Correlation between histology and quantitative MRI relaxation parameters in articular cartilage

Abstract. Osteoarthritis (OA) is the most common joint disease in the world. In osteoarthritis, articular cartilage experiences degeneration, which causes pain, disability and inflammation, among other symptoms in the joint. The diagnosis of osteoarthritis is made at a very late stage, as many symptoms and morphological changes in radiological images do not appear until the degeneration of the articular cartilage is advanced. Hence, new diagnosis methods for early OA diagnostics are welcome. One potential method for early OA diagnosis is quantitative MRI (qMRI). In OA, articular cartilage experiences histological changes; changes in collagen content, proteoglycan content, water content, and collagen orientation. At early OA, these changes are very slight. However, qMRI is a potential method to detect these changes. In qMRI quantitative relaxation parameters, such as T1, T1rho, and T2 can be determined, which correlate with the histology of the cartilage. When histological changes leading to osteoarthritis are known, relaxation parameters may be a potential biomarker for early OA diagnosis

Predictors for future activity limitation in female patients with chronic low back pain

Introduction: Non-specific chronic low back pain (CLBP) have various impact on body functions, activity and participation in daily life and it is a common cause for consulting primary care.The knowledge about various prognostic factors for the recovery for patients with CLBP is still limited. Purpose/Aim: To investigate prognostic factors for future activity limitation in women with CLBP consulting primary care. Materials and Methods: A prospective longitudinal cohort study. Female patients with CLBP consulting primary care were assessed at baseline and re-assessed after two years. Prognostic factors for self-reported activity limitation related to low back pain were analysed by multivariate regression. Results: At the two years 95 % (n=123/130) were followed up. A walk test, self-reported clinical stress symptoms and activity limitation predicted activity limitation at the two -year follow up. Conclusion(s): Physical performance, self-reported clinical stress and activity limitation at baseline was shown to be of prognostic value for future activity limitation in women with CLBP

Predictors for future activity limitation in women with chronic low back pain consulting primary care: a 2-year prospective longitudinal cohort study

Objectives: To assess if body function, activity, participation, health-related quality of life and lifestyle behavioural factors can predict activity limitation in women with chronic low back pain (CLBP) in primary healthcare (PHC) 2 years later. Design: A 2-year prospective longitudinal cohort study within PHC. Settings: PHC in southwestern Sweden. Participants: The cohort comprised 130 women with CLBP attending PHC at baseline 2004-2005 and were reassessed after 2 years. Measures: The dependent outcome variable was self-reported activity limitation (Roland Morris disability questionnaire (RMDQ)) at 2-year follow-up. Independent predictors at baseline were age, body mass index, smoking, alcohol consumption, sleep quantity and quality, leisure time physical activity, a questionnaire of clinical manifestation of stress (Stress and Crises Inventory (SCI-93)), pain localisation, pain intensity, fatigue, anxiety, depression, RMDQ, work status, private social support, health-related quality of life and measures of physical performance specified as 6 min walk test (6MWT) and hand grip strength. Relation between baseline predictors and variation in later self-reported activity limitation (RMDQ) was analysed using multivariate linear regression. Results: Ninety-five per cent (n=123/130) were followed up after 2 years. The participants were middle-aged (mean 45 (SD 10) years), mostly educated > 9 years (88%; 108/123), mainly living with another adult (76%; 93/122) and born in Sweden (90%; 111/123). Seventy nine per cent (97/123) were categorised as having work ability at baseline. The final prognostic model including 6MWT, SCI-93 and RMDQ at baseline explained 54% of the variance in self-reported activity limitation (RMDQ) at the 2-year follow-up. Conclusions: Lower physical performance, more severe clinical stress symptoms and more severe activity limitation predicted activity limitation after 2 years in women with CLBP within PHC. The results can give guidance for interventional trials aiming to improve physical capacity and decrease stress. The impact of the interaction between prognostic factors and interventions on activity limitation needs further investigation

Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia.

OBJECTIVE: To evaluate the short- and long-term efficacy of exercise therapy in a warm, waist-high pool in women with fibromyalgia. METHODS: Thirty-four women (mean +/- SD tender points 17 +/- 1) were randomly assigned to either an exercise group (n = 17) to perform 3 weekly sessions of training including aerobic, proprioceptive, and strengthening exercises during 12 weeks, or to a control group (n = 17). Maximal unilateral isokinetic strength was measured in the knee extensors and flexors in concentric and eccentric actions at 60 degrees /second and 210 degrees /second, and in the shoulder abductors and adductors in concentric contractions. Health-related quality of life (HRQOL) was assessed using the EQ-5D questionnaire; pain was assessed on a visual analog scale. All were measured at baseline, posttreatment, and after 6 months. RESULTS: The strength of the knee extensors in concentric actions increased by 20% in both limbs after the training period, and these improvements were maintained after the de-training period in the exercise group. The strength of other muscle actions measured did not change. HRQOL improved by 93% (P = 0.007) and pain was reduced by 29% (P = 0.012) in the exercise group during the training, but pain returned close to the pretraining level during the subsequent de-training. However, there were no changes in the control group during the entire period. CONCLUSION: The therapy relieved pain and improved HRQOL and muscle strength in the lower limbs at low velocity in patients with initial low muscle strength and high number of tender points. Most of these improvements were maintained long term

Feeding value of grass ensiled with absorbents assessed in growing lambs

Four absorbent materials incorporated into grass at ensiling were compared in terms of their effects on silage quality, effluent production, diet digestibility, ad libitum intake and growth of lambs. The materials used (50 kg t-1 grass) to retain silage effluent flow were molassed and unmolassed sugar beet shreds (MSBS, SBS), a commercial product (CP) based on MSBS (75%) and wheat bran (20%), and rolled barley (RB). With the exception of MSBS and a control (C2), all silages were ensiled with formic acid solution. Unmolassed sugar beet shreds were also ensiled with a granulated formic acid product (grFA). The silages were fed to 56 Finnish Landrace lambs for 21 days. Silage effluent retention rates were similar (1.44-1.55 kg kg-1 absorbent) for the sugar beet shred-based absorbents but zero for RB. The organic matter digestibilities of the diets were not affected (p>0.05) by the silage absorbent treatment. The digestibility of SBS silage was, however, improved by grFA as an additive. Silage intake was generally increased by absorbent inclusion, and was about 29% higher in lambs receiving silages treated with sugar beet shreds than in those receiving untreated silages. The daily growth rate of lambs was highest with the SBS treatment (124 g) followed by SBS ensiled with grFA (108 g) and MSBS (86 g); it was lowest with RB (36 g). With regard to effluent chemical oxygen demand, digestibility and silage intake, the use of SBS as an absorbent material is recommended by ensiling with either liquid or grFA

Moderate-to-high intensity exercise with person-centered guidance influences fatigue in older adults with rheumatoid arthritis

Fatigue is described as a dominant and disturbing symptom of rheumatoid arthritis (RA) regardless of the advances in pharmacological treatment. Fatigue is also found to correlate with depression. The objective was to evaluate the impact of moderate-to-high intensity, aerobic and resistance exercise with person-centered guidance on fatigue, anxiety and depression, in older adults with RA. Comparisons were made between older adults (> 65\ua0years) with RA taking part in a 20-week moderate-to-high intensity exercise at a gym (n = 36) or in home-based exercise of light intensity (n = 38). Assessments were performed at baseline, at 20\ua0weeks, and at 52\ua0weeks. Outcomes were differences in Multidimensional Fatigue Inventory (MFI-20), Visual Analog Scale Fatigue (VAS fatigue), and Hospital Anxiety and Depression Scale (HADS). Analysis of metabolomics was also performed. The subscales “physical fatigue” and “mental fatigue” in MFI-20 and symptoms of depression using HADS depression scale improved significantly at week 20 in the exercise group compared with the control group. Exercise did not influence global fatigue rated by VAS or subscales “reduced motivation”, “reduced activity” and “general fatigue” in MFI-20. No significant change was found on the anxiety index of HADS. The improvements in physical fatigue were associated with changes in the metabolism of lipids, bile acids, the urea cycle and several sugars. Moderate-to-high intensity exercise with person-centered guidance decreased fatigue and improved symptoms of depression and were accompanied by metabolic changes in older adults with RA

Exercise Increases Pressure Pain Tolerance but Not Pressure and Heat Pain Thresholds in Healthy Young Men

Background: Exercise causes an acute decrease in the pain sensitivity known as exercise-induced hypoalgesia (EIH), but the specificity to certain pain modalities remains unknown. This study aimed to compare the effect of isometric exercise on the heat and pressure pain sensitivity. Methods: On three different days, 20 healthy young men performed two submaximal isometric knee extensions (30% maximal voluntary contraction in 3 min) and a control condition (quiet rest). Before and immediately after exercise and rest, the sensitivity to heat pain and pressure pain was assessed in randomized and counterbalanced order. Cuff pressure pain threshold (cPPT) and pain tolerance (cPTT) were assessed on the ipsilateral lower leg by computer-controlled cuff algometry. Heat pain threshold (HPT) was recorded on the ipsilateral foot by a computer-controlled thermal stimulator. Results: Cuff pressure pain tolerance was significantly increased after exercise compared with baseline and rest (p \u3c 0.05). Compared with rest, cPPT and HPT were not significantly increased by exercise. No significant correlation between exercise-induced changes in HPT and cPPT was found. Test–retest reliability before and after the rest condition was better for cPPT and CPTT (intraclass correlation \u3e 0.77) compared with HPT (intraclass correlation = 0.54). Conclusions: The results indicate that hypoalgesia after submaximal isometric exercise is primarily affecting tolerance of pressure pain compared with the pain threshold. These data contribute to the understanding of how isometric exercise influences pain perception, which is necessary to optimize the clinical utility of exercise in management of chronic pain. Significance: The effect of isometric exercise on pain tolerance may be relevant for patients in chronic musculoskeletal pain as a pain-coping strategy. What does this study add? The results indicate that hypoalgesia after submaximal isometric exercise is primarily affecting tolerance of pressure pain compared with the heat and pressure pain threshold. These data contribute to the understanding of how isometric exercise influences pain perception, which is necessary to optimize the clinical utility of exercise in management of chronic pain