Background There is no cure for knee osteoarthritis (KOA) and typically patients live approximately 30-years with the disease. Most common medical treatments result in short-term palliation of symptoms with little consideration of long-term risk. This systematic review aims to appraise the current evidence for the long-term (≥12 months) safety of common treatments for knee osteoarthritis (KOA). Methods Cochrane Database of Systematic Reviews, Medline and PubMed were systematically searched from 1990 to July 2017, inclusive. Inclusion criteria were 1) peer-reviewed publications investigating treatments for KOA referred to in the Australian Clinical Care Standard and/or Therapeutic Guidelines: Rheumatology 2) specifically addressing safety of the treatments 3) with ≥12 months of follow-up and 4) Downs and Black quality score ≥ 13. Results Thirty-four studies fulfilled the inclusion criteria. Lifestyle modifications (moderate exercise and weight loss), paracetamol, glucosamine, Intraarticular Hyaluronic Acid (IAHA) and platelet-rich-plasma (PRP) injections have a low risk of harm and beneficial ≥12 month outcomes. Although Nonsteroidal Anti-inflammatory Drugs (NSAIDs) provide pain relief, they are associated with increased risk of medical complications. Cortisone injections are associated with radiological cartilage degeneration at > 12 months. Arthroscopy for degenerative meniscal tears in KOA leads to a 3-fold increase in total knee arthroplasty (TKA). TKA improves primary outcomes of KOA but has a low rate of significant medical complications. Conclusions Given the safety and effectiveness of lifestyle interventions such as weight loss and exercise, these should be advocated in all patients due to the low risk of harm. The use of NSAIDs should be minimized to avoid gastrointestinal complications. Treatment with opioids has a lack of evidence for use and a high risk of long-term harm. The use of IAHA and PRP may provide additional symptomatic benefit without the risk of harm. TKA is associated with significant medical complications but is justified by the efficacy of joint replacement in late-stage disease. Trial registration PROSPERO International prospective register for systematic reviews; registration number CRD42017072809 . Electronic supplementary material The online version of this article (10.1186/s12891-019-2525-0) contains supplementary material, which is available to authorized users.

Carer stress and patients depression scores are related to the severity of stroke-related disability. Strategies to address patient mood and carer stress should be present in community services providing early stroke rehabilitation.

Purpose: To investigate the effects of 8 weeks of upright water-based exercise training in people with type 2 diabetes.Methods: Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 years, mean ± standard deviation) completed eight weeks of upright water-based exercise training at a moderate intensity (60-80% of exercise test-derived maximum heart rate), for one hour, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 years) acted as a control group (CG) who maintained their usual activities. Pre-and post-intervention, participants performed cardiopulmonary exercise testing to determine VO2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist:hip ratio were employed as measures of anthropometry.Endothelium dependent (brachial artery flow mediated dilation (FMD)) and independent (GTN mediated) function were assessed using vascular ultrasound. Results:Water-based training increased VO2peak (18.5 ± 4.3 to 21.5 ± 5.4 ml.kg-1.min-1) (p=0.002), overall muscle strength (123 ± 44 to 139 ± 43kg) and leg strength (92 ± 28 to 104 ± 29kg), compared with the CG (p=0.001). The effect on pectoral strength (31 ± 17 to 35 ± 16kg) was not significantly different to the CG (24 ± 12 to 26 ± 14kg) (p=0.08). No change was observed in anthropometry, blood profiles, or GTN mediated vascular function. FMD was increased following training (6.1 ± 2.4 to 6.5 ± 3.0%), compared with controls who demonstrated a slight decrease (6.2 ± 1.6 to 5.4 ± 1.6%) (p=0.002). Conclusion:Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength and vascular function in people with type 2 diabetes.

This is the first time an 8-week rehabilitation following Latarjet shoulder reconstruction has been reported. In athletes with anterior glenohumeral dislocation who require accelerated return to play, a Latarjet reconstruction with an 8-week rehabilitation protocol may be considered.

Background: Clinical testing to determine the presence of a cam morphology is becoming more common however the correlation between hip range of motion and the degree of cam morphology remains controversial in the literature. The prevalence of a cam morphology in athletes has been reported as higher than in the general population but the prevalence of cam morphology has not been reported in Australian Football (AF). Purpose:The purpose of this study was to determine the correlation between hip range of motion and hip alpha angle and report the proportion of players with a cam morphology in a sample of AF players.Design: Cross-sectional Study.Methods: Twenty-one semi-elite AF players (42 hips) from the Peel Thunder Football Club were included in this study. A hip Flexion Internal Rotation (IR) test and a modified maximal squat test using the difference in depth of squat in hip internal and external rotation were used. These measures were then compared to alpha angles on 90 degree Dunn view x-rays.Results: Four of the 42 hips (9.5%) had a cam morphology (alpha angle >60 degrees). There was no significant correlation between alpha angle and ROM in a Flexion IR test or the difference in modified maximal squat test depth within this sample of players. Conclusions:The proportion of cam morphology seems to be lower in this sample than the previously reported prevalence in other sports. The lack of correlations between hip range and hip alpha angle in players means that screening hips using clinical measures to detect cam morphology associated with poor hip range of motion may be inaccurate. Level of Evidence: Level 3a