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Objective: To determine whether (diagnostic and interventional) ultrasound imaging can be used to provide visual feedback affecting treatment outcome (pain and disability)., Design: Controlled clinical trial., Subjects: A total of 52 patients with (ultrasonographically confirmed) symptomatic Baker's cysts were enrolled., Methods: The cysts were drained under ultrasound guidance and, if necessary, corticosteroid injections were given on the follow-up visit. In group I (n = 26) the patients did not observe the procedures on the ultrasound (US) screen. In group II (n = 26) the US images/videos were shown and explained to the patients. The patients were included in one of the groups consecutively, unless they refused the protocol of that group. Treatment outcome was assessed via US measurements, aspirate volumes, visual analogue scale (VAS) (knee pain, procedure discomfort), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Rauschning-Lindgren Classification (RLC), Kellgren-Lawrence grading scale, Hospital Anxiety and Depression Scale, and paracetamol intake., Results: The 2 groups were similar regarding US measurements, aspirate volume and paracetamol use (p-values > 0.05). In both groups all VAS (p < 0.001) and WOMAC (p < 0.05) scores decreased after treatment. Although initial VAS and WOMAC scores were similar between the groups, all VAS/WOMAC scores, except VAS-2, WOMAC-2 pain, and WOMAC-3 stiffness, were significantly lower in group II (all p < 0.05). Initial RLC scores were similar between the groups; however, group II had significantly lower scores at visits 2 and 3., Conclusion: In patients with Baker's cysts (diagnostic/interventional) US imaging can be used as a simple means of visual biofeedback, favourably affecting the treatment outcome (pain and disability).

Objective: This study aimed to investigate levels of validity, and inter- and intra-observer reliability of observational gait analysis (OGA) in clinical usage, done by the physical therapists with varying clinical experience, in subjects with knee osteoarthritis., Methods: The study included 33 subjects (22 female, 11 male; mean age: 58.24±9.14 years range: 46 to 81) clinically and radiographically diagnosed with bilateral knee osteoarthritis, and 4 physical therapists to observe the subjects' gaits. The physical therapists were separated into two groups according to their professional experience: those with 10 or more years, and those with fewer than 10 years. Video recordings were made of the subjects undergoing three-dimensional gait analysis (3DGA). These recordings were then observationally assessed twice by the participating physical therapists with at least a 6-week interval between observations. OGA was done via a form comprising 11 kinematic and 5 temporo-spatial parameters., Results: Lowest levels of agreement in both validity (r=0.06, p>0.05), and inter- (ICC:-0.12-0.06) and intra-observer (ICC:0.30-0.45) reliability were found in the parameters of ankle dorsiflexion in initial contact phase and pelvic rotation in midstance phase. Highest inter- and intra-observer agreement was found in the temporo-spatial parameters of step width, double step length, cadence and velocity (ICC:0.61-0.80). Highest validity was found in pelvic tilt in stance phase (r=0.74-0.78, p<0.001). With the exception of stance phase, moderate or good agreement (r=0.52-0.69, p<0.05) was found in the temporo-spatial parameters., Conclusion: This study found that OGA assessment of temporo-spatial parameters had moderate or good validity and reliability. Assessment of the majority of kinematic parameters had fair or moderate validity and inter-observer reliabilty, and moderate or good intra-observer reliability.

Aim: To explore the relationship among clinical, radiological and ultrasonographical findings in knee osteoarthritis (OA)., Method: Sixty-one patients (122 knees) with knee OA were enrolled. Patients' knees were classified into two groups according to symptom severity. Group I consisted of 61 more symptomatic knees and Group II comprised 61 less symptomatic knees. Subjects were clinically assessed for pain and functional status by using a visual analog scale and the Western Ontario and McMaster Universities Arthritis Index (WOMAC), respectively. Knee radiographs were evaluated by using the Kellgren-Lawrence (K-L) grading system. All knees were also evaluated ultrasonographically for meniscal bulging, distal femoral cartilage thickness, cartilage grading and also for the presence of effusion, Baker's cyst and so on., Results: Baker's cyst and joint effusion were observed more in Group I when compared with Group II. Positive correlations were found between meniscal bulging and all WOMAC scores (all P < 0.05). K-L grades of the patients were also positively correlated with WOMAC scores (all P < 0.05). Meniscal bulging measurements and K-L grades were positively correlated (P < 0.001). There was a negative correlation between cartilage grades and cartilage thickness measurements (all P < 0.001)., Conclusions: We found that joint space narrowing seemed to be associated with meniscal bulging. Moreover, increased meniscal bulging and presence of Baker's cyst/joint effusion were associated with worse pain or poorer function., (© 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.)

Objective: The aim of this study was to investigate the differences in temporospatial parameters in according to severity of knee osteoarthritis (OA)., Methods: The study included a total of 110 subjects with no orthopedic or neurologic disease that might affect gait were divided into three study and one control groups. Eighty subjects (mean age: 53.13 ± 6.78 years) were diagnosed with bilateral knee OA and divided into groups according to Kellgren-Lawrence radiologic scale: the Phase 1 group included 29 subjects, Phase 2, 28 subjects, and Phase 3, 23 subjects. The control group was composed of 30 healthy subjects (25 females, 5 males; mean age: 41.50 ± 5.79 years). Temporospatial gait data were evaluated using a gait analysis system., Methods: There were no significant differences in all temporospatial parameters between the control group and the Phase 1 and 2 OA groups (p>0.05). There was a significant decrease in cadence, gait velocity, stride length and step length (p<0.008) and a significant increase in stride time, double support time, step time, single support time and stance phase length in patients with Phase 3 knee OA compared to the other groups (p<0.008)., Conclusion: Changes in temporospatial parameters of patients with Phase 3 knee OA may be correlated with loss of gait stabilization and increase in risk of falling. In subjects with knee OA, gait stabilization and balance loss must be examined and evaluated in terms of risk of falling and necessary precautions must be taken.

Background: Different strengthening exercises are generally prescribed to overcome the undesirable effects of decreased muscular function on the osteoarthritic joint. Although a few studies have shown the effects of strengthening on the muscle structure in healthy individuals, the literature lacks relevant data concerning knee osteoarthritis., Objective: To evaluate the effects of different exercises on quadriceps muscle strength and structure in persons with knee osteoarthritis., Design: A randomized controlled study., Setting: Physical medicine and rehabilitation department of a university hospital., Population: Sixty-one patients with knee osteoarthritis were randomly assigned into 6 exercise groups (isometric right/left, isotonic right/left, isokinetic right/left)., Methods: Subjects were evaluated for pain and functional status with use of the visual analog pain scale, Western Ontario and McMaster Universities Arthritis Index, 50-step walking, and single-leg stance tests before and after 15 sessions of physical therapy. Isokinetic tests were performed at 60° per second. Ultrasonographic measurements for pennation angle, fascicle length, and muscle thickness were performed from the vastus lateralis muscles bilaterally., Results: Increased knee extensor strength was observed bilaterally in the isometric group (P < .01). In the same group, fascicle length and muscle thickness on the strengthened side (P < .01) and fascicle length on the contralateral side (P < .05) were increased. In the isokinetic group, muscle thickness bilaterally and fascicle length on the contralateral side increased (all P < .05). In the isotonic group, muscle thickness increased bilaterally (P < .05)., Conclusion: These findings showed that isometric quadriceps training resulted in bilateral strengthening and that accompanying increase in muscle thickness and fascicle length in the same group was consistent with the strength improvement. In this study we evaluated the effects of different strength training on muscle strength and architecture in patients with knee osteoarthritis by using isokinetic measurements and ultrasound. Our results suggest that exercises may influence the muscle architecture in patients with knee osteoarthritis. To our knowledge, this study is the first to demonstrate the effects of cross-education on muscle architecture., (Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.)