Research Articles

1. Tendinopathy Management

2. Meniscus Repair

3. Life Expectancy and Physical Activity

4. Kypohosis and Pulmonary Function in Eldery

5. Coming Soon...

 

Tendinopathy Management

Pavlova AV, Shim JSC, Moss R, et al. Effect of resistance exercise dose components for tendinopathy management: a systematic review with meta-analysis. Br J Sports Med. 2023;57(20):1327-1334. doi:10.1136/bjsports-2022-105754

Author's Conclusions: For the management of tendinopathies, clinicians should use higher intensity exercises with external loading and lower frequencies.

Our Takeaway: There is a variety of studies looking at tendinopathy. There is a lack of studies that looks at specific dosing for this condition. Furthermore, A key component of tendinopathy is dosing. In this meta-analysis the authors looked at intensity, frequency, and volume. Lower intensity was considered body mass, while higher intensity was considered externally loaded. Frequency was measured as low (less than daily), moderate (daily), and high (more than once per day). Volume was measured as a dichotomous variable as low (less than 45 repetitions for the exercise) and high (greater than or equal to 45 repetitions for exercise). There was not variable for type of exercise (e.g. eccentric, concentric, isometric, isokinetic).
This meta-analysis provides us with some potentially evidence-based information on dosing based upon the current research, but did not identify which type. The anatomical areas of focus they identified were: Achilles, Gluteal, Lateral Elbow, Patellar, and Rotator Curff related shoulder pain. These are common areas of tendinopathy.

 

#tendinopathy

 

Meniscus Repair

 

Solsona-Carcas D, Trenado-Molina J, Buesa-Estéllez A, López-Royo MP, Bellosta-López P. Physical Therapist Interventions Versus or Combined With Surgical Treatment in Nontraumatic Degenerative Meniscal Pathology: A Systematic Review and Network Meta-Analysis. Phys Ther. 2024;104(5):pzae007. doi:10.1093/ptj/pzae007

 

Author's Conclusions: "Physical therapist interventions based on exercise programs demonstrate superior short-term outcomes in pain reduction and knee extensor strength compared to surgical treatment."

 

Our Takeaway: There were 10 studies that were included in the meta-analysis. Only able to assess short-term (3 months) outcomes due to lack of homegenity of follow-up periods. Looked a four different parameters; Visual Analog Scale (VAS) for pain in weight bearing and at rest, Knee Injury and Osteoarthritis Outcome Score (KOOS), and strength of knee extensors.

All of these findings are at 3 months

Physical therapist intervention is perferable compared to surgery and is more cost effective. If surgery is performed, physical therapy intervention should coinside with after surgical care.

One study showed surgery had a better outcome at 24 months compared to just physical therapy. However, physical thearpy was identified to reduce pain and increase function.

 

AI Conclusions: A systematic review and network meta-analysis examining non-traumatic degenerative meniscal tears concluded that physical therapist (PT) intervention should be the primary, first-line management strategy. Across short, mid, and long-term follow-ups, physical therapy was found to be as effective as, or superior to, arthroscopic partial meniscectomy (APM) alone for both pain reduction and improved function. Critically, the data shows that combining surgery with post-operative physical therapy offers no additional benefit over physical therapy alone. This evidence reinforces that APM does not provide a functional advantage for degenerative tears and that pursuing a comprehensive non-surgical physical therapy plan is the optimal, evidence-based pathway for most patients, significantly reducing the likelihood of needing surgery.

 

#meniscus

 

Life Expectancy and Physical Activity

 

Veerman L, Tarp J, Wijaya R, et al. Physical activity and life expectancy: a life-table analysis

British Journal of Sports Medicine Published Online First: 14 November 2024. doi: 10.1136/bjsports-2024-108125

 

Author's Conclusions: "Higher physical activity levels provide a substantial increase in population life expectancy. Increased investment in physical activity promotion and creating physical activity promoting living environments can promote healthy longevity."

 

Our Takeaways: 

The authors are looking at physical activity and it's contribution to mortality rate. Physical activity is defined by the authors as movement that is detected by a wearable device which is a hip worn accelerometer. The amount of movement is characterized by counts per minute (cpm), which is how much movement there was in a minute as detected by the hip worn device. 

Quartile 1 Physical Activity (Ages 40-80) averaged between 108 cpm and 147 cpm

Quartile 2 Physical Activity (Ages 40-80) averaged between 207 cpm and 218 cpm

Quartile 3 Physical Activity (Ages 40-80) averaged between 291 cpm and 298 cpm

Quartile 4 Physical Activity (Ages 40-80) averaged between 412 cpm and 481 cpm

Compared to the most active individuals (Q4), which has an activity level of about 160 daily minutes of walking at 4.8 km/hour (2.98 mph), the lowest active individuals (Q1) would need to increase their activity by 111 mins/day, which in turn would increase life expectancy by 10.9 years. For the lowest active individuals (Q1) to shift to the next level (Q2) would require walking 28.5 min/day, adding 6.3 hours to life. Q2 to shift to Q3 would require 27.8 min/day, adding 3 hours to life and Q3 to shift to Q4 would require 55.0 min/day, adding about an hour to life.

 

AI Conclusions: "New research using device-measured physical activity (PA) data and a life-table analysis reveals that low PA is a more substantial contributor to mortality than previously estimated, with its risk rivaling or exceeding that of hypertension and smoking. The study found that if all Americans over age 40 increased their activity to the level of the top 25%, the population would gain an average of 5.3 years of life expectancy. For the least active individuals, the potential gains are even more dramatic: shifting from the least active quartile (Q1) to the most active quartile (Q4) could increase an individual's life expectancy by up to 10.9 years. These findings underscore the critical importance of promoting PA and creating supportive environments for healthy longevity."

 

#stayhealthy

Kypohosis and Pulmonary Function in Eldery

 

Ueawattanasirikul C, Boripuntakul S, Wonglangka K, Pinkaew D. Correlation between thoracic kyphosis and pulmonary function in elderly. Journal of Associated Medical Sciences. 2020;53(2):23–30. doi: 10.1234/jams.2020.53.2.23

 

Author's Conclusions: "We found that thoracic kyphosis was mildly positive correlation with lung functions in elderly, but FEV1/FVC ratio parameter, maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) were not correlated with thoracic kyphosis. Thoracic kyphosis measurements using the flexicurve method may provide a trend to predict lung function associated with thoracic kyphosis. Further study is warranted."

 

Our Takeaways: 

The difference between this study and many of the other studies that indicate there is a correlation is that the study looked at healthly elderly individuals with no co-morbidities or lung pathologies. As a result, we are making the assumption that without pathology the lung functions normally no matter how much curvature in thoracic kyphosis when looking at FEV1/FVC ratio and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). However, something that isn't concluded, which may need further study is if there is a different when performing exercise, both anerobically and aerobically. Additionally, one of the parameters of the testing was "spine erect" which will result in a decrease thoracic kyphosis which may indicate why there is a difference in this study compared to other studies.

 

AI Conclusions: "Thoracic kyphosis measured by the flexicurve method had a mild positive correlation with the lung functions (FVC, FEV1, and VC) in the elderly. The FEV1/FVC ratio, maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP) were not correlated with thoracic kyphosis."

 

#stayhealthy