sedentary Young Males Aged Between 18 and 25 Years. Dilsad Sindel; Osman Coban; Aysegul Ketenci; Aydan Oral (Istanbul University, Istanbul, Turkey). Disclosure: None. Objective: To investigate the effects of plyometric jump training of 9 months duration on bone mineral density (BMD) in sedentary young males aged between 18 and 25 years. Design: Prospective controlled interventional trial. Setting: School of physical therapy and rehabilitation. Participants: 44 sedentary young males meeting our inclusion criteria participated in the study. The participants were allocated into the exercise (n. 24) and the control groups (n. 20). Interventions: Those in the exercise group performed high-intensity jumping training (jumping vertically, jumping vertically after squat position, forward backward and lateral jumping) for 30-45 minutes per session (including stretching and warming up) 3 times per week for a duration of 9 months. Main Outcome Measures: BMDs of the L1-L4 lumbar spine femoral neck and total hip were assessed using dual-energy x-ray absorptiometry (DXA) at baseline and 9 months later in both groups. We used paired samples t-tests to compare baseline and 9th month BMD in the groups. Level of Evidence: Level 1. Results: There were not any statistically significant differences between baseline and the 9th month BMDs in any region of interest in the exercise group. We observed a trend towards an increase in total hip and L1-L4 lumbar spine BMD. In the control group we found a statistically significant decrease in femoral neck BMD at
Methods: After baseline Doppler assessment of the arterial flow and diameter participants randomized into the DeLorme (DEL; n¼10; 5M/5F) or Oxford (OXF; n¼10; 5M/5F) resistance training (RT) protocols approved for the dominant arm. After completing the RT protocols participants underwent Doppler examination. Study was done in two different days in a cross-over design; ten individuals trained DEL protocol and the other 10 trained with OXF; second day RT protocol was cross changed to prevent bias. Main outcome measurements: baseline and post-exercise 1st, 3rd, 5th and 10th minute serial arterial diameter and BAFV were measured from the dominant and non-dominant brachial artery by using Doppler ultrasonography. Baseline and post-exercise arterial blood pressure heart rate and body temperature were measured in all participants. Sonographer and clinical assessor were blind to the exercise type. Level of Evidence: Level 1. Results: Baseline measurements were similar. There was a sudden increase and gradual decrease in the BAFT of dominant arm after DEL; however a relatively steady increase and gradual decrease after the OXF protocol. Area under the curve analysis revealed that post exercise BAFV was similar for both RT protocols on the dominant (p¼0.07) and non-dominant arm (p¼0.756). Post-exercise brachial artery diameter changes were similar between protocols. Conclusion: Although the timeflow pattern differs, both exercise protocols show similar changes in BAFV and diameter at the dominant and non-dominant arm in young healthy individuals.
No. 375 Effects of Prolotherapy on Patients With Primary Knee Osteoarthritis: A Prospective Uncontrolled Clinical Trial. Presno-Rubín Diana Helena; González-Sánchez Mariana; Aceves-Dávalos Ana Eloina; Gómez-Toledo Carmina (Hospital Civil De Guadalajara Faa Guad. Jal. Mex). Disclosure: None. Objective: To evaluate the short-term effects of prolotherapy with dextrose on knee pain, joint stiffness, and function in adults with symptomatic knee osteoarthritis (KOA). Design: Prospective uncontrolled clinical trial. Setting: Tertiary care general hospital (outpatient setting). Participants: Adults (45-70 years) with at least 6 months of symptomatic KOA recruited from clinical and community settings. Interventions: Participants received extra-articular injections of 15% dextrose and intra-articular prolotherapy injections of 25% dextrose at base-line, 4 and 8 weeks. Main Outcome Measures: The primary outcome measure was the validated Western Ontario McMaster University Osteoarthritis Index (WOMAC) designed to evaluate quality of life according to pain, joint stiffness and function. The second outcome measure was the validated analog visual scale (AVS) on which patients grade from 1-10 their knee pain level. Third the measure of knee flexion by goniometry. We performed all these measures at base-line, 4 and 8 weeks. Evidence Level: level 2. Results: We studied fifteen patients (aged 58.27.89; 9 females and 6 males). On WOMAC we found lower scores on all subscales at both 4 and 8 week follow-ups (compared to base-line). (pain: baseline¼11.25.57, 4 weeks¼8.674.67 and 8 weeks¼6.84.93. Joint stiffness: base-line¼4.672.41, 4 weeks¼3.332.19 and 8 weeks¼2.51.72. Function: base-line¼38.1317.9, 4 weeks ¼27.4716.99 and 8 weeks¼ 22.6715.57). In all cases the differences were statistically significant: p<0.01. The AVS also showed a decrease score on each assessment (baseline¼81.8, 4 weeks¼6.32.58 and 8 weeks¼5.53.38) both with p<0.01 compared with base-line. Knee flexion range showed an increase on both follow-up measures with statistical significance (p<0.01) compared with base-line (base-line¼108.6711.56 , 4 weeks¼114.28.42 and 8 weeks¼1188.4 ). Conclusions: In this population prolotherapy resulted in clinically meaningful short-term improvement on all measured variables: pain, joint stiffness, function and knee flexion range on patients with knee osteoarthritis studies with larger populations and control groups are required for establishing definitive effectiveness.
PRESENTATIONS
No. 377 Intrarater Reliability and Level of Agreement of the Visual Analogue Scale, Goniometry, Hand-Held Dynamometry and the Six-Minute Walk Test in Persons With Knee Osteoarthritis. Rodriguez Eliana; Ramírez Carolina; Serrano Yannely (School of Physical Therapy Industrial University of Santanderbucaramanga Santander Colombia). Disclosure: None. Objective: To evaluate the intrarater reliability and agreement of visual analogue scale (VAS) (at rest palpation and after functional activities), goniometry of knee flexion and extension, the hand-held dynamometry (HHD) of quadriceps and hamstrings and the sixminute walk test (6-MWT) in persons with knee osteoarthritis (OA). Design: Evaluation of diagnostic technologies with cross-section sampling. The analysis included intraclass correlation coefficient (ICC 2K) the bland and Altman’s limits of agreement. Setting: School of Physical Therapy Bucaramanga Colombia. Participants: 11 subjects were included 1 male and 10 females (647 years old) with medical diagnosis of knee OA. Interventions: The measurements were standardized and then performed twice by examiner with an interval of 2 days between assessments. Before the first examination test each participant had a brief period of familiarization with the procedures. Main Outcome Measures: VAS (at rest palpation and after functional activities) for pain intensity, goniometric assessment of knee flexion and extension for the range of motion, HHD of quadriceps and hamstrings for muscle strength and 6-MWT for the functionality. Level of Evidence: Level 1. Results: The reliability of the goniometric measurements was good (ICC 0.96). The VAS at rest, palpation and after functional activities showed good reliability (ICC 0.93; 0.82; and 0.95, respectively). The reliability for the HHD assessment was good for quadriceps and hamstrings (ICC 0.97 and 0.93, respectively); and the 6-MWT showed good reliability (ICC 0.97). The agreement level was good for goniometry HHD and for VAS at rest and palpation and moderate after functional activities. Conclusions: The results indicate that the evaluated tests have good reliability and agreement level. Our findings support the use in controlled clinical trials. The measurement standardization and the familiarization are necessary to ensure confident results.
No. 378 The Effect of High Intensity Jumping Exercises on Bone Mineral Density in Sedentary Young Males Aged Between 18 and 25 Years. Dilsad Sindel; Osman Coban; Aysegul Ketenci; Aydan Oral (Istanbul University, Istanbul, Turkey). Disclosure: None. Objective: To investigate the effects of plyometric jump training of 9 months duration on bone mineral density (BMD) in sedentary young males aged between 18 and 25 years. Design: Prospective controlled interventional trial. Setting: School of physical therapy and rehabilitation. Participants: 44 sedentary young males meeting our inclusion criteria participated in the study. The participants were allocated into the exercise (n. 24) and the control groups (n. 20). Interventions: Those in the exercise group performed high-intensity jumping training (jumping vertically, jumping vertically after squat position, forward backward and lateral jumping) for 30-45 minutes per session (including stretching and warming up) 3 times per week for a duration of 9 months. Main Outcome Measures: BMDs of the L1-L4 lumbar spine femoral neck and total hip were assessed using dual-energy x-ray absorptiometry (DXA) at baseline and 9 months later in both groups. We used paired samples t-tests to compare baseline and 9th month BMD in the groups. Level of Evidence: Level 1. Results: There were not any statistically significant differences between baseline and the 9th month BMDs in any region of interest in the exercise group. We observed a trend towards an increase in total hip and L1-L4 lumbar spine BMD. In the control group we found a statistically significant decrease in femoral neck BMD at