مجال
التميز
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تميز دراسي و بحثي
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البحوث المنشورة
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البحث (1):
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عنوان البحث:
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Effect of physical activity and
dietary restriction interventions on weight loss and the musculoskeletal
function of overweight and obese older adults with knee osteoarthritis: a
systematic review and mixed method data synthesis
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رابط إلى البحث:
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تاريخ النشر:
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01/06/2017
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موجز عن البحث:
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BACKGROUND:
Despite the clinical
recommendation of exercise and diet for people with knee osteoarthritis (OA),
there are no systematic reviews synthesising the effectiveness of combining
physical activity and dietary restriction interventions on the
musculoskeletal function of overweight and obese older adults with knee OA.
OBJECTIVE:
To evaluate the effectiveness of
combined physical activity and dietary restriction programmes on body weight,
body mass index (BMI) and the musculoskeletal function of overweight and
obese older adults with knee OA.
INFORMATION SOURCES:
A detailed search strategy was
applied to key electronic databases (Ovid, Embase, Web of Science andCumulative
Index to Nursing and Allied Health Literature (CINAHL)) for randomised
controlled trials (RCTs) published in English prior to 15 January 2017.
PARTICIPANTS:
Participants with BMI ≥25 kg/m2,
aged ≥55 years of age and with radiographic evidence of knee OA.
INTERVENTIONS:
Physical activity plus dietary
restriction programmes with usual care or exercise as the comparators.
OUTCOME MEASURES:
Primary outcome measures were
body weight, BMI or musculoskeletal function. Secondary outcome measures were
pain and quality of life.
RESULTS:
One pilot and two definitive
trials with n=794 participants were included. Two articles reporting
additional data and outcome measures for one of the RCTs were identified. All
included RCTs had an unclear risk of bias. Meta-analysis was only possible to
evaluate mobility (6 min walk test) at 6 months and the pooled random effect
15.05 (95% CI -11.77 to 41.87) across two trials with n=155 participants did
not support the combined intervention programme. Narrative synthesis showed
clear differences in favour of a reduced body weight and an increased 6 min
walk in the intervention group compared with control groups.
CONCLUSION:
The quality of evidence of
benefit of combining exercise and dietary interventions in older overweight/obese
adults with knee OA is unclear.
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البحث (2):
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عنوان البحث:
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Barriers and facilitators of
physical activity in knee and hip osteoarthritis: a systematic review of
qualitative evidence
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رابط إلى البحث:
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تاريخ النشر:
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موجز عن البحث:
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Background
Physical activity (PA), including engagement in structured exercise, has a
key role in the management of hip and knee osteoarthritis (OA). However,
maintaining a physically active lifestyle is a challenge for people with OA.
PA determinants in this population need to be understood better so that they
can be optimised by public health or healthcare interventions and social
policy changes.
Objectives The
primary aim of this study is to conduct a systematic review of the existing
qualitative evidence on barriers and facilitators of PA for patients with hip
or knee OA. Secondary objective is to explore differences in barriers and
facilitators between (1) lifestyle PA and exercise and (2) PA uptake and
maintenance.
Methods Medline,
Embase, Web of Science, Cumulative Index to Nursing and Allied Health
Literature, SPORTDiscus, Scopus, Grey literature and qualitative journals
were searched. Critical Appraisal Skills Programme—Qualitative checklist and
Lincoln and Guba’s criteria were used for quality appraisal. Thematic
synthesis was applied.
Findings Ten
studies were included, seven focusing on exercise regimes, three on overall
PA. The findings showed a good fit with the biopsychosocial model of health.
Aiming at symptom relief and mobility, positive exercise experiences and
beliefs, knowledge, a ‘keep going’ attitude, adjusting and prioritising PA,
having healthcare professionals’ and social support emerged as PA facilitators.
Pain and physical limitations; non-positive PA experiences, beliefs and
information; OA-related distress; a resigned attitude; lack of motivation,
behavioural regulation, professional support and negative social comparison
with coexercisers were PA barriers. All themes were supported by high and
medium quality studies. Paucity of data did not allow for the secondary
objectives to be explored.
Conclusion Our
findings reveal a complex interplay among physical, personal including
psychological and social-environmental factors corresponding to the
facilitation and hindrance of PA, particularly exercise, engagement. Further
research on the efficacy of individualised patient education, psychological
interventions or social policy change to promote exercise engagement and
lifestyle PA in individuals with lower limb OA is required.
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المؤتمرات العلمية:
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المؤتمر (1):
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عنوان المؤتمر:
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8th Saudi
Students’ Conference
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تاريخ الإنعقاد:
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31/01/2015
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مكان
الإنعقاد:
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London. United Kingdom
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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Applicability and Effectiveness
of Strengthening and Balance Exercise program on the Quality of Life of Older
Saudi Women with Bilateral Knee Osteoarthritis: A pilot study”
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ملخص المشاركة:
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Background
Osteoarthritis (OA) is the most common joint disease that causes pain, joint
instability and muscle weakness, which can lead to physical function
impairment and quality of life (QOL) reduction. However, designing a suitable
training program for older Saudi women with knee OA considering several
factors such as their cultural habits, physical activity levels and believe
in exercise has becomes a big demand.
Objective To
evaluate the applicability of the proposed exercise program and its effect on
the function and QOL of older Saudi women with Knee OA.
Methods One
group, repeated measure design was conducted. Ten Saudi female participants
with bilateral knee OA (mild to moderate), aged 60-70 years have been
recruited. The exercise program included gait re-education, strengthening
exercise by using theraband, sit to stand exercise and aerobic exercise
(walking), two sessions per week as group therapy by trained therapist. SF-36
and Saudi Knee Function Scale SKFS were used pre and post four weeks of
intervention to identify the changes.
Results Ten
participants had clinical and statistical improvement in their QOL and
function, SF-36 showed a significant improvement in all subscales related to
QOL with p<0.05 except pain p=0.705. While the disease specific measure
SKFS reflected a significant improvement in function with p<0.05. By
comparing the two measurements, the SF-36 reflected more improvement in
psychological state, 90% of the participants were improved, while SKFS
reflected more improvement in pain and functional activities in all
participants. Finally, the social activities were improved equally by the two
scales by 70%.
Conclusion Group
therapy is the key element of maximizing participants’ adherence to the
exercise. Moreover, the proposed program is applicable and effective and can
be applied clinically to improve physical function and QOL of older Saudi
women with knee OA.
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المؤتمر (2):
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عنوان المؤتمر:
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The MRC – Arthritis Research UK Centre for
Musculoskeletal Research and The MRC – Arthritis Research UK Centre for
Integrated research into Musculoskeletal Ageing Joint Conference
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تاريخ الإنعقاد:
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15/05/2015
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مكان
الإنعقاد:
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Nottingham.UK
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طبيعة المشاركة:
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Poster
presentation
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عنوان المشاركة:
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Effect of physical activity and
dietary restriction interventions on the musculoskeletal function of
overweight and obese elders with knee osteoarthritis: A systematic review
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ملخص المشاركة:
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Background Knee OA is the most common form of arthritis. The
incidence of knee OA is increasing, due to increasing age and changes in body
composition within the population, (age and obesity being key risk factors
for the development of this condition [1,2]. The consequences are chronic
pain, functional limitation and emotional distress which lead to disability
and negatively affect quality of life [2].
Since knee OA is progressive, therapies rely on patient education,
self-management, pain reduction, weight reduction, physical activity
enhancement and improvement in function and quality of life [3,4,5]. A
preliminary scoping study identified both diet and exercise interventions as
practical strategies to reduce weight and decrease joint inflammation [2,6].
However, there is no systematic review to date investigating the
effectiveness of combining these
interventions on the musculoskeletal function of overweight and obese elders
with knee osteoarthritis. Consequently, identifying the most effective
type and amount of diet as well as the most suitable exercise may help health
care practitioners.
Objective to investigate the effectiveness of combined
physical activity and dietary restriction programmes on the musculoskeletal
function of overweight and obese elders with knee OA.
Design systematic review. The study protocol followed the Cochrane handbook
method guidelines for a systematic review and PRISMA statement.
Information sources key
electronic databases (Ovid, Embase, Web of science and CINAHL) were searched
by 2 independent researchers. Eligibility of included studies was
independently assessed by two reviewers, plus 3rd reviewer in the
case of disagreement. Eligibility criteria for included studies randomized
control trials published in English prior to 13 February 2015. The included
participants were overweight and obese elders with BMI ≥25Kg/m², aged
≥55 year and with radiographic evidence of unilateral or bilateral knee OA.
Animal studies and reports not written in English were excluded. The
interventions included physical activity plus dietary restriction programmes
and their effect on the musculoskeletal function of overweight and obese
elders with knee OA. Usual care either intervention or non intervention was
the comparator in this systematic review. Included outcome measures assessed
musculoskeletal function (mobility, balance, walking speed), pain and quality
of life.
Results 50
studies where identified from the searches. Following review of title and
abstract and full text 17 trials were included. Risk of bias evaluation, data
extraction and synthesis of results are currently underway
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المؤتمر (3):
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عنوان المؤتمر:
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9th Saudi Students’
Conference
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تاريخ الإنعقاد:
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13/02/2016
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مكان
الإنعقاد:
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Birmingham. United Kingdom
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طبيعة المشاركة:
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Poster presentation
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عنوان المشاركة:
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The effect of physical activity
and dietary restriction interventions on the musculoskeletal function of
overweight and obese elders with knee osteoarthritis: a systematic review
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ملخص المشاركة:
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Objective: To investigate the
effectiveness of combined physical activity and dietary restriction
programmes on the musculoskeletal function of overweight and obese elders
with knee osteoarthritis (OA). Design: Systematic review and meta-analysis.
Information sources: A detailed
search strategy with comprehensive terms was applied to key electronic
databases (Ovid, Embase, Web of Science and CINAHL). Additional studies were
searched manually in the bibliographies of key journals.
Eligibility criteria for included
studies were randomised controlled trials published in English prior to 13
February 2015. The included participants were overweight and obese elders
with BMI ≥25kg.m-2, aged ≥55 years of age and with radiographic evidence of
unilateral or bilateral knee OA. Animal studies and reports not written in
English were excluded. The interventions included physical activity plus
dietary restriction programmes and their effect on the musculoskeletal
function of overweight and obese elders with knee OA. Usual care was the
comparator. The primary outcome
measures were body weight, BMI, musculoskeletal function, (including
mobility, range of movement (ROM) and muscle strength). Secondary outcome
measures included pain and quality of life. Results: One pilot study and two
large trials with n=794 participants were included. Two articles reporting
additional data and outcome measures for one of the trials were identified.
All of the included studies were evaluated as having a high risk of bias.
Meta-analysis was used to assess the inter-trial comparability of outcomes
between the intervention group and control group at two assessment points (6
and 18 months). Four/five studies were included in a meta-analysis with n=416
participants. The comparable outcome measures between the combined programme
group and the control group were weight loss, 6 minute walk test, stair
climb, physical function, pain and quality of life. The pooled random effects
of stair climb time at 18 months (-2.42, 95% CI -4.49 to -0.36), pain (WOMAC)
at 6 and 18 months (-0.68, 95% CI -2.06 to -0.70); (-0.95, 95% CI -2.58 to
0.68), physical component of the SF-36 at 6 and 18 months (0.18, 95% CI –
0.02 to 0.38); (0.23, 95% CI 0.03 to 0.42) supported only a combined
programme intervention effect. Conclusion: There is a need for more high
quality trials to optimise diet and physical activity interventions and to
investigate the effect on novel outcome measures which will help health
practitioners in this field.
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المؤتمر (4):
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عنوان المؤتمر:
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14th Congress of European Forum for Research in Rehabilitation
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تاريخ الإنعقاد:
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24/05/2017
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مكان
الإنعقاد:
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Glasgow. United Kingdom
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طبيعة المشاركة:
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Poster
presentation
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عنوان المشاركة:
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The effect of dietary
restriction and physical activity on physical function and body composition
of obese elders with knee OA
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ملخص المشاركة:
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Background: Knee OA
is a common condition in older adults which affects approximately 3.64% of
the global population¹. Despite the clinical
recommendation of exercise and diet for people with knee osteoarthritis (OA) there are no published UK studies reporting efficacy
of a combined intervention programme of physical activity and dietary
restriction on the musculoskeletal function of overweight and obese elders
with knee OA.
Aim: To
assess the feasibility and acceptability and collect preliminary data on the
effectiveness of a combined dietary restriction/ exercise intervention
programme.
Method: The
trial will begin in February 2017 and conclude in August 2017. It will take
place at the Royal Orthopaedic Hospital (ROH), Birmingham and the School of
Sport, Exercise and Rehabilitation Sciences, University of Birmingham. Participants will receive a physiotherapy
usual care programme for knee OA for one month, after which they will
continue to exercise in their local gyms for 3 months. Participants will also
follow dietary restriction throughout the 4 months of the intervention.
Results/ Findings: The
primary outcome will be feasibility which will be assessed via focus group
(participants) and questionnaire (ROH physio staff) at the end of the trial.
Secondary outcome measures will include WOMAC, body weight, BMI, body
composition, waist circumference, musculoskeletal function (including knee
ROM, lower limb muscle power, stair climb and timed up-and-go), pain, QoL,
and markers of joint remodeling.
Discussion and Conclusion: The result of this trial will inform the design of a
combined intervention programme within the UK population. Also, it will help
to identify optimal method(s) for weight reduction plus the most effective
way of delivering exercise to optimize patient outcome in a secondary health
care setting.
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المؤتمر (5):
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عنوان المؤتمر:
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3rd Conference on
Obesity and Chronic Diseases
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تاريخ الإنعقاد:
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23/07/2018
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مكان
الإنعقاد:
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Los Angeles.USA
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طبيعة المشاركة:
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Poster
presentation
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عنوان المشاركة:
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The Effect of A combined Program
of Dietary Restriction and Physical Activity on The Physical Function and
Body Composition of Obese Older Adults with Knee Osteoarthritis
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ملخص المشاركة:
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Knee Osteoarthritis (OA) is the most common
cause of disability, affecting approximately 3.64% of the global population.
Interventions including intensive weight loss and exercise have shown a
significant effect on pain reduction in older adults with symptomatic knee
OA. We aim to assess the feasibility and acceptability of a combined dietary
restriction and physical activity intervention program and collect
preliminary data.
This single-arm intervention study will run
from December 2017 to June 2018 at one site in the UK. Thirty obese
participants will receive a knee OA physiotherapy usual care program for 4
weeks and then continue to exercise in their local gym/ leisure facility for
a further 12 weeks. Participants will also follow dietary restriction aiming
for a decrease of 300-500 kcal.day-1 or 500-1000 kcal.day-1 as appropriate to
initial BMI. The outcome measures are focus group and questionnaire to assess
feasibility. Also, physical function (WOMAC) scale, body weight, waist
circumference and BMI, musculoskeletal function; knee ROM, lower limb power,
physical performance; stair climb; timed up-and-go, pain intensity using
WOMAC pain subscale, quality of life (SF-36) will be assessed at baseline, 4
and 16 weeks. Body composition and markers of joint remodeling will be
measured only at baseline and 16 weeks. Mixed analysis techniques will be
used to analyze the quantitative and qualitative outcome measures.
The results of this study will inform a
refined intervention and a future adequately powered low risk of bias
definitive trial. This trial is registered with the ISRCTN registry (ISRCTN
12906938).
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