Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Jan 2009
Review Meta AnalysisEffectiveness of physiotherapy exercise following hip arthroplasty for osteoarthritis: a systematic review of clinical trials.
Physiotherapy has long been a routine component of patient rehabilitation following hip joint replacement. The purpose of this systematic review was to evaluate the effectiveness of physiotherapy exercise after discharge from hospital on function, walking, range of motion, quality of life and muscle strength, for osteoarthritic patients following elective primary total hip arthroplasty. ⋯ Insufficient evidence exists to establish the effectiveness of physiotherapy exercise following primary hip replacement for osteoarthritis. Further well designed trials are required to determine the value of post discharge exercise following this increasingly common surgical procedure.
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Bmc Musculoskel Dis · Jan 2009
Randomized Controlled Trial Comparative StudyA three-group study, internet-based, face-to-face based and standard- management after acute whiplash associated disorders (WAD) - choosing the most efficient and cost-effective treatment: study protocol of a randomized controlled trial.
The management of whiplash associated disorders is one of the most complicated challenges with high expenses for the health care system and society. There are still no general guidelines or scientific documentation to unequivocally support any single treatment for acute care following whiplash injury. The main purpose of this study is to try a new behavioural medicine intervention strategy at acute phase aimed to reduce the number of patients who have persistent problems after the whiplash injury. The goal is also to identify which of three different interventions that is most cost-effective for patients with whiplash associated disorders. In this study we are controlling for two factors. First, the effect of behavioural medicine approach is compared with standard care. Second, the manner in which the behavioural medicine treatment is administered, Internet or face-to-face, is evaluated in it's effectiveness and cost-effectiveness. ⋯ This new self-help management will concentrate to those psychosocial factors that are shown to be predictive in long-term problems in whiplash associated disorders, i.e. the importance of self-efficacy, fear of movement, and the significance of catastrophizing as a coping strategy for restoring and sustaining activities of daily life. Within the framework of this project, we will develop, broaden and evaluate current physical therapy treatment methods for acute whiplash associated disorders. The project will contribute to the creation of a cost-effective behavioural medicine approach to management of acute whiplash associated disorders. The results of this study will answer an important question; on what extent and how should these patients be treated at acute stage and how much does the best management cost.
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X-ray images of lumbar degenerative diseases often show not only claw osteophytes, but also pairs of osteophytes that form in a direction away from the adjacent disc. We have investigated the direction of the formation of anterior lumbar vertebral osteophytes across the lumbar vertebrae using a sufficient number of lumbar radiographs, because osteophytes images can provide essential information that will contribute to the understanding of the pathology and progress of lumbar spine degeneration. ⋯ Our study showed that pairs of osteophytes frequently formed in the direction of the adjacent disc in the upper lumbar vertebrae (L1-L2 and L2-L3) and in the direction away from the adjacent disc in middle or lower lumbar vertebrae (L3-L4, L4-L5, and L5-S1).
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Bmc Musculoskel Dis · Jan 2009
Meta Analysis Comparative StudyBisphosphonates and atrial fibrillation: Bayesian meta-analyses of randomized controlled trials and observational studies.
Occurrence of atrial fibrillation (AF) amongst bisphosphonate users has been increasingly reported but results are conflicting. We performed a Bayesian meta-analysis to address the possible association between the occurrence of AF and bisphosphonate use and estimated the posterior probability of development of AF with bisphosphonate use. ⋯ The current meta-analysis revealed no evidence of a higher risk of AF associated with bisphosphonate use. Nevertheless, based on Bayesian meta-analysis with the effect size of the observational studies as the prior, the posterior probabilities of development of AF was found to be 0.484 if the risk of AF was estimated to be more than 20%. The results of the current meta-analysis thus offer clinicians the practical probability of development of AF in patients who take bisphosphonates for the treatment of bone loss and corticosteroid induced osteoporosis.
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Bmc Musculoskel Dis · Jan 2009
Randomized Controlled TrialPrinciples of brain plasticity in improving sensorimotor function of the knee and leg in healthy subjects: a double-blind randomized exploratory trial.
Principles of brain plasticity is used in the treatment of patients with functional limitations to improve sensorimotor function. Training is included in the treatment of knee injury to improve both patient-reported function and sensorimotor function. However, impairment in sensorimotor function often persists despite training. Therefore, it was suggested that training programs need to be more effective to improve sensorimotor function after knee injury. The aim of the current study was to investigate if principles of brain plasticity that have been successfully used on the hand and foot to improve sensorimotor function can be applied on the knee. We hypothesized that temporary anesthesia of the skin area above and below the knee would improve sensorimotor function of the ipsilateral knee and leg. ⋯ We found no effect of temporary cutaneous anesthesia on sensorimotor function of the ipsilateral knee and leg in uninjured subjects. The principles used in this study remain to be tested in subjects with knee injury.