Osteoarthritis case study.
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Adjuvants, Immunologic↗
Biomedical subjects
Vijay Vad
Publications and source records attributed to Vijay Vad.
Quantitative electromyography analysis of disc unloader brace.
The purpose of this study was to determine if the Disc Unloader brace was effective in reducing intradiscal pressure. There is a strong correlation between lumbar paraspinal activity and intradiscal pressure. We used ten healthy volunteers to measure lumbar paraspinal activity at L5 using a quantitative EMG system. After doing reliability and reproducibility testing which showed margin of error of 7%, ten volunteers were measured for quantitative EMG activity at the L5 paraspinal level in full lumbar flexion without the Disc Unloader brace three times and averaged. The same quantitative EMG testing was done in full flexion with the Disc Unloader brace on at the L5 paraspinal level three times and averaged. For five of the ten patients, we performed the test first with the Disc Unloader brace on whereas for the rest of the five, the test was performed first without the brace on. There were 7 females and 3 males with average age of 39 (range 26-46). The average area under the curve score was 173 +/- 27.1 microvolts at the L5 paraspinal for the ten healthy subjects without the Disc Unloader brace on. The average area under the curve score was 102 +/- 19.6 microvolts at the L5 paraspinal for ten healthy subjects with the Disc Unloader brace on. There was a statistically significant (p<0.05) reduction in quantitative paraspinal activity of 41% with the Disc Unloader brace on. We conclude that the Disc Unloader brace is effective in reducing quantitative EMG lumbar paraspinal myoelectric activity and therefore intradiscal pressures.
Journal Article↗
Exercise recommendations in athletes with early osteoarthritis of the knee.
Osteoarthritis of the knee is a common condition that afflicts millions of individuals annually. The benefits of exercise are self evident as athletes and middle-aged individuals grow older, and the focus has centered on pain-free participation in their sports and activities. In the past, medical treatment has primarily relied on oral medications to manage symptoms, without the incorporation of therapeutic exercise. Consequently, as the osteoarthritis progresses, patients are offered surgical management and eventual joint replacement. A goal-oriented progressive rehabilitation programme that incorporates medical management in the initial stages would allow patients a greater ability to participate in sports, thereby obtaining the numerous benefits of exercise and perhaps delaying surgery. A progressive rehabilitation programme consists of five stages (I to V). Medical management is primarily reserved for stage I: protected mobilisation and pain control. It entails the use of pain medications, nonsteroidal anti-inflammatory drugs, with or without the use of chondroprotective agents such as glucosamine. Injection therapy is usually incorporated at this stage with intra-articular injections of corticosteroids or viscosupplementation, either of which may be combined with minimally invasive single-needle closed joint lavage procedure. Stages II and III introduce open kinetic-chain nonweightbearing exercises to the affected joint, with progression to closed kinetic-chain exercises. Stage IV focuses on return to sporting activities, with continued closed kinetic-chain exercises. There is also the incorporation of sport-specific exercises to improve neuromuscular coordination, timing and protect against future injury. Finally, stage V, or the maintenance phase, is primarily aimed at educating the patient on how to reduce the risk of re-injury and optimise their current exercise programme. Medical management of knee osteoarthritis within the framework of a progressive rehabilitation programme that includes active therapeutic exercise may delay the progression of this disease and allow patients years of greater pain-free activity and improved quality of life.
Athletic Injuries↗