No description available.

No description available.

Juvenile idiopathic arthritis (JIA) is a common chronic disease of childhood. Children with JIA have lower peak oxygen consumption (V0₂ peak) than healthy children. In order to examine the cardiorespiratory response during aerobic exercise and the anaerobic to aerobic ratio (metabolic index), maximal exercise tests were performed in JIA subjects and age- and sex-matched controls (CON). Thirteen children aged 10 to 17 years with JIA and 9 CON participated. Peak powe r(watts, W) and total work (Joules, j) were determined with the Wingate anaerobic cycling test. VO₂ peak was measured by a maximal staged exercise test on a cycle ergometer. Cardiac output (CO, liters/minute) was measured with Doppler echocardiography. Arterial — mixed venous oxygen index (A-V0₂) and systemic vascular resistance (SVR) were calculated. Patient questionnaires included habitual activity, visual analog scale for joint pain and the childhood health assessment questionnaire. Physician completed data included active joint count and articular severity index. Compared to CON and reference age-matched norms, JIA subjects had lower aerobic fitness. VO₂ peak in JIA was 31.3 ml/min/kg (20.2-49.9), Z score -1.4 (-.06--2.4) and in CON was 47.9 ml/min/kg (32.7-54.1), Z score of -0.17 (-1.6-.87). [p = 0.013 V0₂ peak, p=0.011 Z score]. There were no significant differences in CO, A-V0₂ or SVR buttrends towards lower CO and higher SVR in JIA subjects were observed. During anaerobic exercise JIA subjects completed less total work (168.5 j/kg (107-252) JIA, 224 j/kg (180-248) CON, p=.036) but had similar peak power (9.7 W/kg (5.6-13.7) JIA, 11.3 W/kg (9.8-14.5) CON, p=.095). The metabolic index did not differ between JIA and CON. There was no significant correlation between disease activity, function and fitness measures in JIA subjects. Children with JIA have moderate impairments in aerobic fitness. CO and A-V0₂ during aerobic exercise did not significantly differ between JIA subjects and CON. Anaerobic fitness was mildly impaired with less total work completed by JIA subjects. Further research with larger numbers is required to determine factors contributing to limited fitness in JIA.

Abstract Graeme Kohler BSc. (Health Education), MA (Health Promotion) School of Health and Human Performance, Dalhousie University Objective: To understand the experiences of young men living with Ankylosing Spondylitis (AS). Methods: Using an interpretive phenomenological research approach, two semi-structured interviews were conducted with 7 male informants ranging from ages 22 – 37. All of the informants lived in Nova Scotia and had been diagnosed with AS for at least one year. Thematic analysis was used to analyze the data. Results & Conclusions: Informants displayed a strong affinity to hegemonic masculine behaviours. The overriding theme was I’m a Man. The four emerging themes were: Trying to maintain normalcy, Do what I like to do, I have to work, and I don’t really ask for support. Several barriers to support and health care access were identified that have implications for health promotion, the men themselves, and various AS care providers.

The purpose of this study was to develop a model of post-traumatic osteoarthritis in the palmar metacarpal condyle and to evaluate the timing of the early events following impact trauma on subchondral bone and articular cartilage. In each of 12 skeletally mature horses, an impact injury was created on the palmar metacarpal condyle of one randomly chosen limb, under arthroscopic and fluoroscopic guidance. A low to moderate level of forced exercise was instituted; and horses were evaluated clinically via lameness examinations, synovial fluid analysis, and radiographs. Macroscopic examination, micro-computed tomography, and sample collection were performed following euthanasia at one month (3 horses), 4 months (4 horses), and 8-10 months (5 horses) after impact injury. There was variability in impact-lesion location, depth, and area on macroscopic inspection; histologic evaluation revealed more consistent cartilage defects due to impact injury. Cartilage degeneration, in terms of color and clarity, was observed in impacted joints. The mean sulfated glycosaminoglycan (sGAG) concentration from cartilage at the impact site was significantly lower than for a similar site in control limbs. Higher concentrations of cartilage oligomeric matrix protein (COMP) were observed in synovial fluid from impacted joints. Bone viability, as evaluated by the Alamar blue assay, was significantly decreased in impact specimens versus control specimens one month after impact injury. This impact injury model caused lesions consistent with mild focal osteoarthritis in the palmar metacarpophalangeal joint, involving cartilage more than subchondral bone. Further development is required to create a reliable and consistent model of naturally occurring post-traumatic osteoarthritis at this site. / Equine Guelph, University of Guelph

A consecutive series of 280 Charnley low-friction arthroplasties, performed between 1966 and 1978, on 192 patients, who were less than 40 years of age at the time of operation, were followed up for an average duration of 20.1 years. Patients were divided into four groups based on underlying disease process, and only three patients (5 hips) could not be traced. Patients with rheumatoid arthritis had significantly lower rates of acetabular component loosening, migration and revision (all p< 0.05), and patients with developmental dysplasia of the hip had the highest rates as well as a significantly higher rate of combined clinical and radiological component failure (p < 0.05). Patients with degenerative arthrosis had the highest rates of femoral implant loosening, revision and failure (all p < 0.05), and patients with ankylosing spondylitis and rheumatoid arthritis had the lowest. Age (< 30 years or 30 to 40 years at operation), gender, heterotopic ossification, hypertrophy of the femoral cortex at the tip of the prosthesis or development of changes in the medial femoral calcar were not associated with an increased risk of component failure or revision (all p > 0.05). The average annual rate of wear of revised components, in each of the four groups and the series as a whole, was significantly higher than the rate in surviving original components (p < 0.04), and the development of osteolysis, and increasing wear of the acetabular component were associated with failure and revision of both the acetabular and femoral components (both p < 0.01). Cox regression analysis confirmed that increasing average annual acetabular wear was the most significant factor determining the outcome of the arthroplasty (p < 0.001). For each additional millimetre of wear observed, the risk of component failure or revision in any one year increased significantly (p < 0.02). The 25-year survivorship of implants with an average acetabular wear rate of less than 0.1 mm/yr (117 arthroplasties) was greater than 90% but no arthroplasties with a rate in excess of 0.2 mm/yr survived 25 years, and only 40% survived 20 years.

No description available.

The problem considered in this thesis is developing a set of digital features relevant in describing finger-hand function of early-onset rheumatoid arthritis (RA) patients. The premise is based on a novel telerehabilitation gaming system that operates on a store-and-forward design. The solution to this problem was to develop a full-scale gaming platform to examine client movement performance for precision aiming tasks based on a set of digital features. To complement the movement performance, still imagery in three unique poses are captured during a session to detect visual symptoms during disease activity and early warning signs of deformities that can arise from joint damage. Resulting data is gathered in a clinic or housed in a content management system where features are extracted and analyzed, providing reports/queries for care providers and allowing remote monitoring. The goal is to help automate monitoring patient finger-hand function between office visits from a remote location, on a smaller scale and with minimal supervision. The contributions presented in this work include development of a detailed set of digital features derived from a custom built gaming platform to highlight client movement performance and algorithms to extract hand structure to approximate goniometry measurements of joint angles monitoring for potential changes during progression of the disease. The significance of this contribution is that it provides a readily accessible, experimental platform for the provision of physical therapy tailored to the individual RA patient through the use of a telerehabilitation gaming platform.

Juvenile idiopathic arthritis (JIA) is a common chronic disease of childhood. Children with JIA have lower peak oxygen consumption (V0₂ peak) than healthy children. In order to examine the cardiorespiratory response during aerobic exercise and the anaerobic to aerobic ratio (metabolic index), maximal exercise tests were performed in JIA subjects and age- and sex-matched controls (CON). Thirteen children aged 10 to 17 years with JIA and 9 CON participated. Peak powe r(watts, W) and total work (Joules, j) were determined with the Wingate anaerobic cycling test. VO₂ peak was measured by a maximal staged exercise test on a cycle ergometer. Cardiac output (CO, liters/minute) was measured with Doppler echocardiography. Arterial — mixed venous oxygen index (A-V0₂) and systemic vascular resistance (SVR) were calculated. Patient questionnaires included habitual activity, visual analog scale for joint pain and the childhood health assessment questionnaire. Physician completed data included active joint count and articular severity index. Compared to CON and reference age-matched norms, JIA subjects had lower aerobic fitness. VO₂ peak in JIA was 31.3 ml/min/kg (20.2-49.9), Z score -1.4 (-.06--2.4) and in CON was 47.9 ml/min/kg (32.7-54.1), Z score of -0.17 (-1.6-.87). [p = 0.013 V0₂ peak, p=0.011 Z score]. There were no significant differences in CO, A-V0₂ or SVR buttrends towards lower CO and higher SVR in JIA subjects were observed. During anaerobic exercise JIA subjects completed less total work (168.5 j/kg (107-252) JIA, 224 j/kg (180-248) CON, p=.036) but had similar peak power (9.7 W/kg (5.6-13.7) JIA, 11.3 W/kg (9.8-14.5) CON, p=.095). The metabolic index did not differ between JIA and CON. There was no significant correlation between disease activity, function and fitness measures in JIA subjects. Children with JIA have moderate impairments in aerobic fitness. CO and A-V0₂ during aerobic exercise did not significantly differ between JIA subjects and CON. Anaerobic fitness was mildly impaired with less total work completed by JIA subjects. Further research with larger numbers is required to determine factors contributing to limited fitness in JIA.

Thesis (M. P. H.)--University of Hong Kong, 2006. / Also available in print.