Nonweight-bearing Exercise Research Articles

Effect of Weight Bearing Versus Non-Weight Bearing Strengthening Exercises on Dynamic Balance in Knee Osteoarthritis Patients: Randomized Controlled Trial

Background: knee osteoarthritis (OA) is one of the most aging problems that causes many problems such as pain, reduced balance, difficulty of walking, up & down stairs and may result in inability to move and dependency. Dynamic balance has been found to be affected in patients with knee OA. Purpose: The aim of this study was to evaluate and compare the effect of weight bearing (WB) and non-weight bearing (NWB) strengthening exercises on dynamic balance, pain and proprioception in knee OA patients. Subjects & Methods: Sixty patients from both genders, diagnosed with bilateral knee OA mild to moderate (according to Kellgran and Lawrence classification) divided equally into three groups G I (control), G II (WB) and G III (NWB), their mean value of age were 59.7 ± 4.5, 60.6 ± 4 and 60.1 ± 4.9 years respectively and body mass index were 28.8 ± 1, 28.6 ± 0.8and 28.2 ± 1.6 kg/m2 respectively. G I received conventional treatment (TENS and stretching exercises for quadriceps, hamstring and calf muscles), G II received the conventional treatment and WB strengthening exercises while G III received the conventional treatment and NWB strengthening exercises. Interventions were performed for 12 sessions (3 sessions/ week) over a period of four weeks. Outcomes were assessed at the beginning and at the end of the fourth week using biodex balance system for dynamic balance, visual analogue scale (VAS) for pain intensity and bubble inclinometer for joint repositioning error (JRE) for measuring proprioception. Result: G II was improved in all measurements with significant difference between the pre and post measurements of all measured variables, while G II were significant difference of BBS and VAS and G I there was significance difference of VAS only. There were significance differences between G II and G I in VAS, BBS and JRE measurements and between G II and G III in VAS and JRE only with superiority to G II, while there were significance differences between G I and G III in VAS and BBS with superiority to G III. Conclusion: Both WB and NWB exercises are effective in improving dynamic balance and pain in patients with knee OA. With superiority to WB exercises in improving proprioception.

Evaluating the Impact of Weight Bearing and Non-Weight Bearing Exercises on Pain and Physical Function in Obese Knee Osteoarthritic Patients: A Randomized Controlled Trial

Background Exercise is advised as a primary treatment for knee OA; however, the best exercise is still unknown among these patients with different comorbid like obesity. Hence, this trial was aimed to identify which regime is more suitable in patients with knee OA and obesity. Methods A randomized controlled trial conducted in Lahore, Pakistan, compared the effectiveness of two exercise regimens i.e. Group A: Weight-bearing functional exercise program and Group B: Quadriceps strengthening through non-weight bearing techniques in obese individuals aged 50 and above with painful medial knee OA. A total of 128 participants were randomly assigned to either group. They attended supervised sessions with a therapist 5 times/week for 12 weeks. Pain and physical function were measured as primary outcomes at baseline and after the intervention. Results The mean age of participants was 57±4.03, with 78 females and 50 males. The results revealed that outcomes were improved in both groups. However, Group B showed more significant results, with a mean of 3.92±0.9, whereas Group A results were also substantial, with a mean of 4.53±1.02. The findings were consistent for physical function, which improved more in Group B with a mean of 42.35±3.02 compared to Group A with a mean of 45.68±81. Conclusion Both groups showed significant improvement in both outcomes. However, participants in non-weight-bearing quadriceps strengthening show more statistically and clinically relevant results. Keywords Exercise, Obesity, Osteoarthritis, Pain, Physical Activity.

My Top Five Concepts for Selecting Lower Extremity Exercises For Cruciate Ligament and Patellofemoral Rehabilitation.

This clinical commentary will address five key concepts that can be used by clinicians as criteria for selecting lower extremity weight bearing exercises (WBE) and non-weight bearing exercises (NWBE) employed for cruciate ligament and patellofemoral rehabilitation. The following will be discussed for both cruciate ligament and patellofemoral rehabilitation: 1) Knee loading varies between WBE and NWBE; 2) Knee loading varies with technique variations within WBE and NWBE; 3) Knee loading varies between different WBE; 4) Knee loading varies as a function of knee angle; and 5) Knee loading increases with increased knee anterior translation beyond toes.

Differences in left ventricular wall thickness in aerobic weight-bearing exercise and non-weight-bearing exercise in elderly Mus Musculus

Due to the process of aging, the function of human organs and muscles decreases. Exercise is a solution to improve organ and muscle function. But it all must be in proportion. So far, aerobic exercise is an exercise solution. This study aims to test the differences between the effects of aerobic weight- bearing exercise and aerobic non-weight-bearing exercise as a sports solution for the elderly. The experimental laboratory used a completely randomized post-test design using 30 mus musculus samples with three actions, namely 10 mus musculus that were not exercised, 10 mus musculus with aerobic weight-bearing exercise and 10 mus musculus with aerobic non- weight-bearing exercise. This process is carried out for 6 weeks with a frequency of exercise 5 times a week, and processed statistically using the statistical product and service solution (SPSS) program. There were significant differences between control group and both aerobic weight- bearing exercise and aerobic non-weight bearing exercise with both p-value being <0.05. However, aerobic weight-bearing exercise and aerobic non– weight-bearing exercise resulted in an enlargement of the ventricle sinistra but there was no significant difference between groups due to the post hoc Mann Whitney test, with p-value>0.05.

CHANGES IN PLASMA VOLUME WHEN MEASURING BIOCHEMICAL MARKERS IN RELATION TO ACUTE PHYSICAL ACTIVITY IN OSTEOARTHRITIS

Purpose: Physical activity can induce acute changes in plasma volume (PV) and thereby influence concentration of plasma constituents, such as biochemical markers. However, it remains undocumented to what extent PV changes occur during physical exercise in osteoarthritis (OA) patients. The objective of the current report was to investigate the acute course and magnitude of PV changes during and after weightbearing (WB) and non-weightbearing (NWB) exercise, adrenaline-induced cardiovascular stress, and resting in an OA population.

Aerobic Weight and Non-Weight Bearing Exercise Effects on Myocardium: An in vivo Study on Elderly Mus Musculus

Background: Due to the process of aging, the function of human organs and muscles decreases. Exercise is a solution to improve organ and muscle function. But it all must be in proportion. So far, aerobic exercise is an exercise solution for the elderly, but which aerobic exercise has not been widely studied. Purpose: To test aerobic weight bearing exercise and aerobic non weight bearing exercise as a sports solution for old age. Methods: The experimental laboratory used a completely randomized post-test design using 26 elderly females’ mice samples with three actions, namely 9 mice that were not exercised, 9 mice with aerobic weight bearing exercise and 8 mice with aerobic non weight bearing exercise. this process is carried out for 6 weeks with a frequency of exercise 5 times a week, and processed statistically using the statistical product and service solution (SPSS) program. Results: Aerobic weight-bearing exercise and aerobic non-weight-bearing exercise resulted in an enlargement of the myocardium but there was significant difference between groups due to the One Way ANOVA test, with p-value < 0,05.Conclusion: weight bearing exercise induce hipertrophic effects and significant differences between aerobic weight bearing exercise and aerobic non weight bearing exercise between the two groups.

Effect of Different Forms of Activity-Based Recovery Training on Bladder, Bowel, and Sexual Function After Spinal Cord Injury

ObjectivesTo investigate whether the urogenital and bowel functional gains previously demonstrated post-locomotor step training after chronic spinal cord injury could have been derived due to weight-bearing alone or from exercise in general. DesignProspective cohort study; pilot trial with small sample size. SettingUrogenital and bowel scientific core facility at a rehabilitation institute and spinal cord injury research center in the United States. ParticipantsMen and women (N=22) with spinal cord injury (American Spinal Injury Association Impairment Scale grades of A-D) participated in this study. InterventionsApproximately 80 daily 1-hour sessions of either stand training or nonweight-bearing arm crank ergometry. Comparisons were made with previously published locomotor training data (step; N=7). Main Outcome MeasuresAssessments at both pre- and post-training timepoints included cystometry for bladder function and International Data Set Questionnaires for bowel and sexual functions. ResultsCystometry measurements revealed a significant decrease in bladder pressure and limited improvement in compliance with nonweight-bearing exercise but not with standing. Although International Data Set questionnaires revealed profound bowel dysfunction and marked deficits in sexual function pretraining, no differences were identified poststand or after nonweight-bearing exercise. ConclusionsThese pilot trial results suggest that, although stand and weight-bearing alone do not benefit pelvic organ functions after spinal cord injury, exercise in general may contribute at least partially to the lowering of bladder pressure and the increase in compliance that was seen previously with locomotor training, potentially through metabolic, humoral, and/or cardiovascular mechanisms. Thus, to maximize activity-based recovery training benefits for functions related to storage and emptying, an appropriate level of sensory input to the spinal cord neural circuitries controlling bladder and bowel requires task-specific stepping.

Calcaneal Bone Quality and Physique in Elite Hungarian Male Athletes.

Abstract Regular physical activity has favourable influence on the bone status. The purpose of this study was to analyze the relationships between the bone quality index (BQI) in the calcaneus and anthropometric variables in male elite athletes. Participants were Hungarian elite male athletes: kayak-canoe (KC, n=43); triathlon (T, n=16); track & field (TF, n=46); water-polo (WP, n=19). Their physique was characterised by Heath-Carter somatotype. Calcaneal Quantitative Ultrasound (QUS) parameters were registered by Sonost3000 densitometer. Differences in bone quality between the groups and correlation patterns between QUS and physique were analysed (p<0.05). There were significant differences in QUS parameters. T and TF had significantly higher SOS (speed of sound, m/s) values than WP. KC had lower SOS values than T athletes (TF: 1519.3±16.0; T: 1512.9±20.8; KC: 1505.6±12.4; W: 1495.1±10.8. BUA (broadband ultrasound attenuation, dB/MHz) was the largestest in TF but this only differed significantly from WP (TF: 106.5±14.8; T: 98.9±11.5; KC: 98.7±16.5; WP: 92.2±8.8). BQI (αSOS+βBUA) was higher in TF (92.0±16.7) than in KC (79.2±13.1), WP (69.3±10.0); it was higher in T (84.8±19.6) than WP. Muscle percentage correlated positively, while absolute bone measurements correlated inversely with bone parameters. Higher QUS values were associated with lower endomorphy and mesomorphy, while more linear physiques correlated with better bone parameters. Physique and type of exercise training appear to be associated with bone status. Both weight-bearing and non-weight bearing exercise improve calcaneus bone parameters such as BQI to different extents. It might be preferable to combine some weight-bearing exercise during the sessions, and it is also highly recommended after a competitive period and during recreational sport activities.

A comparison of the efficacy of nonweight-bearing and weight-bearing exercise programmes on function and pain pressure thresholds in knee osteoarthritis: a randomised study

Aim To establish what type of intervention (nonweight-bearing [NWB] or weight-bearing [WB]) was more effective in enhancing muscle strength and knee function and in increasing pressure pain thresholds (PPT) points close and distant from the knee (hyperalgesia) in persons with mild and moderate knee osteoarthritis (KOA). Methods Thirty persons (62 ± 9 years) with mild or moderate KOA and knee pain for 6 months or more were randomly stratified according to sex and KOA severity to groups of intervention: WB or NWB. The intervention was performed three times a week over 8 weeks, focussing on progressive strength exercise. One-repetition maximum strength (1-RM) test, the Western Ontario and McMaster Universities (WOMAC) function scale and PPT points close and distant from the knee were evaluated before and after the intervention. Results Both interventions promoted improvement in 1-RM test (NWB exercise [IC 63–88], p = 0.001; WB exercise [IC 57–122], p = 0.007), functional capacity (NWB exercise [IC 10–29.4], p = 0.001; WB exercise [IC 10–45], p = 0.001), PPT points close to the knee (NWB exercise [IC 5.42–8.93], p = 0.001; WB exercise [IC 3.97–8.47], p = 0.001) and PPT points distant from the knee (NWB exercise [IC 4.38–7.70], p = 0.001; WB exercise [IC 3.75–7.31], p = 0.002). There were no statistical differences between them. Conclusions The WB and NWB interventions were effective in improving muscle strength, knee function, and PPT points close and distant from the knee (hyperalgesia) in persons with mild and moderate KOA, with no significant differences between them. Trial registration Clinical trial registration number: RBR-5t95n5; Date of registration: July 15, 2013.

Comparison of weight bearing functional exercise and non-weight bearing quadriceps strengthening exercise on pain and function for people with knee osteoarthritis and obesity: protocol for the TARGET randomised controlled trial

BackgroundClinical guidelines recommend exercise as a core treatment for individuals with knee osteoarthritis (OA). However, the best type of exercise for clinical benefits is not clear, particularly in different OA subgroups. Obesity is a common co-morbidity in people with knee OA. There is some evidence suggesting that non-weight bearing exercise may be more effective than weight bearing exercise in patients with medial knee OA and obesity.MethodsTo compare the efficacy of two different exercise programs (weight bearing functional exercise and non-weight bearing quadriceps strengthening) on pain and physical function for people ≥50 years with painful medial knee OA and obesity (body mass index ≥30 kg/m2) 128 people in Melbourne, Australia will be recruited for a two group parallel-design, assessor- and participant-blinded randomised controlled trial. Participants will be randomly allocated to undertake a program of either weight bearing functional exercise or non-weight bearing quadriceps strengthening exercise. Both groups will attend five individual sessions with a physiotherapist who will teach, monitor and progress the exercise program. Participants will be asked to perform the exercises at home four times per week for 12 weeks. Outcomes will be measured at baseline and 12 weeks. Primary outcomes are self-reported knee pain and physical function. Secondary outcomes include other measures of knee pain, physical function, quality-of-life, participant-perceived global change, physical performance, and lower limb muscle strength.DiscussionThis study will compare the efficacy of two different 12-week physiotherapist-prescribed, home-based exercise programs for people with medial knee OA and obesity. Findings will provide valuable information to help inform exercise prescription in this common OA patient subgroup.Trial registrationAustralian New Zealand Clinical Trials Registry reference: ACTRN12617001013358, 14/7/2017

Exercise Mode Combined with Essential Amino Acid and Carbohydrate Supplementation Differentially Regulate Skeletal Muscle microRNA

Skeletal muscle microRNAs (myomiR) have been implicated in modulating intracellular regulation of muscle protein synthesis by negative inhibition of the mTORC1 pathway. The acute effects of endurance exercise mode and recovery essential amino acid and carbohydrate (EAA+CHO) nutrition on myomiR expression are not well defined. PURPOSE: Determine the effects of endurance exercise mode, with or without EAA+CHO ingestion on myomiR expression. METHODS: Twenty five adults (mean ± SD; 22 ± 2 y, 82 ± 11 kg, VO2peak 4.0 ± 0.5 L[BULLET OPERATOR]min-1) performed 90 min of metabolically-matched (2.2 ± 0.1 VO2 L[BULLET OPERATOR]m-1) load carriage (LC; performed on a treadmill wearing a vest equal to 30% of individual body mass; load carried 24 ± 3 kg) or cycle ergometry (CE) exercise, during which EAA+CHO (10 g EAA and 46 g CHO) or non-nutritive control (CON) drinks were consumed. Expressions of myomiR were determined using RT-qPCR in muscle samples obtained at rest (PRE), immediately post-exercise (POST) and after 3-hr recovery (REC). RESULTS: Relative to PRE, POST and REC expressions of miR-1-3p, miR-206, miR-208a-5 and miR-499 were lower (P < 0.05) for LC compared to CE, regardless of dietary treatment. Independent of exercise mode, miR-1-3p and miR-208a-5p expression were lower (P < 0.05) after ingesting EAA+CHO compared to CON. Expression of miR-206 was highest for CE+CON than any other treatment (exercise-by-drink, P < 0.05). CONCLUSIONS: These data show that myomiR expression is differentially regulated by endurance exercise mode and EAA+CHO nutrition. Weight bearing exercise downregulates myomiR expression, whereas myomiR expression appears to be upregulated after non-weight bearing exercise. Consuming EAA+CHO attenuated the increase in myomiR expression with non-weight bearing exercise, yet the suppression of myomiR expression with feeding was more pronounced when EAA+CHO were consumed during weight bearing exercise. These findings suggest that combining weight bearing exercise with protein and carbohydrate supplementation may facilitate muscle anabolic adaptations to exercise by lowering mTORC1 inhibition.

Game-Based Non-Weight Bearing Exercise to Improve Motor Performance in Hemodialysis Diabetic Patients with Neuropathy

Game-Based Non-Weight Bearing Exercise to Improve Motor Performance in Hemodialysis Diabetic Patients with Neuropathy

D2-3 Ergonomic Management and Muscle Strengthening in Thai Aged Farmers with Knee Osteoarthritis

Background: Ergonomic hazards are the most important causes of knee osteoarthritis (OA) in aged para rubber farmers. Ergonomic management comprising working condition improvement and muscle strengthening exercise has been well-documented in terms of workers’ health benefit. However, those interventions were not adequate to sustain the advantage. Few studies have demonstrated the effect of integrating participatory ergonomic management (PEM) in Non-Weight-Bearing Exercise (NWE) and Progressive Resistance Exercise (PRE) and none has focused on aged para rubber farmers with knee osteoarthritis. This study investigated the effect of PEM-NWE, PEM-PRE and standard treatment (STG) on self-care and functional ability in the aged population.

Bone Mineral Density in Female Professional Athletes Involved in Weight Bearing and Non-Weight Bearing Exercises

The present study was designed to assess the effect of different types of exercises on the BMD values in female professional atheletes. The case control study was conducted on 59 healthy female atheletes aged between 20 and 30 years who were a member of the country’s national teams in the past three years. They were involved in weight-bearing (soccer and golf) and non-weight bearing (swimming and rowing) exercises. The BMD values of the L1–L4 anteroposterior lumbar spine and femoral subregions were recorded using a DXA bone densitometer and compared to that of a group of age and sex-matched non-athletes. Mean BMD values at all the studied sites were highest among the footballers and lowest among the golf players. Except for the spine, a significant difference between the BMD values at all the studied sites. As for spine, a significant difference was only seen in the BMD values of the footballers and that of golf players. There was no significant difference between the BMD values of the controls and those involved in either weight bearing or non-weight bearing exercises. The considerable difference noted in BMD values at different sites in footballers and golf players’ points out the great influence of weight-bearing exercises on the bone structure. The bones’ response to exercises is site-specific. High-impact weight bearing exercises stressing bones in a variety of directions are more effective in improving BMD values. Athletes involved in non-weight bearing exercises should do certain weight-bearing exercises to strengthen their bones.

The osteogenic effects of swimming on bone mass, strength, and microarchitecture in rats with unloading-induced bone loss.

The effect of nonweight-bearing exercise on osteoporotic bones remains controversial and inconclusive. The purpose of this study was to evaluate the effects of swimming on osteoporotic tibias of rats submitted to hindlimb suspension. Initially, 20 Wistar rats were used to confirm a significant bone loss following 21 days of unloading. Thirty rats were then divided into 3 groups and followed during 51 days: CON (nonsuspended rats), S + WB (suspended rats for 21 days and then released for regular weight-bearing) and, S + Swim (suspended rats for 21 days and then released from suspension and submitted to swimming exercise). We observed that swimming exercise was effective at fully recovering the bone deterioration caused by suspension, with significant increments in BMD, bone strength and bone volume. On the other hand, regular weight-bearing failed at fully restoring the bone loss induced by unloading. These results indicate that swimming exercise may be a potential tool to improve bone density, strength, and trabecular volume in tibias with bone loss induced by mechanical unloading in suspended rats. We conclude that this modality of activity could be beneficial in improving bone mass, strength, and architecture in osteoporotic individuals induced by disuse, such as bed rest or those exposed to microgravity, who may not be able to perform weight-bearing exercises.

Higher rate of fat oxidation during rowing compared with cycling ergometer exercise across a range of exercise intensities.

The relative contribution of carbohydrate and fat oxidation to energy expenditure during exercise is dependent on variables including exercise intensity, mode, and recruited muscle mass. This study investigated patterns of substrate utilization during two non-weightbearing exercise modalities, namely cycling and rowing. Thirteen young, moderately trained males performed a continuous incremental (3-min stages) exercise test to exhaustion on separate occasions on an electronically braked cycle (CYC) ergometer and an air-braked rowing (ROW) ergometer, respectively. On two further occasions, participants performed a 20-min steady-state exercise bout at ∼50%VO2peak on the respective modalities. Despite similar oxygen consumption, rates of fat oxidation (FATox ) were ∼45% higher during ROW compared with CYC (P < 0.05) across a range of power output increments. The crossover point for substrate utilization occurred at a higher relative exercise intensity for ROW than CYC (57.8 ± 2.1 vs 42.1 ± 3.6%VO2peak , P < 0.05). During steady-state submaximal exercise, the higher FATox during ROW compared with CYC was maintained (P < 0.05), but absolute FATox were 42% (CYC) and 28% (ROW) lower than during incremental exercise. FATox is higher during ROW compared with CYC exercise across a range of exercise intensities matched for energy expenditure, and is likely as a consequence of larger muscle mass recruited during ROW.

The Effect of Vigorous Running and Cycling on Novel Markers of Knee Joint Function

To date, no study has been undertaken to compare the effects of running (weight-bearing) and cycling (non-weight bearing) exercise on biomarkers of knee joint loading. PURPOSE: To investigate knee articular cartilage deformation and changes in serum oligomteric matrix protein (COMP) and lubricin in response to vigorous recreational exercise. We tested the hypothesis that the mode of biomechanical loading of the knee joint (weight-bearing versus non-weight bearing) would influence the nature of the responses. METHODS: 11 male runners (age: 40±6 years; weight: 76±8 kg; VO2max: 4.3±0.3 L/min mean±SD) and 11 male cyclists (35±12 years; 75±5 kg; 4.4±0.6 L/min) were investigated. Venous blood samples and supra-patellar ultrasound imaging scans were obtained at baseline rest, immediately after, and 30 minutes after, vigorous exercise (time trial: either 10 km run or 25 km cycle). Knee cartilage thicknesses and serum COMP and lubricin (ELISA) were determined for each time point. Statistical analyses were performed using two-factor repeated measures (group x time) ANOVA. RESULTS: At baseline rest, there were no significant differences between groups for cartilage thicknesses measured at the intercondyle notch, medial condyle and lateral condyle. Vigorous exercise did not result in significant change in any of the cartilage thicknesses for either group. There were no significant differences between runners and cyclists for COMP (runners: 804.1±87.5 ng/ml; cyclists: 693.0±84.7 ng/ml) and lubricin (runners: 104.0±19.8 ng/ml; cyclists: 119.1±23.9 ng/ml) at baseline. For both groups, vigorous exercise was generally accompanied by an increase in both serum COMP (cyclists: 32.1%; p < 0.05; runners: 14.2%; p = 0.14) and lubricin (cyclists: 39.4%; p < 0.05; runners 56.9%; p < 0.05). Following 30 minutes of rest, serum COMP and lubricin decreased towards baseline values in both groups (p < 0.05). CONCLUSIONS: In the absence of ultrasonographic evidence of knee cartilage deformation, responses of lubricin following an acute bout of vigorous exercise is not influenced by the modality of knee joint loading, and may reflect a temporary increase in joint lubrication. However, changes in cartilage metabolism following exercise, as measured by serum COMP, may be dependent on the exercise modality.

The association between different types of exercise and energy expenditure in young nonoverweight and overweight adults.

With decades of trends for decreasing activity during work and travel, exercise becomes an important contributor to total physical activity (PA) and energy expenditure. The purpose of this study was to examine the contribution of different types of exercise to the variability in energy expenditure and time spent at different PA intensities in young adults. Four hundred and seventeen adults (49.9% male; 46.2 overweight/obese) between 21 and 36 years of age provided valid objective PA and energy expenditure data, assessed via the SenseWear Armband (BodyMedia Inc.). Frequency and duration of participation in various exercise types was self-reported. Weight status was based on body mass index (BMI) (kg/m(2)) with body weight and height being measured according to standard procedures. Eighty-four percent of the participants reported regular exercise engagement with no difference in participation rate by sex or BMI category. Exercise time along with sex and ethnicity explained roughly 60% of the variability in total daily energy expenditure (TDEE) while the association between exercise and time spent in moderate to vigorous PA or being sedentary was low or nonsignificant. Engagement in endurance exercise and sports contributed predominantly to the variability in energy expenditure and PA in nonoverweight participants. In overweight/obese participants engagement in resistance exercise and swimming contributed significantly to variability in TDEE. Current exercise recommendations focus primarily on aerobic exercise, but results of the present study suggest that nonweight-bearing exercises, such as resistance exercise and swimming, contribute significantly to the variability in TDEE in overweight/obese adults, which would make these types of activities viable options for exercise interventions.

The impact of adding weight-bearing exercise versus nonweight bearing programs to the medical treatment of elderly patients with osteoporosis.

Background:Osteoporosis is a major public health problem affecting the elderly population, particularly women. The objective of the study was to evaluate the effects of adding weight-bearing exercise as opposed to nonweight-bearing programs to the medical treatment of bone mineral density (BMD) and health-related quality of life (HRQoL) of elderly patients with osteoporosis.Materials and Methods:Participating in the study were 40 elderly osteoporotic patients (27 females and 13 males), with ages ranging from 60 to 67 years, who were receiving medical treatment for osteoporosis. They were assigned randomly into two groups: Group-I: Twenty patients practiced weight-bearing exercises. Group-II: Twenty patients did nonweight-bearing exercises. All patients trained for 45-60 min/session, two sessions/week for 6 months. BMD of the lumbar spine, right neck of femur, and right distal radial head of all patients were measured by dual-energy X-ray absorptiometry before and after both treatment programs. In addition, the QoL was measured by means of the HRQoL “ECOS-16” questionnaire.Results:T-tests proved that mean values of BMD of the lumbar spine, right neck of femur and right distal radial head were significantly increased in both groups with greater improvement in the weight-bearing group. The QoL was significantly improved in both groups, but the difference between them was not significant.Conclusion:Addition of weight-bearing exercise program to medical treatment increases BMD more than nonweight-bearing exercise in elderly subjects with osteoporosis. Furthermore, both weight-bearing and nonweight-bearing exercise programs significantly improved the QoL of patients with osteoporosis.

Open Kinetic Chain Exercises in a Restricted Range of Motion After Anterior Cruciate Ligament Reconstruction

Background: Recent studies have shown that an early start of open kinetic chain (OKC) exercises for quadriceps strengthening in a full range of motion (ROM) could increase anterior knee laxity after anterior cruciate ligament (ACL) reconstruction with flexor tendons. However, there are no clinical trials that evaluated outcomes of OKC exercises in a restricted ROM for pain, function, muscle strength, and anterior knee laxity at 1 year after surgery. Purpose: To determine if an early start of OKC exercises for quadriceps strength in a restricted ROM would promote a clinical improvement without causing increased anterior knee laxity in patients after ACL reconstruction. Study Design: Randomized controlled clinical trial; Level of evidence, 1. Methods: A total of 49 patients between 16 and 50 years of age who underwent ACL reconstruction with semitendinosus and gracilis autografts were randomly assigned to an early start OKC (EOKC) exercise group or a late start OKC (LOKC) exercise group. The EOKC group (n = 25; mean age, 26 years) received a rehabilitation protocol with an early start of OKC (fourth week postoperatively) within a restricted ROM between 45° and 90°. The LOKC group (n = 24; mean age, 24 years) performed the same protocol with a late start of OKC exercises between 0° and 90° (12th week postoperatively). Quadriceps and hamstring muscle strength, 11-point numerical pain rating scale (NPRS), Lysholm knee scoring scale, single-legged and crossover hop tests, and anterior knee laxity were measured to assess outcomes at the 12-week, 19-week, 25-week, and 17-month postoperative follow-up (range, 13-24 months). Results: No difference (P < .05) was noted between groups with respect to demographic data. Both groups (EOKC and LOKC) had a higher level of function and less pain at the 19-week, 25-week, and 17-month assessments when compared with 12 weeks postoperatively (P < .05). The EOKC group had improved quadriceps muscle strength at the 19-week, 25-week, and 17-month follow-up when compared with 12 weeks postoperatively (P < .05); the LOKC group showed improvement only at the 17-month postoperative assessment. However, the analysis between groups showed no difference for all pain and functional assessments, including anterior knee laxity (P > .05). Conclusion: An early start of OKC exercises for quadriceps strengthening in a restricted ROM did not differ from a late start in terms of anterior knee laxity. The EOKC group reached the same findings in relation to pain decrease and functional improvement when compared with the LOKC group but showed a faster recovery in quadriceps strength. The nonweightbearing exercises seem appropriate for patients who have undergone ACL reconstruction, when utilized in a specific ROM. The magnitude of difference in quadriceps strength between the 2 rehabilitation protocols was around 5%; however, this difference was not clinically significant, especially because both groups had equal function on the hop tests.