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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Patients with knee osteoarthritis have both poor strength and endurance of their quadriceps muscles. It is possible to assess muscle fatigue by monitoring frequency spectrum using electromyography (EMG). This study used the closed kinetic chain approach to muscle assessment. Fifty-five subjects with knee osteoarthritis were examined twice within 1 week. To test maximum voluntary isometric contraction into extension an isokinetic dynamometer, with a closed kinetic chain "leg press" attachment was used. EMG assessment of signal median frequency was done by measuring median frequency shift associated with fatiguing of muscle during a 60s isometric contraction at 60% of maximum isometric contraction. Intra-class correlation coefficients with 95% confidence intervals, standard errors of measurement and smallest detectable differences were calculated. Results showed the reliability of the maximum voluntary isometric contraction extension strength test was ICC 0.99 and SEM 3.95Nm. The initial median frequency indices also demonstrated excellent ICC and SEM statistics (ICC 0.84-0.91, SEM 9.2-11Hz) for the three heads of the quadriceps; however, the fatigue slopes for all three muscles were unreliable with poor ICCs (0.04-0.72) and SDD values (2207-4000%). The assessment of peak muscle torque using a closed kinetic chain isometric technique is reliable, as is the determination of median frequency values for the quadriceps. Error for the assessment of fatigue was of an unacceptable scale. While the use of a closed kinetic chain leg press technique provides a reliable measurement of lower limb strength, EMG power spectrum decrease during an isometric contraction is of little value.
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PMID:The reliability of isometric strength and fatigue measures in patients with knee osteoarthritis. 1729 24

We propose that the pathogenesis of obesity-induced osteoarthritis may be explained by the metabolic changes in the striated muscle induced by the interaction of insulin resistance and systemic inflammation in obese individuals with metabolic syndrome being osteoarthritis the latest consequence by the physiological changes seen in the metabolic syndrome. Increased levels of TH1 cytokines are produced by activated macrophages in the presence of an acute or chronic infectious disease and suppress the sensitivity of insulin receptors on the membrane of muscle cell and adipocytes. Both cells are activated by inflammatory cytokines and contribute to enhance acute inflammation and to maintain a state of chronic, low-grade inflammation in apparently healthy obese individuals. The increased number of macrophage in the adipose tissue of obese individuals acts as an amplifier of inflammation. Patients with osteoarthritis and metabolic syndrome frequently are complaining about hotness and recurrent edema of feet and hands. It is probable that hyperinsulinemia in the presence of insulin resistance and inflammation, induce vasodilation through the TNF mediated-iNOS overexpression. Patients with metabolic syndrome express clinically the consequence of a poor uptake, storage and energy expenditure by the muscle and any other insulin dependent tissue and the consequence of high insulin plasma levels are vasodilation and increased protein synthesis. The fatigue and muscle weakness induced by insulin resistance and inflammation in obese patients with metabolic syndrome increase the frequency and the intensity of traumatic events of peripheral or axial joints that result in stretch and breaking of tenoperiosteal junction and abrasive damage of cartilage and therefore in these patients with metabolic syndrome and pro-inflammatory state the reparative process of cartilage and periarticular tissues would be severely modified by the growth factor activity in presence of high levels of insulin.
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PMID:The relationship between the metabolic syndrome and energy-utilization deficit in the pathogenesis of obesity-induced osteoarthritis. 1736 54

Chronic pain is very common in all European countries, with musculoskeletal problems predominating. About 1% of the adult population develops a syndrome of chronic muscle pain, fibromyalgia (FMS), characterized by multiple tender points, back or neck pain, and a number of associated problems from other organs, including a high frequency of fatigue. Evidence points to central sensitization as an important neurophysiological aberration in the development of FMS. Importantly, these neurological changes may result from inadequately treated chronic focal pain problems such as osteoarthritis or myofascial pain. It is important for health professionals to be aware of this syndrome and to diagnose the patients to avoid a steady increase in diagnostic tests. On the other hand, patients with chronic widespread pain have an increased risk of developing malignancies, and new or changed symptoms should be diagnosed even in FMS. In rheumatology practice it is especially important to be aware of the existence of FMS in association with immune inflammatory diseases, most commonly lupus and rheumatoid arthritis. Differential diagnoses are other causes of chronic pain, e.g. thyroid disease. The costs of this syndrome are substantial due to loss of working capability and direct expenses of medication and health-system usage. Fibromyalgia patients need recognition of their pain syndrome if they are to comply with treatment. Lack of empathy and understanding by healthcare professionals often leads to patient frustration and inappropriate illness behavior, often associated with some exaggeration of symptoms in an effort to gain some legitimacy for their problem. FMS is multifaceted, and treatment consists of both medical interventions, with emphasis on agents acting on the central nervous system, and physical exercises.
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PMID:Chronic widespread pain in the spectrum of rheumatological diseases. 1760 90

This study's aim was to determine the between days reliability of surface EMG recordings from the superficial quadriceps during a multi joint sub-maximal fatiguing protocol. Three subject groups (healthy n=29; patellofemoral pain syndrome n=74; knee osteoarthritis n=55) performed the task at 60 maximum voluntary isometric contraction on three separate days. Spectral and amplitude EMG parameters were recorded from vastus medialis oblique, vastus lateralis and rectus femoris and were analysed for between days reliability using intraclass correlation coefficient (ICC((2,1))), the standard errors of measure and smallest detectable differences. For frequency results, initial and final frequency values had 'good' or 'excellent' reliability in all groups for all muscles. ICCs for median frequency slopes for vastus medialis oblique, vastus lateralis, and rectus femoris respectively, in the osteoarthritis group were 0.04, 0.55, and 0.72; in the patellofemoral pain group were 0.41, 0.17, and 0.33; in the healthy group were 0.68, 0.64, and 0.31. The standard errors of measurement and smallest detectable differences for all groups and for all muscles were unacceptably high. For amplitude results, ICC root mean squared initial and final values were 'good' to 'excellent' for all groups and all muscles, albeit with high measurement error. The ICCs for root mean squared slopes in all tests were 'poor' with extremely high measurement error. The poor between days reliability and high measurement error suggests that surface EMG should not be adopted to assess fatigue during multi joint sub-maximal isometric quadriceps testing.
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PMID:The reliability of surface electromyography to assess quadriceps fatigue during multi joint tasks in healthy and painful knees. 1762 11

More than 120 kinds of arthritis exist. This article focuses on the more common types of musculoskeletal disorders, which are osteoarthritis, rheumatoid arthritis, and osteoporosis. Because of the pain, fatigue, and joint stiffness associated with arthritis, physical intimacy may be difficult. These symptoms can be ameliorated during sexual activity by good communication between the partners, timing medication, and experimenting with different positions. Clients may need to be taught to be creative and to be willing to experiment. Learning the relaxation response, in addition to fantasizing and guided imagery, can enhance the sexual experience for people who have arthritis.
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PMID:Arthritis and sexuality. 1799 59

Patient assessment in rheumatology is characterized by an important paradox: many extensively-characterized quantitative measures and indices have been developed for rheumatoid arthritis (RA), psoriatic arthritis, systemic lupus erythematosus (SLE), ankylosing spondylitis, vasculitis, osteoarthritis, fibromyalgia, and other rheumatic diseases. However, most regular rheumatology care is guided largely by qualitative clinical impressions, without such measures or indices or any quantitative data other than laboratory tests to assess patient status and/or quality of care. This paradox may be explained in part by regarding the development of measures primarily as clinical research activities, while viewing the application of measurements in regular clinical care as continuous quality improvement (CQI) activities. The development of measures has emphasized validity and reliability, but generally ignored feasibility and acceptability to patients and health professionals, both of which are needed for application in regular clinical care. A summary of the application of clinical measurement in patients with RA over 25 years between 1982 and 2007 at a weekly academic rheumatology clinic conducted by the senior author is presented as 20 often contemporaneous CQI cycles. These cycles include development of a user-friendly modified health assessment questionnaire (MHAQ); assessment of psychological status; monitoring of mortality outcomes; comparisons of joint counts, radiographic scores, and laboratory tests to the MHAQ; a 28-joint count; prospective study of the MHAQ to predict mortality when joint counts, radiographic scores, and laboratory tests are available; development of a multidimensional HAQ (MDHAQ) with complex activities; a fatigue scale; a self-report joint count; scoring templates; a computerized data management system; flow sheets to monitor MDHAQ status; visual analog scales as 21 circles rather than 10 cm lines; composite RAPID3 (rheumatology assessment patient index data) scores for 3 patient measures; and defining RAPID categories for high, moderate and low severity, and near remission. The latter cycles remain under study as ongoing CQI activities.
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PMID:Quantitative measurement of patient status in the regular care of patients with rheumatic diseases over 25 years as a continuous quality improvement activity, rather than traditional research. 1802 10

This chapter discusses the effects of biochemical control of acromegaly on cardiovascular diseases, metabolic complications, respiratory abnormalities, malignancies and bone alterations. Acromegaly is associated with increased morbidity and mortality for cardiovascular and respiratory complications, whereas neoplasms seem to be a minor cause of increased risk of death. Other associated diseases are osteoarthritis, carpal tunnel syndrome, fatigue, visual abnormalities and reproductive disorders. Acromegaly results in premature death because of prolonged elevation of GH an IGF-I levels, and a strong biochemical control improves well-being and restores life expectancy to normal. The main goals of medical treatment of acromegaly include normalization of biochemical markers of disease activity, improvement in signs and symptoms of the disease, removal or reduction of tumor mass and preservation of pituitary function.
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PMID:Medical consequences of acromegaly: what are the effects of biochemical control? 1816 12

A 58-year-old man with osteoarthritis in the left knee underwent a total knee arthroplasty with a New Jersey anterior-posterior gliding low contact stress mobile-bearing implant. All femoral, tibial, and patellar components were implanted with bone cement. Pain developed at 43 months postsurgery, and plain radiography revealed a vertical crack in the femoral component and osteolysis at the medial femoral condyle. The femoral and tibial components were revised, and the bone defect at the medial femoral condyle was reconstructed using an allogeneic strut bone graft. Microscope examination identified polyethylene particles with foreign body granulomatous reaction, and scanning electron microscopy revealed fatigue failure of the femoral component. Osteolysis due to polyethylene particles can lead to fracture of the femoral component after cemented anterior-posterior gliding low contact stress mobile-bearing total knee arthroplasty.
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PMID:Femoral component fracture due to osteolysis after cemented mobile-bearing total knee arthroplasty. 1853 39

The aim was to assess the self-efficacy and health outcomes of an adopted Arthritis Self-Management Programme (ASMP) among osteoarthritic knee sufferers in Hong Kong at 1 year. An experimental study with 95 participants assigned randomly to the intervention (n=45) or control group (n=50). Seventy-seven (81.1%) participants joined at least one out of three follow-ups in the 12 month period. Participants in the intervention group received a 6-week ASMP with an added exercise component in two general clinics. Outcome measures included arthritis self-efficacy (ASE) and health outcomes including pain and fatigue rating, self-rated health, daily activities limitation and number of unplanned arthritis-related medical consultations. Mean change (12 months minus baseline) and the effect size of the outcome measures were calculated by Mann-Whitney U test and nQuery Advisor 4.0. At 12 months, there were significant reductions of current pain (p=0.0001), pain at night (p=0.001), pain during walking (p=0.01) and number of unplanned arthritis-related medical consultations (p=0.03) and a significant increase in ASE for pain (p=0.01) and other symptoms (p=0.02) and self-rated health (p=0.04) among the intervention group but not for the control group. However, there were similarities in outcome measures of pain while switching from a sitting to a standing position, fatigue rating and physical functional limitation (p=0.15; p=0.22 and p=0.91, respectively) for both groups. Our findings add to the evidence that the modified arthritis empowering programme improved perception of control of osteoarthritis and three health outcomes after 12 months of treatment.
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PMID:A 1-year follow-up of an experimental study of a self-management arthritis programme with an added exercise component of clients with osteoarthritis of the knee. 1882 79

The presentation of haemochromatosis is typified by abdominal pain, arthralgia and fatigue or weakness. Arthropathy may be the major presenting feature. The detection of an osteoarthritis-like process involving the metacarpophalangeal (MCP) and wrist joints in middle aged men should signal the possibility of under lying haemochromatosis. Other joints such as the shoulder, hip,knee or ankle may be affected. However, the preferential involvement of the second and third MCP joints is striking and may provide the opportunity for early identification of iron overload disease. The "iron salut" can be an efficient screening tool for this MCP joint arthropathy but it is not well known by clinicians.
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PMID:The 'iron salute' in haemochromatosis. 1928 50


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