These findings suggest that patients with advanced knee osteoarthritis and malalignment can experience substantial gains in strength after a high-intensity resistance training program without concomitant increases in pain, adverse events, or compromised adherence. These findings provide support for future clinical trials with longer-term outcomes.

Objective Our aim was to assess prior use of core recommended non-surgical treatment among patients with knee osteoarthritis (OA) scheduled for total knee arthroplasty (TKA), and to assess potential patient-level correlates of underuse, if found. Methods This was a cross-sectional study of patients undergoing TKA for primary knee OA at 2 provincial central intake hip and knee clinics in Alberta, Canada. Standardized questionnaires assessed sociodemographic characteristics, social support, coexisting medical conditions, OA symptoms and coping, and previous non-surgical management. Multivariable logistic regression was used to assess the patient-level variables independently associated with receipt of recommended non-surgical knee OA treatment, defined as prior use of pharmacotherapy for pain, rehabilitation strategies (exercise or physiotherapy), and weight loss if overweight or obese (body mass index ≥ 25 kg/m2). Results There were 1273 patients included: mean age 66.9 years (SD 8.7), 39.9% male, and 44.1% had less than post-secondary education. Recommended non-surgical knee OA treatment had been used by 59.7% of patients. In multivariable modeling, the odds of having received recommended non-surgical knee OA treatment were significantly and independently lower among individuals who were older (OR 0.97, 95% CI 0.95–0.99), male (OR 0.33, 0.25–0.45), and who lacked post-secondary education (OR 0.70, 0.53–0.93). Conclusion In a large cross-sectional analysis of knee OA patients scheduled for TKA, 40% of individuals reported having not received core recommended non-surgical treatments. Older individuals, men, and those with less education had lower odds of having used recommended non-surgical OA treatments.

Recent studies have suggested that vibration therapy may have a positive influence on motor symptoms in individuals with Parkinson's disease (PD). However, quantitative evidence of these benefits is scarce, and the concept of "whole-body" vibration in these studies is vague. The objectives of the current study were to evaluate the influence of vibration on motor symptoms and functional measures in PD by delivering sound waves to the entire body. We delivered whole body sound wave vibration to 40 individuals with PD using a Physioacoustic Chair, a piece of equipment with speakers spaced throughout the chair permitting a series of programmed low frequency sound waves through the body. Using a parallel cross-over design we utilized the Unified Parkinson's Disease Rating Scale (UPDRS), quantitative gait assessments, and a grooved pegboard for upper limb control. Improvements were seen in all symptom, motor control and functional outcome measures at the time of assessment. Specifically, a significant decrease in rigidity, and tremor were shown, as well as a significant increase in step length and improved speed on the grooved pegboard task. Results of this initial investigation provide support for vibration therapy as a non-pharmacological treatment alternative. Long-term benefits of vibration therapy will require further research.

In a large population cohort aged ≥55 years who were free of diabetes at baseline, and controlling for confounders, the presence and burden of hip/knee osteoarthritis was a significant independent predictor of incident diabetes. This association was partially explained by walking limitation. Increased attention to osteoarthritis and osteoarthritis-related functional limitations has the potential to reduce diabetes risk.

Objective. To assess the relationship of hip and knee osteoarthritis (OA) to walking difficulty. Methods. A population cohort ages ≤55 years recruited from 1996 to 1998 (n = 28,451) completed a standardized questionnaire assessing demographics, health conditions, joint symptoms, and functional limitations, including difficulty walking in the past 3 months. Survey data were linked to health administrative databases; self-report and administrative data were used to identify health conditions. Hip/knee OA was defined as self-reported swelling, pain, or stiffness in a hip or knee lasting ≥6 weeks in the past 3 months without an inflammatory arthritis diagnosis. Using multivariable logistic regression, we examined the determinants of walking difficulty and constructed a clinical nomogram. Results. A total of 18,490 cohort participants were eligible (mean age 68 years, 60% women), and 25% reported difficulty walking. Difficulty walking was significantly and independently associated with older age, female sex, body mass index, and several health conditions. Of the conditions examined, the likelihood of walking difficulty was greatest with hip and knee OA and increased with the number of hip/knee joints affected. The predicted probability of difficulty walking for a 60-year-old middle-income, normal-weight woman was 5-10% with no health conditions, 10-20% with diabetes mellitus and cardiovascular (CV) disease, 40% with OA in 2 hips/knees, 60-70% with diabetes mellitus, CV disease, and OA in 2 hips/knees, and 80% with diabetes mellitus, CV disease, and OA in all hips/knees. Conclusion. In a population cohort, symptomatic hip/knee OA was the strongest contributor to walking difficulty. Given the importance of walking to engagement in physical activity for chronic disease management, greater attention to OA is warranted.

In a large population cohort, a greater burden of hip/knee OA was associated with higher CV risk; the relationship was explained by OA-related difficulty walking. Increased attention to management of OA with a view to improving mobility has potential to reduce CV events.

In a population cohort with OA and diabetes, OA-related difficulty walking was a significant - and potentially modifiable - risk factor for diabetes complications.

Adiponectin and leptin may be associated with cartilage loss. Further work will determine the relative contributions of metabolic and mechanical factors in the obesity-related joint changes.