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Efficacy and safety of a supplement combination on hand pain among people with symptomatic hand osteoarthritis an internet-based, randomised clinical trial the RADIANT study.
Liu, X, Robbins, S, Eyles, J, Fedorova, T, Virk, S, Deveza, LA, McLachlan, AJ, Hunter, DJ
Osteoarthritis and cartilage. 2021;(5):667-677
Abstract
OBJECTIVE The RADIANT study aimed to investigate the efficacy and safety of a complementary medicine supplement combination in people with hand osteoarthritis (HOA). METHOD This was an internet-based, double-blind, randomised, placebo-controlled trial. Participants aged over 40 years with symptomatic HOA with radiographic confirmation (Kellgren Lawrence grade ≥ 2) throughout Australia were recruited and randomly assigned (1:1) to receive either a supplement combination composed of Boswellia serrata extract 250 mg/day, pine bark extract 100 mg/day, methylsulfonylmethane 1,500 mg/day and curcumin 168 mg/day or placebo for 12 weeks. The primary outcome was change in hand pain assessed using a visual analogue scale (VAS 0-100) from baseline to week 12. A range of secondary outcomes and additional measures were recorded. Adverse events were monitored weekly. RESULTS One hundred and six participants were included with mean age 65.6 years and 81% were women. 45% of the participants were graded as KLG 4, 40% KLG three and 39 (37%) had erosive OA. There was no significant difference in pain VAS reduction between groups. The adjusted between group difference in means (95%CI) was 5.34 (-2.39 to 13.07). Five participants (10%) in the supplement combination group discontinued study treatment due to AE vs four participants (7%) in the placebo group. CONCLUSION There were no significant differences in symptomatic relief between the two groups over 12 weeks. These findings do not support the use of the supplement combination for treating hand pain in people with HOA. REGISTRATION Prospectively registered (Australian New Zealand Clinical Trials Registry ACTRN12619000835145, 31/05/2019).
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Acute Whole-Body Vibration Exercise Promotes Favorable Handgrip Neuromuscular Modifications in Rheumatoid Arthritis: A Cross-Over Randomized Clinical.
Coelho-Oliveira, AC, Lacerda, ACR, de Souza, ALC, Santos, LMM, da Fonseca, SF, Dos Santos, JM, Ribeiro, VGC, Leite, HR, Figueiredo, PHS, Fernandes, JSC, et al
BioMed research international. 2021;:9774980
Abstract
OBJECTIVE Rheumatoid arthritis (RA) causes progressive changes in the musculoskeletal system compromising neuromuscular control especially in the hands. Whole-body vibration (WBV) could be an alternative for the rehabilitation in this population. This study investigated the immediate effect of WBV while in the modified push-up position on neural ratio (NR) in a single session during handgrip strength (HS) in women with stable RA. METHODS Twenty-one women with RA (diagnosis of disease: ±8 years, erythrocyte sedimentation rate: ±24.8, age: 54± 11 years, BMI: 28 ± 4 kg·m-2) received three experimental interventions for five minutes in a randomized and balanced cross-over order: (1) control-seated with hands at rest, (2) sham-push-up position with hands on the vibration platform that remained disconnected, and (3) vibration-push-up position with hands on the vibration platform turned on (45 Hz, 2 mm, 159.73 m·s-2). At the baseline and immediately after the three experimental interventions, the HS, the electromyographic records (EMGrms), and range of motion (ROM) of the dominant hand were measured. The NR, i.e., the ratio between EMGrms of the flexor digitorum superficialis (FDS) muscle and HS, was also determined. The lower NR represented the greater neuromuscular efficiency (NE). RESULTS The NR was similar at baseline in the three experimental interventions. Despite the nonsignificance of within-interventions (p = 0.0611) and interaction effect (p = 0.1907), WBV exercise reduced the NR compared with the sham and control (p = 0.0003, F = 8.86, η 2 = 0.85, power = 1.00). CONCLUSION Acute WBV exercise under the hands promotes neuromuscular modifications during the handgrip of women with stable RA. Thus, acute WBV exercise may be used as a preparatory exercise for the rehabilitation of the hands in this population. This trial is registered with trial registration 2.544.850 (ReBEC-RBR-2n932c).
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Efficacy and safety of a supplement combination for hand osteoarthritis pain: protocol for an internet-based randomised placebo-controlled trial (The RADIANT study).
Liu, X, Robbins, S, Eyles, J, Fedorova, T, Virk, S, Deveza, LA, McLachlan, A, Hunter, D
BMJ open. 2020;(2):e035672
Abstract
INTRODUCTION Hand osteoarthritis (HOA) is a highly prevalent disabling joint disease. The current management regimens are limited. Potentially as a consequence, many people turn to complementary and alternative medicines for symptomatic relief. A combination of two or more supplements is common in clinical practice; however, evidence for the efficacy of this approach is lacking. The aim of this study is to investigate the efficacy of a supplement combination for treating symptomatic HOA in comparison to placebo. METHODS AND ANALYSIS The RADIANT study is an internet-based, parallel, superiority, double-blind, placebo-controlled, randomised, two-arm clinical trial. A participatory design is used to facilitate the study procedures. One hundred and six participants aged over 40 years with painful HOA and structural change on X-ray (Kellgren and Lawrence grade (KLG) ≥2) will be recruited from the community and randomly allocated to receive either a supplement combination composed of: (1) combined supplement containing Boswellia serrata extract, pine bark extract and methylsulfonylmethane and (2) curcumin or placebo for 12 weeks. The primary outcome will be 12-week change in hand pain on a visual analogue scale (VAS). Main secondary outcomes include adverse events, change in hand function, patient global assessment of disease activity and quality of life. A range of additional measures will be recorded, and an individual patient placebo response will be performed. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored weekly throughout the study. ETHICS AND DISSEMINATION This protocol has been approved by the University of Sydney Human Research Ethics Committee (HREC No. 2018/766). Dissemination will occur through conferences, social media, scientific publications and PhD thesis. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12619000835145); Pre-results.
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Two new cases of aquagenic wrinkling of the palms and literature review on drug interactions.
Bouwman, K, Menichino, S, Kruithof, I, Aalfs, AS
Dermatology online journal. 2020;(11)
Abstract
Aquagenic wrinkling of the palms (AWP) is a rare, acquired condition of the skin, defined by transient rapidly developing white to translucent papules on palms and/or soles after brief exposure to water. Aquagenic wrinkling of the palms is associated with cystic fibrosis (CF). Therefore, the diagnosis of AWP can be important. Etiopathogenesis of AWP is still unclear. Treatment is often unsatisfactory and can be very challenging. This article contributes to the knowledge of AWP as we describe two new cases of aquagenic wrinkling of the palms: one patient with familial history of CF and one patient with AWP that was presumed to be induced by use of non-steroidal anti-inflammatory drugs. In addition, we present a review of the literature on drug-induced AWP.
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Effects of Hand Exercise on Eating Action in Patients With Alzheimer's Disease.
Chen, LL, Li, H, Chen, XH, Jin, S, Chen, QH, Chen, MR, Li, N
American journal of Alzheimer's disease and other dementias. 2019;(1):57-62
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Abstract
We aim to investigate whether a popular hand exercise could be used to improve the action of eating in patients with Alzheimer's disease (AD). A 6-month intervention was conducted in 60 patients with AD who live in a nursing home. They were divided into hand exercise and control groups. Patients of the control group maintained their daily routine. The improvement of Edinburgh Feeding Evaluation in Dementia scale in hand exercise group was significantly greater than in the control group ( P = .003). Significant differences in time of autonomous eating and time of simulated eating between patients in the hand exercise and control groups ( P < .05) were noted. The improvements in accuracy of eating action and coordination of eating action from baseline were significant in hand exercise group compared to the control group ( P = .020 and .014, respectively). Hand exercise is a safe and effective intervention to improve the feeding and eating of people with AD.
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Heat pain modulation with virtual water during a virtual hand illusion.
Käthner, I, Bader, T, Pauli, P
Scientific reports. 2019;(1):19137
Abstract
Immersive virtual reality is a powerful method to modify the environment and thereby influence experience. The present study used a virtual hand illusion and context manipulation in immersive virtual reality to examine top-down modulation of pain. Participants received painful heat stimuli on their forearm and placed an embodied virtual hand (co-located with their real one) under a virtual water tap, which dispensed virtual water under different experimental conditions. We aimed to induce a temperature illusion by a red, blue or white light suggesting warm, cold or no virtual water. In addition, the sense of agency was manipulated by allowing participants to have high or low control over the virtual hand's movements. Most participants experienced a thermal sensation in response to the virtual water and associated the blue and red light with cool/cold or warm/hot temperatures, respectively. Importantly, the blue light condition reduced and the red light condition increased pain intensity and unpleasantness, both compared to the control condition. The control manipulation influenced the sense of agency, but did not influence pain ratings. The large effects revealed in our study suggest that context effects within an embodied setting in an immersive virtual environment should be considered within VR based pain therapy.
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Use of illicit amphetamines is associated with long-lasting changes in hand circuitry and control.
Pearson-Dennett, V, Faulkner, PL, Collie, B, Wilcox, RA, Vogel, AP, Thewlis, D, Esterman, A, McDonnell, MN, Gandevia, SC, White, JM, et al
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology. 2019;(5):655-665
Abstract
OBJECTIVE The study aim was to determine if use of illicit amphetamines or ecstasy is associated with abnormal excitability of the corticomotoneuronal pathway and manipulation of novel objects with the hand. METHODS Three groups of adults aged 18-50 years were investigated: individuals with a history of illicit amphetamine use, individuals with a history of ecstasy use but minimal use of other stimulants, and non-drug users. Transcranial magnetic stimulation was delivered to the motor cortex and the electromyographic response (motor evoked potential; MEP) was recorded from a contralateral hand muscle. Participants also gripped and lifted a novel experimental object consisting of two strain gauges and an accelerometer. RESULTS Resting MEP amplitude was larger in the amphetamine group (6M, 6F) than the non-drug and ecstasy groups (p < 0.005) in males but not females. Overestimation of grip force during manipulation of a novel object was observed in the amphetamine group (p = 0.020) but not the ecstasy group. CONCLUSIONS History of illicit amphetamine use, in particular methamphetamine, is associated with abnormal motor cortical and/or corticomotoneuronal excitability in males and abnormal manipulation of novel objects in both males and females. SIGNIFICANCE Abnormal excitability and hand function is evident months to years after cessation of illicit amphetamine use.
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Monitoring of functional blood flow on human hand due to effect of different treatments by laser biospeckle imaging.
Kumari, S, Nirala, AK
Lasers in medical science. 2019;(6):1167-1176
Abstract
In the proposed work, we report on qualitative as well as quantitative biospeckle monitoring of functional blood flow on the human hand. Intensity-based algorithms namely generalized difference and our earlier proposed algorithm parameterized global-average Fujii have been approached for the first time to analyze various physiological changes due to effect of different treatments such as hot and cold water treatments on the palm which can be helpful in examining cardiovascular and related diseases. In addition, blood flow has been monitored for the first time on face scrub, beauty creams, and pain relief ointments applied over the back of the palm. It has been found that, on application of four beauty creams namely Fair & Lovely, Ponds White Beauty, Vicco Turmeric, and Lotus Herbals Safe Sun on the back of the palm, blood flow increases and becomes highest (mean activity, 154.87) for Fair & Lovely among the four beauty creams. In addition, pain relief ointments such as Volini, Fast Relief, Molid Gel, and Zandu Gel increase blood flow after their applications on the back of the palm and Volini gives maximum increase of average blood flow (31.59) and hence can be considered one of the best among the four ointments. It has been further concluded that the person having more hemoglobin (14) and higher blood pressure (120/90) may have more blood flow or mean activity (85.80). In addition, it has been also concluded that although hot and cold water treatments can be used for increment in blood flow, temperature should be retained according to need and sensitivity of the sample.
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Herbal Medicines for Cold Hypersensitivity in the Hands and Feet: A Systematic Review and Meta-Analysis.
Yu, JS, Lee, D, Hyun, D, Chang, SJ
Journal of alternative and complementary medicine (New York, N.Y.). 2018;(12):1150-1158
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Objectives: Cold hypersensitivity in the hands and feet (CHHF) and Raynaud's phenomenon (RP) are prevalent among Asian populations, especially among women, who exhibit a higher rate of cold hypersensitivity that may be associated with gynecological problems. In several countries, herbal medicine has effectively treated cold hypersensitivity symptoms. This systematic review and meta-analysis of the literature was undertaken to evaluate the efficacy of herbal medicine for the treatment of CHHF in adults. Design: Through March 31, 2018, comprehensive databases were searched, including MEDLINE, EMBASE, Cochrane Library, Chinese Academic Journal, and Japanese National Institute of Informatics, to identify relevant studies and extract data. Outcome measures: Primary: total effective rate (TER); secondary: skin temperature, peripheral blood flow, adverse events. Results: Fourteen randomized controlled trials (n = 974) were included. Thirteen studies with dichotomous values showed a significant reduction in CHHF and RP (risk ratio 0.31, 0.24-0.40) when comparing herbal medicine with/without Western medicine, and no treatment or Western medicine alone. Reductions in CHHF and RP were also observed between herbal medicine plus Western medicine and Western medicine alone (risk ratio 0.45, 0.24-0.86), as well as between herbal medicine and Western medicine alone (risk ratio 0.30, 0.21-0.41). In the only study using a placebo arm, herbal medicine was found to be superior to placebo in increasing skin temperature and peripheral blood flow. Six participants exhibited minor adverse drug reactions. Herbal medicine showed a superior TER, especially when combined with Western medicine, to Western medicine alone or placebo. However, there was a high risk of bias within all studies. Conclusion: Although herbal medicine shows potential to be a safe and effective treatment for CHHF and RP, the high risk of bias in all studies prevents definitive conclusions; thus, higher quality studies must be performed.
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Sensorimotor integration in healthy aging: Baseline differences and response to sensory training.
Brown, KE, Neva, JL, Feldman, SJ, Staines, WR, Boyd, LA
Experimental gerontology. 2018;:1-8
Abstract
Sensorimotor integration is the process through which somatosensory information is incorporated to inform motor output. Given its important behavioural implications, understanding the influence of healthy aging on the underlying neurophysiology of sensorimotor integration and whether it is modifiable through intervention is important. The aims of the current work were to: 1) profile aging-related differences in sensorimotor integration, and 2) to determine if sensorimotor integration in older adults can be modulated in response to sensory training. A group of older healthy individuals and younger healthy individuals participated in two experimental sessions. First, baseline neurophysiology of sensorimotor integration was assessed. Short-latency afferent inhibition, afferent facilitation, and long-latency afferent inhibition provided nerve-based assessment of sensorimotor integration. Vibration-based measures of sensorimotor integration combined vibration of abductor pollicis brevis with single and paired-pulse transcranial magnetic stimulation techniques. In the second experimental session, a 15-min block of sensory training designed to modulate sensorimotor integration preceded the same neurophysiological assessment. Results indicate that there are aging-related differences in nerve-based measures of sensorimotor integration, specifically short- and long-latency afferent inhibition. In contrast, there are not aging-related differences when peripheral muscle belly vibration is used to probe sensorimotor integration. Following sensory training there is a reduction in the cortical response to vibration. These results suggest that there is differential aging-related modulation of sensorimotor integration, based on the type of afferent information. Additionally, sensorimotor integration is modifiable with a single session of sensory training, and this ability for neuroplastic change is retained with healthy aging.