Intermachine variation of ultrasound strain elastographic measures of the quadriceps and patellar tendons in healthy participants

ObjectivesTo evaluate intermachine variation and compare intraoperator and interoperator agreement and repeatability characteristics of 2 ultrasound (US) systems for measurements of quadriceps and patellar tendons by strain elastography (SE).MethodsForty tendons from 20 healthy participants were investigated by operators with different experience (operator 1, 12 years of US experience and >50 SE examinations; operator 2, no US experience and 1 day of SE training). Repeated measures were performed on GE Healthcare (Waukesha, WI) and Esaote (Genoa, Italy) US systems. The percentage of agreement, Cohen κ, intraclass correlation coefficient, and correlation tests assessed agreement, repeatability, and associations of SE measures. A paired t test and Wilcoxon signed rank test assessed differences in SE measures. ResultsThe study participants included 5 male and 15 female volunteers (mean [range] age, 29.3 [21–39] years). Better agreement and repeatability characteristics were observed for the patellar compared to the quadriceps tendon and the color score (CS) method over the elasticity ratio (ER). Intraoperator agreement was better for the experienced operator. Intraoperator repeatability was achieved in 55% of ER (intraclass correlation coefficient, 0.40–0.91; P  [less than] .05) and 77% to 85% (κ = –0.25–1) of CS measures. Interoperator repeatability was achieved in 35% (t /z , –2.93–7.94; P  [less than] .001–.048) of all ER measures. No significant differences in proximal (z , –0.13– –0.78) and distal patellar (z , –1.52–2.26; P  > .5) patellar ER measures were observed. Seventy‐four percent to 75% mean agreement (κ = 0–0.5) for CS measures comparable across both US systems was observed. Intermachine ER associations were poor (r = –0.39–0.13; P  > .05), whereas greater than 70% agreement (κ = –0.87–0.53) for the CS was achieved. ConclusionsThe reproducibility of knee tendon SE measurements is influenced by the operator experience, US system, and tendon site

Factors associated with fatigue in hip and/or knee osteoarthritis: a systematic review and best evidence synthesis

Objective: The aim was systematically to identify and evaluate factors related to fatigue in individuals with hip and/or knee OA. Methods: A systematic literature search was conducted using AMED, CINAHL, MEDLINE, ProQuest and Web of Science Core Collections databases. Inclusion criteria comprised cross-sectional, case-control or longitudinal studies on patients with a diagnosis of hip and/or knee OA that included self-reported fatigue measures. Study quality was assessed using the National Heart, Lung and Blood Institute quality appraisal tool, and factors were synthesized within a bio-behavioural framework. Study designs and quality were combined to determine current evidence levels using best evidence synthesis grading. The full review protocol is available from PROSPERO (PROSPERO 2019: CRD42019138571). Results: Twenty-four studies were included, of which 19 were high, 4 moderate and 1 low quality. There was strong evidence of an association between poor self-reported physical function and high depressive symptoms with higher fatigue. Moderate evidence of an association was found between severe pain, high numbers of co-morbidities and low physical activity levels with higher fatigue. There was moderate or limited evidence of no association between most sociodemographic factors and radiographic OA severity with fatigue. Conclusion: Targets for fatigue management might include improving physical function, reducing depressive symptoms, pain and co-morbidities, and increasing physical activity levels. There is a need for more rigorous longitudinal studies to understand the causal effect of fatigue determinants within the hip and knee OA populations

Physical activity during covid-19 lockdown: Relationship with sedentary behaviour, health-related quality of life, loneliness, and sleep quality among a sample of Nigerian adults

COVID-19 lockdown, targeted at preventing the spread of coronavirus, had deleterious effects on physical and psychosocial health. This study examined the association between physical activity (PA), sedentary behaviour, health-related quality of life (HRQoL), loneliness and quality of sleep of 507 Nigerian adults during the COVID-19 lockdown. Five hundred and seven respondents (aged 18-67 years) from 12 States completed an online survey on RedCap. Questionnaires comprising the Stages of Change scale, Pittsburgh Sleep Quality Index, International Sedentary Assessment Tool, UCLA Loneliness Questionnaire, Short Form-12 Health Survey, and International Physical Activity Questionnaire were used. Respondents were categorised based on exercise behaviour as non-exercisers, non-regular exercisers, or regular exercisers; and based on age into 18-24, 25-34, 35-44 and > 44 years categories. Descriptive and inferential statistics were used to analyse the data. About 33.1% of respondents did not meet moderate-to-vigorous PA levels. The physical component of HRQoL was positively associated with total PA (p = 0.04). Among the non- exercisers, the odds of being regular exercisers during pre-COVID-19 lockdown were significantly higher for the 35-44 (odds ratio [OR] = 3.49; 95% CI = 1.44, 8.48, p = 0.01) and > 44 years age groups (OR = 2.98; 95% CI: 1.16, 7.62, p = 0.02) relative to 18-24 years age category. During COVID-19 lockdown, > 44 (OR = 3.65; 95% CI: 1.47, 9.07, p = 0.005), 35-44 (OR = 6.42; 95% CI 2.75, 14.96, p = 0.001) and 25-34 (OR = 2.35; 95% CI: 1.15, 4.80, p = 0.02) years age categories had significant higher odds of being regular exercisers compared to the 18-24 years age group. There was a high rate of physical inactivity among Nigerian adults during the COVID-19 lockdown, which was directly influenced by the physical components of HRQoL. Older age was an independent predictor of exercise behaviour before and during the COVID-19 lockdown among Nigerian adults

Temporal associations between physical activity, mental activity and fatigue dimensions in knee osteoarthritis : an exploratory intensive longitudinal study

Background: Fatigue may include both physical and mental dimensions. Evidence suggests that physical and mental activity may influence fatigue in knee osteoarthritis (OA). However, how physical and mental activities relate to fatigue dimensions in knee OA is unclear. Purpose: This study estimated intra-day contributions of physical and mental fatigue to general fatigue and evaluated temporal associations between physical activity, mental activity and fatigue dimensions in knee OA. Methods: An intensive longitudinal study combined with ecological momentary assessment of mental activity intensity and fatigue dimensions was conducted on 23 participants with knee OA. Physical activity was monitored continuously with an accelerometer over 7 days. Results: Physical fatigue contributed 33% more to general fatigue earlier in the day than mental fatigue, and 11% more near the end of the day. Within-day, previous general fatigue significantly and negatively predicted: future step counts, light intensity physical activity time, and light intensity physical activity + standing time. We found a significant bidirectional association between mental activity and general fatigue, a positive association between mental activity and mental fatigue and a significant negative association between mental fatigue and mental activity. Conclusion: Within-day general fatigue may be a significant fatigue dimension that reduces physical activity. Conversely there was no evidence that physical activity might contribute to lower scores on any fatigue dimensions in this population. To manage general fatigue, physical and mental fatigue might have to be targeted more precisely at different time of the day

An Analysis of Work-Related Musculoskeletal Disorders Among Butchers in Kano Metropolis, Nigeria

Background: Butchering is often associated with high rates of work-related musculoskeletal disorders (WRMSDs). However, published work on the prevalence of WRMSDs among butchers in Nigeria is scarce. This is important because meat processing practices differ across geographical and cultural locations. This study was therefore aimed at analyzing WRMSDs among butchers in Kano metropolis. Methods: Sociodemographic and work-settings information was obtained from 102 male cattle butchers (age, 37.49 ± 11.68 years) through survey. Information on the prevalence and pattern of musculoskeletal disorders was obtained from the respondents using the Standardized Nordic Questionnaire. Additional information on health seeking practices was also obtained using a pro forma. Associations between the prevalence of WRMSDs and each of the sociodemographic data and work settings were explored using Chi-square analysis. The level of significance was set at p < 0.05. Results: The 12-month and point prevalence rates of WRMSDs among butchers in this study were 88.2% and 74.5%, respectively. Whereas lower back complaints (66.7%) were the overall and lower body quadrant's most commonly reported WRMSDs among the butchers surveyed, wrist/hand complaints were the leading upper quadrant's (45.1%) most commonly reported WRMSDs among the respondents. There were significant associations between age and majority of WRMSDs in the body regions. Only 23.3% of the 90 individuals who had WRMSD visited the hospital to seek redress for their WRMSD. Conclusion: The prevalence of WRMSDs is high among butchers in Kano Metropolis. Few individuals with WRMSD utilize healthcare facilities. Age is a major risk factor in this setting