جستجوی مقالات مرتبط با کلیدواژه "استئوآرتریت زانو" در نشریات گروه "پزشکی"

Knee osteoarthritis is a common degenerative joint disorder. That mainly affects the elderly population and lead to physical disorders and makes a person unable to perform functional activities. Therefore, the use of sports programs is necessary to reduce the complications caused by the disease and improve the performance of daily functional activities. This study, It was conducted with the aim of investigating the effect of massage therapy along with strength training on functional problems and indicators of lower limb damage in the elderly with knee osteoarthritis.

This research was a randomized controlled trial that included 40 elderly men diagnosed with knee osteoarthritis. Participants are randomly assigned to one of two groups: Experimental (20 people) and control group (20 people) were included. Experimental group, A combination of massage therapy and strength training and the control group received only strength training. The exercises were performed three times a week for eight weeks. Functional problems were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). While, lower limb injury indicators were evaluated by measuring pain intensity, range of motion (ROM) and muscle strength. All data using(SPSS 26)software. The normality of the data distribution was determined using the Kolmogorov-Smirnov test and the intra-group evaluation (pre-test-post-test) was performed using the paired t statistical method. The significance level of this research was considered to be  0.05.

The results of the present study show a significant improvement in various indicators of lower limb damage in the experimental group compared to the control group, a significant increase in the indicators of knee range of motion (0.002), functional capacity (0.001),proprioception (0.003), contraction flexion (0.001), instability (0.002), isometric strength of knee and hip joint flexors and extensors (0.003), as well as improvement in static and dynamic balance (0.001).

The findings showed that massage therapy along with strength training is an effective method for improving functional problems, indicators of lower limb damage, reducing pain intensity, increasing range of motion and improving muscle strength. Therefore, this combined method is suggested as an effective intervention in reducing functional problems due to its low cost, availability, absence of side effects and greater effectiveness in treatment.

Osteoarthritis of the knee (KO) is a chronic and common disease that is associated with pain, limits of movement, and reduced physical performance, and walking forward and backward may be an effective form of rehabilitation in knee osteoarthritis. Therefore, the aim of the study was to examine the effect of two walking methods on the physical function of people with knee osteoarthritis: a systematic review and meta-analysis of studies that walking ability was considered as the main variable in measuring people's physical function in the research.

Among the articles published from January 1990 to July 2024 in the field of knee osteoarthritis and various exercises-related keywords such as Muscle Strength AND Osteoarthritis AND Pain AND Rehabilitation, Walking OR Walking Speed in combination with the Physical Function keyword, 1515 articles were reviewed from Medline/PubMed, Science Direct, Scopus, and Web of science databases. Moreover, Prisma flowchart was used to perform the research steps and for the validity of each study, the Pedro scale was used.

Among the 1515 studies, twenty relevant studies were finally selected, and in the present meta-analysis, 20 studies and 69 sub-studies were evaluated as walking exercise intervention and control groups that they reported their results by pain instruments using visual analog scale as well as numerical rating scale and physical function by Western Ontario and McMaster Universities standardized arthritis index and knee injury and osteoarthritis outcome score as well as quadriceps muscle strength assessment. Forward walking training significantly improved physical function in participants with KO (SMD=1.177, 95% CI=1.011-1.344, P=0.0001). Moreover, backward walking training had a significant effect on improving physical function in osteoarthritis individuals (SMD = 1.578, 95% CI = 1.17 - 1.98, P = 0.0001). In addition, no bias was observed between studies and subgroups related to the effect of walking training using Egger and Begg tests (p < 0.05).

The findings of the study demonstrated that walking training intervention regardless of the type of training method can be an important modality in improving KO (effect size = 17.21). Therefore, forward and backward walking exercises can be used as part of the rehabilitation program for these patients.

Electromyographic activity of lower limb muscles decreases in knee osteoarthritis. Whole body vibration is a suitable intervention in strengthening muscles, whose effect on the electromyographic activity of lower limb muscles during functional activity has not been properly investigated. The purpose of this study is to investigate the effects of whole-body vibration on the electromyography of the lower limb muscles of people with knee osteoarthritis during functional activity.

This clinical trial study was conducted on 30 people with knee osteoarthritis who were included in the study based on the inclusion and exclusion criteria. The participants were randomly divided into intervention and control groups (15 people in each group). Both groups were subjected to routine physiotherapy treatment, and the intervention group was subjected to whole-body vibration with a frequency of 30 Hz and an amplitude of 2 mm for 4 weeks and 3 times a week. Before and after the intervention, the EMG of the vastus medialis, vastus lateralis, biceps femoris, and semitendinosus muscles were recorded using surface electromyography while walking.

The results of this study showed that the RMS activity of the lower limb muscles increased significantly in both the intervention and control groups, and no statistically significant difference was observed between the two groups.

Whole body vibration has no significant effect on electromyography of lower limb muscles of people with knee osteoarthritis. Another study with a larger sample size is recommended.

Knee osteoarthritis is a common joint disease that is more common among Older adults and leads to decreased performance and increased fear of falling in affected people. Based on this, the present study was conducted with the aim of determining the effect of fall-proof exercises on function and fear of falling in elderly women with knee osteoarthritis.

In the year 2023, a semi-experimental intervention with a pre-test and post-test design was conducted on 25 elderly women aged 60 to 75, all diagnosed with knee osteoarthritis and divided into an experimental group and a control group. All subjects entered the study with complete satisfaction and after filling the consent form.Participants in the experimental group engaged in targeted fall-proof exercises for 8 weeks, three days a week. The control group did not participate in any exercise activities. The WOMAC questionnaire was used to evaluate function and the Fall Efficacy scale-International questionnaire was used to evaluate the subjects' fear of falling.Data analysis was performed using repeated measures analysis in SPSS version 26, with the significance level set at 0.05.

The results showed that the total scores of the WOMAC questionnaire and its three subscales (pain, dryness and function) decreased significantly after the exercise in the experimental group (F1.23 = 7.35, p = 0.01, η = 0.24).While the total scores of the WOMAC questionnaire and its three subscales (pain, stiffness and function) did not differ significantly between the control and experimental groups (F1.23=2.42, p=0.13,). Also, the results showed that the fear of falling scores decreased significantly after performing the exercises in the experimental group (F1.23= 9.52, p = 0.005, η = 0.29). While there was no significant difference between the fear of falling scores between the control and experimental groups (F1.23= 2.37, p=0.13).

The fall-proof exercise program is recommended for coaches aiming to enhance the function and fear of falling in Older adults with knee osteoarthritis. This recommendation is based on its effectiveness. Please cite this article as: Sheikh Shoaei H, Bahiraei S. The effect of 8 weeks of fall-proof exercises on function and fear of falling in Older adults women with knee osteoarthritis. Irtiqa Imini Pishgiri Masdumiyat. 2023;11(3):164-183.https://doi.org/10.22037/iipm.v11i3.44602 

The effectiveness of stabilizing core muscles of the trunk and pelvis has been studied more in osteoarthritis (OA) of the hip and less in knee. Performing these exercises while standing, removes the limitation of performing them in different environments. The current study examines the effectiveness of standing core exercises on pain and performance of patients with knee OA, who have no strenuous activity and often have sedentary jobs. On the one hand, by reducing the social restrictions of doing these exercises and on the other hand, by reducing the occupational interfering factors that cause knee arthrosis, we have tried to get a purer and more accurate conclusion from these therapeutic exercises.

This is a randomized, controlled trial. Patients with knee osteoarthritis were invited to enter the study and if they met the criteria and received the consent, they were randomly divided into two groups. The control group, which only received the program of performing conventional exercises of knee OA, and the intervention group, which received the program of standing core exercises in addition to conventional exercises. The primary outcome of this study was visual analytic score (VAS) of pain and the secondary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne and 6-minute walking test (6WMT) at 6 and 12 weeks.

In this study, 38 patients completed the study per-protocol. The baseline characteristics and outcome measurements did not differ significantly before the intervention. Within-group analysis showed that there is a significant difference in VAS, WOMAC pain, discomfort and maximum distance of Lequesne and 6MWT indices in both groups (P<0.05). Also, within-group analysis showed that there was a significant difference in WOMAC physical performance and Lequesne daily activity only in the intervention group (P<0.05). The results of the between-group analysis showed a significant difference between the two groups in all outcomes in 12 weeks (P<0.0001), and in the VAS and Lequesne index, a significant difference can be seen between the two groups even in 6 weeks (P<0.005). The effect size on the primary outcome of VAS is 0.68 in the core exercise group compared to the control group.

The results of this study show that standing core exercises, after 12 weeks, causes a significant reduction of pain, improvement of function and activity in patients with knee osteoarthritis compared to conventional exercises, and its positive effect on pain or discomfort, ‘maximum distance walked’, and ‘activities of daily living’ after 6 weeks, also observed. Although previous studies showed the positive effect of core exercise on the pain index and activity of knee osteoarthritis patients, the results of this study showed that even standing core exercises may be effective.

Knee osteoarthritis as a common chronic illness leading to disability, imposes numerous challenges on individuals in terms of daily living and self-care. Therefore, the implementation of tele-rehabilitation nursing interventions that foster patients' internal health locus of control and enhance the development of self-care behaviors may be useful. This study aimed to determine the effect of tele-nursing rehabilitation on the health locus of control in patients with knee osteoarthritis.

Methods & Materials: 

In this randomized clinical trial study, a total of 34 patients with knee osteoarthritis referred to the rehabilitation clinics affiliated with Shiraz University of Medical Sciences in 2022 were enrolled. The intervention group participated in an 8-session tele-rehabilitation nursing program, while the control group received standard routine care. The Multidimensional Health Locus of Control scale was administered to both groups on three separate occasions. The data were subjected to descriptive and inferential statistical analyses using SPSS software version 26.

According to the results from a two-way repeated measures analysis of variance (ANOVA), a statistically significant difference was observed solely in the trend of changes in the mean score of internal belief between the two groups and over the study time period (P<0.001). Specifically, the scores of the intervention group exhibited a significant increase over time, surpassing those of the control group.

The implementation of tele-rehabilitation nursing care, which emphasizes patient responsibility for their internal health locus of control can improve self-care. Therefore, it is recommended that nurses employ this approach in managing additional chronic conditions.

People with Knee osteoarthritis (KOA) suffer from weak quadriceps muscles and decreased proprioception in the knee joint. Therefore, one of the most important complications that patients with KOA face is imbalance and falls. This study aimed to determine the effect of four weeks of Swedish massage on the fluctuation indices of the center of pressure of middle age women with KOA.

The present study is a controlled randomized trial and has a Swedish massage intervention group (age 52.6±6.72 y, height 1.57±0.05 m, weight 74.4±9.95 N) and a control group (age 52.4±6.71 y, height 1.61±0.05 m, weight 75.93±9.83 N) (n=15 in each). 30 adult women with unilateral knee osteoarthritis were purposefully and accessibly selected based on the inclusion criteria. Then, they were divided into two groups based on Blocked Randomization with Randomly Selected Block Sizes. The static balance of patients had been measured by a foot scan device. And after that, the intervention group received quadriceps muscles Swedish massage (Including exfoliation, petrissage and tapotement techniques) 3 sessions per week for 4 weeks. After four weeks, both groups conducted the post-test. The descriptive and inferential data analyses were conducted using SPSS statistical software with a significance level of p≤0.05. According to the number of subjects, the data’s normality was assessed using the Shapiro-Wilk test and the Homogeneity of variance was assessed by Leven’s test. After confirming these assumptions, the Analysis of Variances was used with SPSS software for between and within groups comparison.

The present study showed that a Swedish massage intervention course effectively improves the balance (with open and closed eyes) of the intervention group. Parameters related to static balance with eyes open: average speed of the center of pressure (p=0.040), ellipse area (p=0.011), minor axis length (p=0.015), major axis length (0.001) (p=0.001), as well as closed eyes: average speed of the center of pressure (p = 0.001), ellipse area (p = 0.001), minor axis length (p=0.001), major axis length (p=0.021) decreased in the post-test, which indicates the improvement of static balance in the intervention group (p≤0.05).

This is the first study investigating the mid-term effect of quadriceps Swedish massage on static balance in patients with knee osteoarthritis. The results of this study showed that massage can improve the fluctuation indices of the center of pressure of adult women with KOA. Therefore, it is suggested to use this technique in addition to other therapeutic interventions to improve balance and prevent falls in these populations.

Knee osteoarthritis (KOA) is associated with decreased muscle strength, muscle activity, and impaired knee range of motion (ROM). This study aimed to investigate the effect of Swedish massage on pain, the flexion of knee joint ROM, the electrical activity of the quadriceps muscles, and their co-contraction with the hamstring muscles during walking in women with medial compartment KOA.

30 patients with KOA participated in this randomized clinical trial study. Patients were randomly assigned to two intervention and control groups. The intervention group received the massage intervention for four weeks. The patient's pain, the electrical activity of muscles around the knee, and the knee joint ROM were measured in pre-and post-tests. For data analysis, SPSS software was used.

The level of pain (p=0.008) and the flexion range of motion (p=0.033) of the patients showed a significant improvement in the post-test. The electrical activity of the vastus medialis and vastus lateralis muscles increased after the test, but the electrical activity of the semitendinosus and biceps femoris muscles did not show a significant change. Also, the co-contraction ratio of the vastus lateralis-biceps femoris muscles also showed a significant improvement (p=0.020), but the ratio between the vastus medialis-semitendinosus muscles didn’t show a significant decrease (p=0.091).

Considering the improvement of the symptoms and consequences of KOA following the application of massage intervention in this study, it seems that using this intervention along with other medical and therapeutic interventions is beneficial for patients with KOA.

The growth of aging reveals the importance of paying attention to the health needs of the elderly. According to some studies, falls and its consequences are more common in the individuals with knee osteoarthritis (KOA) than those without KOA, but due to lack of evidence, its related factors are still unknown. Thus, the aim of this study was to compare the falls and its determinants in the elderly with and without KOA.

In this case-control study, 700 older adults in two groups of elderly with and without KOA were compared in terms of falls and some variables including KOA, sex, age, body mass index, living status, quadriceps femoris muscle strength, hand muscles strength, balance, number of comorbidities, number of drugs used, walking duration, physical activity and frailty. KOA was diagnosed based on The American College of Rheumatology (ACR) criteria.

In this study, falls were 1.90 times higher in the elderly with KOA than elderly without KOA. Although all variables were significantly different in case and control groups, only female gender (p=0.035) and KOA (p=0.012) were significantly associated with falls.

These findings suggest that variables in combination may increase the risk of falls in the elderly with KOA, while each of them alone may not be associated with falls.

Osteoarthritis of the knee is the most prevalent type of arthritis that causes persistent pain and reduces the quality of life. However, no treatment alleviates symptoms or stops the disease from progressing. Functional magnetic resonance imaging (fMRI) studies can provide information on neural mechanisms of pain by assessing correlation patterns among the different regions of the brain. This study aimed to determine brain connectivity patterns in patients with knee osteoarthritis compared to healthy individuals using advanced statistical models.

The data of this study were downloaded from https://openneuro.org/. These data included fMRI imaging of 36 knee osteoarthritis patients with a range age between 45-70 years old and 12 healthy individuals with a range age between 48-78 years old. Graph-based models were used to examine the brain functional alterations in knee osteoarthritis patients.

The results showed a disease-related cluster of eight regions in the brain, including the right Rolandic operculum, right amygdala, left caudate nucleus, left putamen, right putamen, left pallidum, and right pallidum. According to correlation comparisons in the cluster, the connectivity of 18 pair regions revealed a significant difference between the two groups. In comparison to the other regions, the right Rolandic and right amygdala had more communication.

Interestingly, in patients with knee osteoarthritis, the effect of chronic pain can cause functional alterations in the brain.

Knee osteoarthritis is the most common arthritis and musculoskeletal disease. The low efficacy and significant side effects of synthetic drugs in the treatment of this disease have led many researchers to look for a drug that is effective but has fewer side effects. Recently, ginger is one of the most popular herbal remedies in the treatment of this disease. This study aimed to compare the effect of ginger by skin patch and oral capsule on pain intensity, joint dryness, and daily performance of patients with osteoarthritis of the knee.

This was a three-group clinical trial study that was performed on patients referred to Afshar orthopedic clinic in Dezful in 2015. Sampling was available. Subjects were randomly divided into three groups according to the table of random numbers: skin patch, ginger capsule, and control. All three groups received treatment prescribed by an orthopedic specialist. In addition, the ginger capsule group used 2 500 mg ginger capsules daily and the ginger skin patch group used one ginger skin patch daily in the middle of the waist for 9 weeks. The data collection tool was a demographic questionnaire and a translated version of the Arthritis Index of Western Ontario and McMaster Universities (WOMAC). One-way analysis of variance, paired t-test, and Tukey post hoc test aswas used to analyze the data. A significant level were considered 0.05.

The total number of participants in the study was 135.In the groups of ginger capsules, ginger skin patch, and control. the mean pain intensity before the intervention was 13.08, 14.52, and 13.55, respectively, and after the intervention, it decreased to 7.05, 8.62, and 11.37(P<0.00).

Ginger in both oral capsules and skin patches is effective in reducing the severity of pain and dysfunction in patients with osteoarthritis of the knee. It seems that only oral capsules reduce joint dryness and the ginger skin patch is ineffective.

Knee osteoarthritis is a debilitating disorder. Limited studies have shown that Prolotherapy using saline instead of dextrose is effective, especially in diabetic patients and reduces the negative effects of this disease. In the present study, 40 patients with knee osteoarthritis along with joint effusion were divided into two groups of 20. The first group went under simultaneous intra-articular and peri-articular knee injection of hypertonic saline and the second one had only intra-articular injection. In each group, three sessions of injection were done in two weeks interval. The standard questionnaires of VAS, WOMAC and OKS, were completed for both groups, before intervention and in the 2nd and 4th weeks after the last injection. VAS was used for pain relief; WOMAC to assess pain in various daily activities; and OKS to assess the amount of pain, lameness and the ability to perform various activities. Using SPSS version 25, data was analyzed by independent and paired t- test. Although both groups showed improvement of outcomes after intervention there was a significant difference between simultaneous intra-articular and peri-articular Prolotherapy method compared to intra-articular Prolotherapy alone in favor of the first method.

 Knee instability has become a debilitating problem among patients with knee osteoarthritis which may have many causes and complications. In this study, researchers evaluated the Knee Flexion Contracture (KFC), function, quality of life, and balance and its relationship with knee instability (KI). In this study, the researchers investigated the function, quality of life, Knee Flexion Contracture (KFC), and balance of the patients with knee osteoarthritis and its relationship with knee joint instability.

 In this double-blinded case-control study, 60 females with knee osteoarthritis participated and divided into two groups (30 in each) of osteoarthritis (mean age: 52.80) and without knee instability (mean age: 54.43) based on the knee instability index scores.Pain was evaluated with a visual analog scale(VAS), KFC with a universal goniometer, performance with WOMAC, and physical performance of the patients with the time up and go (TUG) and and time of up and down stairs tests, quality of life with the SF36 questionnaire, and balance with the Single Leg Lift test. Data were analyzed by SPSS version 22 software and independent sample t-test at a significance level of 0.05.

 The mean scores of KFC showed significantly difference between the two groups with and without KI (right foot: P=0.0001, left foot: P=0.001). Also, the mean scores of pain, fall times, WOMAC, physical function, quality of life, and One-legged balance were significantly different between groups (P=0.0001 in all variables). Regarding the time of up and down stairs, there was no significant difference between the two groups (P=0.057), although the difference between them was significant in the descent time (P=0.0001).

 According to the findings of this study, it was found that there was a significant difference between the two groups of osteoarthritis with and without KI in pain, function, KFC, quality of life, and One-legged balance, which paying attention to the causes and side effects of this problem makes it more clear.

Objectives :

Knee osteoarthritis is one of the most common musculoskeletal problems in older adults. Pain, stiffness, tenderness, decreased muscle strength and joint range of motion, impaired proprioception, and balance problems lead to impaired physical function, making the person incapable of performing functional activities. Therefore, it is necessary to use strategies to control and reduce the complications of this disease and improve the daily functional activities of patients. This study aims to compare the effects of land-based exercise and hydrotherapy on functional activities in older women with knee osteoarthritis.

Methods & Materials :

Fifty-four female patients with knee osteoarthritis aged 60-69 years (Mean height:159.96 ±5.53 cm, mean weight:76.93±9.50 kg) were selected using a convenience sampling method and randomly divided into two groups of land-based exercise and hydrotherapy. The interventions were performed for 8 weeks. To evaluate the patients' functional activities, timed up & go test, 30- second chair stand test, 40-meter fast-paced walk test, stair climb test, and 6-minute walk test were used. Repeated measures analysis of variance was used for data analysis in SPSS v. 26.

Results :

Both land-based exercise and hydrotherapy caused significant changes in the scores of functional tests (P≤0.05). The difference between them was not significant (P≥0.05), which indicates their same effects.

Conclusion:

 Both land-based exercise and hydrotherapy can improve the performance of older women with knee osteoarthritis in timed get up & go test, 30-second chair stand test, 40-meter fast-paced walk test, stair climb test, and 6-minute walk test. These two methods are recommended based on the conditions of each patient.

Knee osteoarthritis is a common, progressive, and chronic disease that affects approximately 13% of the population over the age of 60. Osteoarthritis causes progressive disability and changes in gait parameters, decreased function and quality of life of patients by causing malalignment of the knee in the frontal plane following destruction of articular cartilage. Braces as a mechanical intervention are a successful treatment for osteoarthritis knee and its associated malalignment. Using a three-point pressure mechanism, braces create a natural alignment in the knee by straps attached to the thigh and shank shells, which reduce the medial knee load and correct the varus alignment. This distributes the force properly while walking. However, applying a constant force on three pressure points of the leg, thigh and affected knee joint reduces the adduction angle of the knee in all phases of gait cycle , while the correction of the adduction angle of the knee in patients is essential only in phases between 30% to 60% of the stance phase, when the knee deviation reaches its peak. The aim of this study is to design and fabricate a brace joint with a new intermittent correction mechanism for patients with osteoarthritis medial compartment knee and to investigate its effect on a patient's gait parameters.

The new joint design of the knee brace was based on the conversion of the knee extension movement at the end of the swing on the sagittal plane to the abduction movement on the frontal plate by stretching the converter piece. Participant gait was assessed in two ways with and without braces. Kinematic variables including knee joint angles in the sagittal and frontal planes and spatio-temporal variables of patient gait were measured and recorded.

 The results of the new brace joint function on the knee showed that the angle of flexion of the knee in the swing phase increased from 44.72° to 46.19° when using brace. Also, knee adduction angle in the stance phase decreased from 4.25° to 2.3° and patient's walking speed while wearing the brace increased from 0.88 m/s to 0.93 m/s. On the other hand, step length increased from 1.125 m to 1.451 m when using brace and the percentage of stance phase decreased from 63.53 to 62.68 when using brace.

 In this one-sample study, a knee brace with a new joint was able to help correct the direction of knee joint in the frontal and sagittal plane and affect the patient's gait parameters. It seems that if the same results are obtained in a large-scale clinical study, this brace could be a suitable replacement for invasive methods and inappropriate orthoses.

Knee osteoarthritis (OA) is a debilitating chronic disease that leads to swelling, inflammation, and pain in the knee joints. Most falls occur while walking, and it is thought that there is a correlation between gait characteristics and the risk of falling in the elderly. The aim of the present study was to determine the correlation between the kinematic and spatiotemporal characteristics of walking and the history of falls in women with knee OA.

60 women with unilateral OA of the knee were selected based on the research inclusion criteria in a purposeful and available manner and after filling out a written consent form, they were included in the study using a limited randomization method of block randomization type. Then, the falling history of participants was recorded. To record spatiotemporal and kinematic variables of walking, a motion analysis system was used. To measure the correlation between the spatiotemporal parameters of walking (movement and spatiotemporal data) and the history of falling, the biserial correlation coefficient was used.

According to the results of the biserial correlation coefficient test, there was no relationship between spatiotemporal and kinematic factors in all three joints of the hip, knee, and ankle and the subject's history of falling..

No correlation was observed between walking characteristics and a history of falls in patients with knee OA. It is possible that the participants with OA symptoms may be aware of their presence and physical activity, or may limit their daily life activities. It should also be noted that the current study is retrospective and patients may underestimate or overestimate their history of falls accordingly.

Knee osteoarthritis is associated with problems such as poor sleep quality. Finding effective, low-complication, and cost-effective measures to improve the sleep quality of these patients seems necessary. The aim of this study was to determine a regular exercise program at home to improve the sleep quality of the elderly with osteoarthritis of the knee.

In this clinical trial study, 72 elderly patients referred to the orthopedic clinic of Allameh Bohlool Gonabadi Hospital in Gonabad were selected by convenience sampling and assigned into the intervention and control groups by block randomization method. The intervention group underwent an exercise program at home for one month after a face-to-face training course. The Pittsburgh Sleep Quality Index was completed by both groups before and 4 weeks after the intervention. In order to observe the ethical points for the control group, at the end of the study, the necessary trainings were given along with the pamphlet. Data were analyzed using SPSS software version 18 and descriptive and analytical statistical methods.

Before the intervention, all demographic variables were not statistically significant in the experimental and control groups. After the intervention, there was a significant difference between the two groups (total sleep quality score and other sleep quality subscales), except for two subscales of mental sleep quality and sleep disturbances (p <0.05).

The present study showed that doing exercise at home improves the sleep quality of the elderly with osteoarthritis of the knee.

Knee osteoarthritis (OA) is a serious health issue and economic burden worldwide. Several treatment modalities have been proposed, each with its own limitations. Systematic reviews advocate the use of acupuncture for knee OA. Regarding the anti-inflammatory effects of gold, it was assumed that acupuncture with gold needles may have added value compared with the conventional stainless steel needles.

In a randomized controlled trial, 45 patients with knee OA grade two or three according to the Kellgren Lawrence criteria were enrolled. Pain severity score was evaluated at baseline. Patients were randomly allocated into three groups of acupuncture with gold, steel, or placebo needles for ten sessions over a period of 4 weeks. Participants were followed for 12 weeks after the end of treatment sessions.
Results. The pain score was lower in the acupuncture groups than in the placebo group, but the difference between gold and steel acupuncture groups was not statistically significant.

Acupuncture with conventional needling is an effective and well-tolerated method for the management of knee OA.