Associations between case control status, HbA_1c and hand pain, function and stiffness.

<p>Associations between case control status, HbA_1c and hand pain, function and stiffness.</p

Associations between case-control status, HbA_1c, glycaemic burden and structural hand OA features.

<p>Associations between case-control status, HbA_1c, glycaemic burden and structural hand OA features.</p

Age and sex stratified analyses for the association between long term type 1 diabetes and hand pain, disability and hand stiffness.

<p>Age and sex stratified analyses for the association between long term type 1 diabetes and hand pain, disability and hand stiffness.</p

Participants' characteristics.

<p>Participants' characteristics.</p

Efficacy of High Intensity Exercise on Disease Activity and Cardiovascular Risk in Active Axial Spondyloarthritis: A Randomized Controlled Pilot Study

<div><p>Background</p><p>Physical therapy is recommended for the management of axial spondyloarthritis (axSpA) and flexibility exercises have traditionally been the main focus. Cardiovascular (CV) diseases are considered as a major health concern in axSpA and there is strong evidence that endurance and strength exercise protects against CV diseases. Therefore, the aim of this study was to investigate the efficacy of high intensity endurance and strength exercise on disease activity and CV health in patients with active axSpA.</p><p>Methods</p><p>In a single blinded randomized controlled pilot study the exercise group (EG) performed 12 weeks of endurance and strength exercise while the control group (CG) received treatment as usual. The primary outcome was the Ankylosing Spondylitis (AS) Disease Activity Score (ASDAS). Secondary outcomes included patient reported disease activity (Bath AS Disease Activity Index [BASDAI]), physical function (Bath AS Functional Index [BASFI]), and CV risk factors measured by arterial stiffness (Augmentation Index [Alx]) and Pulse Wave Velocity [PWV]), cardiorespiratory fitness (VO₂ peak) and body composition. ANCOVA on the post intervention values with baseline values as covariates was used to assess group differences, and Mann Whitney U-test was used for outcomes with skewed residuals.</p><p>Results</p><p>Twenty-eight patients were included and 24 (EG, n = 10, CG, n = 14) completed the study. A mean treatment effect of −0.7 (95%CI: −1.4, 0.1) was seen in ASDAS score. Treatment effects were also observed in secondary outcomes (mean group difference [95%CI]): BASDAI: −2.0 (−3.6, −0.4), BASFI: −1.4 (−2.6, −0.3), arterial stiffness (estimated median group differences [95% CI]): AIx (%): −5.3 (−11.0, −0.5), and for PVW (m/s): −0.3 (−0.7, 0.0), VO₂ peak (ml/kg/min) (mean group difference [95%CI]: 3.7 (2.1, 5.2) and trunk fat (%): −1.8 (−3.0, −0.6). No adverse events occurred.</p><p>Conclusion</p><p>High intensity exercise improved disease activity and reduced CV risk factors in patients with active axSpA. These effects will be further explored in a larger trial.</p><p>Trial Registration</p><p>ClinicalTrials.gov <a href="https://clinicaltrials.gov/ct2/show/NCT01436942" target="_blank">NCT01436942 </a></p></div

Aiming for a healthier life: a qualitative content analysis of rehabilitation goals in patients with rheumatic diseases

<p><b>Purpose:</b> To explore and describe rehabilitation goals of patients with rheumatic diseases during rehabilitation stays, and examine whether goal content changed from admission to discharge.</p> <p><b>Method:</b> Fifty-two participants were recruited from six rehabilitation centers in Norway. Goals were formulated by the participants during semi-structured goal-setting conversations with health professionals trained in motivational interviewing. An inductive qualitative content analysis was conducted to classify and quantify the expressed goals. Changes in goal content from admission to discharge were calculated as percentage differences. Goal content was explored across demographic and contextual characteristics.</p> <p><b>Results:</b> A total of 779 rehabilitation goals were classified into 35 categories, within nine overarching dimensions. These goals varied and covered a wide range of topics. Most common at admission were goals concerning healthy lifestyle, followed by goals concerning symptoms, managing everyday life, adaptation, disease management, social life, and knowledge. At discharge, goals about knowledge and symptoms decreased considerably, and goals about healthy lifestyle and adaptation increased. The health profession involved and patient gender influenced goal content.</p> <p><b>Conclusions:</b> The rehabilitation goals of the patients with rheumatic diseases were found to be wide-ranging, with healthy lifestyle as the most prominent focus. Goal content changed between admission to, and discharge from, rehabilitation stays.Implications for rehabilitation</p><p>Rehabilitation goals set by patients with rheumatic diseases most frequently concern healthy lifestyle changes, yet span a wide range of topics.</p><p>Patient goals vary by gender and are influenced by the profession of the health care worker involved in the goal-setting process.</p><p>To meet the diversity of patient needs, health professionals need to be aware of their potential influence on the actual goal-setting task, which may limit the range of topics patients present when they are asked to set rehabilitation goals.</p><p>The proposed framework for classifying goal content has the capacity to detect changes in goals occurring during the rehabilitation process, and may be used as a clinical tool during goal-setting conversations for this patient group.</p><p></p> <p>Rehabilitation goals set by patients with rheumatic diseases most frequently concern healthy lifestyle changes, yet span a wide range of topics.</p> <p>Patient goals vary by gender and are influenced by the profession of the health care worker involved in the goal-setting process.</p> <p>To meet the diversity of patient needs, health professionals need to be aware of their potential influence on the actual goal-setting task, which may limit the range of topics patients present when they are asked to set rehabilitation goals.</p> <p>The proposed framework for classifying goal content has the capacity to detect changes in goals occurring during the rehabilitation process, and may be used as a clinical tool during goal-setting conversations for this patient group.</p

Effects of high intensity exercise on disease activity, inflammatory markers and cytokines.

<p>Differences between the groups in post intervention (3 months) values, analyzed with ANCOVA with baseline values as covariates.</p><p>All BAS-instruments 0–10, 10 =  worst.</p><p>ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index; BASFI, Bath Ankylosing Spondylitis Functional Index; BASMI, Bath Ankylosing Spondylitis Metrology Index; CRP, C-reactive protein; ESR, erythrocyte sedimentation rate; IL, interleukin; sTNFR, soluble tumor necrosis factor receptor.</p>a<p>Estimated regression coefficients,</p>b<p>Hodges-Lehman median estimator,</p>c<p>Mann-Whitney U-test.</p><p>Effects of high intensity exercise on disease activity, inflammatory markers and cytokines.</p

Baseline descriptive of all patients, exercise group and control group.

<p>ASDAS, Ankylosing Spondylitis Disease Activity Score; BASDAI, Bath Ankylosing Spondylitis Disease Activity Index (0–10, 10 =  worst); CRP, C-reactiv protein; ESR, erythrocyte sedimentation rate NSAIDs, non-steroidal anti-inflammatory drugs; TNF, tumor necrosis factor, SD; standard deviation.</p>a<p>Statistically significant differences between groups. Analysed with bivariate test as appropriate.</p><p>Baseline descriptive of all patients, exercise group and control group.</p

Median change in arterial stiffness after 3 months intervention of high intensity exercise, compairsons between control group and exercise group using Mann-Whitney U-test.

<p>Median change in arterial stiffness after 3 months intervention of high intensity exercise, compairsons between control group and exercise group using Mann-Whitney U-test.</p

Flow of participants through the randomized controlled pilot study.

<p>EG: exercise group. CG: control group.</p