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6. Effects of a neuromuscular joint-protective exercise therapy program for treatment of wrist osteoarthritis: a randomized controlled trial

Author

Larsson, Sara L., Ekstrand, Elisabeth, Dahlin, Lars, Bjoerkman, Anders, Brogren, Elisabeth, Larsson, Sara L., Ekstrand, Elisabeth, Dahlin, Lars, Bjoerkman, Anders, and Brogren, Elisabeth

Abstract

BackgroundIndividuals with wrist osteoarthritis (OA) can suffer from pain, muscular weakness, and impaired motion of the wrist, which can reduce the quality of life. While there is strong evidence that all patients with OA should receive first-line treatment with education and exercises, this approach has not yet been proposed for individuals with wrist OA. Therefore, this trial aimed to evaluate the effectiveness of a first line neuromuscular joint-protective exercise therapy program compared to a training program with range of motion (ROM) exercises in patients with wrist OA.MethodsIn this randomized controlled trial (RCT), 48 patients with symptomatic and radiographically confirmed wrist OA were randomly allocated to a 12-week self-management program with either a neuromuscular joint-protective exercise therapy program (intervention group) or a training program with ROM exercises only (control group). Our primary outcome measure was the Patient-Rated Wrist Evaluation (PRWE) with secondary outcome measures of grip strength, range of wrist motion, the Numerical Pain Rating, Scale (NPRS), the Disabilities of the Arm, Shoulder, and Hand (DASH) and the Generalized Self-Efficacy Scale (GSES). The outcome measures were evaluated by a blinded assessor at baseline and 12 weeks. Between-groups differences were analyzed using the Mann-Whitney U test and within-group differences were analyzed with the Wilcoxon signed-rank test.ResultsA total of 41 participants were analyzed at 12 weeks. There were no significant differences in PRWE between the groups at 12 weeks (p = 0.27). However, DASH improved significantly in the intervention group compared to the control group (p = 0.02) and NPRS on load within the intervention group (p = 0.006). The difference in DASH should be interpreted with caution since it could be due to a non-significant increase (worsening) from baseline in the control group in combination with a non-significant decrease (improvement) in the intervention group., Funding Agencies|Grants from Lund University, Skne University Hospital

Published
2024
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13. A self-managed exercise therapy program for wrist osteoarthritis: study protocol for a randomized controlled trial

Author

Larsson, Sara L., Ekstrand, Elisabeth, Dahlin, Lars, Bjoerkman, Anders, Brogren, Elisabeth, Larsson, Sara L., Ekstrand, Elisabeth, Dahlin, Lars, Bjoerkman, Anders, and Brogren, Elisabeth

Abstract

BackgroundPost-traumatic wrist osteoarthritis (OA) can eventually lead to pain, muscular weakness, and stiffness of the wrist, which can affect the function of the entire upper limb and reduce the quality of life. Although there is strong evidence that all patients with OA should be offered adequate education and exercises as a first-line treatment, an effective self-management program, including structured education and therapeutic exercises, has not yet been introduced for individuals with wrist OA. This trial aims to evaluate the effectiveness of an exercise therapy program with joint protective strategies to improve neuromuscular control (intervention group) compared to a training program with range of motion exercises (control group).MethodsThis is a single-blinded randomized controlled trial (RCT) with two treatment arms in patients with symptomatic and radiographically confirmed wrist OA. The trial will be conducted at a hand surgery department. The participants will be randomly assigned either to a neuromuscular exercise therapy program or to a training program with range of motion exercises only. Participants in both groups will receive a wrist orthosis and structured education on wrist anatomy, pathophysiology, and joint protective self-management strategies. The programs consist of home exercises that will be performed twice a day for 12 weeks. The Patient-Rated Wrist Evaluation (PRWE) is the primary outcome measure of pain and function. Wrist range of motion (ROM), grip strength, the Numeric Pain Rating scale (NPRS), Disabilities of the Arm, Shoulder, and Hand (DASH), the General Self-Efficacy Scale (GSES), Global Rating of Change (GROC), and conversion to surgery are the secondary measures of outcome. Assessments will be performed at baseline and at 3, 6, and 12 months after baseline by a blinded assessor.DiscussionThe upcoming results from this trial may add new knowledge about the effectiveness of a self-managed exercise therapy program on pain and fu, Funding Agencies|Not applicable.

Published
2023
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14. The Swedish COVID-19 approach: a scientific dialogue on mitigation policies

Author

Bjoerkman, Anders, Gisslen, Magnus, Gullberg, Martin, Ludvigsson, Johnny, Bjoerkman, Anders, Gisslen, Magnus, Gullberg, Martin, and Ludvigsson, Johnny

Abstract

During the COVID-19 pandemic, Sweden was among the few countries that did not enforce strict lockdown measures but instead relied more on voluntary and sustainable mitigation recommendations. While supported by the majority of Swedes, this approach faced rapid and continuous criticism. Unfortunately, the respectful debate centered around scientific evidence often gave way to mudslinging. However, the available data on excess all-cause mortality rates indicate that Sweden experienced fewer deaths per population unit during the pandemic (2020-2022) than most high-income countries and was comparable to neighboring Nordic countries through the pandemic. An open, objective scientific dialogue is essential for learning and preparing for future outbreaks.

Published
2023
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25. Arterolane, a New Synthetic Trioxolane for Treatment of Uncomplicated Plasmodium falciparum Malaria: A Phase II, Multicenter, Randomized, Dose-Finding Clinical Trial

Author

Valecha, Neena, Looareesuwan, Sornchai, Martensson, Andreas, Abdulla, Salim Mohammed, Krudsood, Srivicha, Tangpukdee, Noppadon, Mohanty, Sanjib, Mishra, Saroj K., Tyagi, P. K., Sharma, S. K., Moehrle, Joerg, Gautam, Anirudh, Roy, Arjun, Paliwal, Jyoti K., Kothari, Monica, Saha, Nilanjan, Dash, Aditya P., and Björkman, Anders

Published
2010

38. Efficacy and safety of artemether-lumefantrine dispersible tablets compared with crushed commercial tablets in African infants and children with uncomplicated malaria: a randomised, single-blind, multicentre trial

Author

Abdulla, Salim, Sagara, Issaka, Borrmann, Steffen, D'Alessandro, Umberto, González, Raquel, Hamel, Mary, Ogutu, Bernhards, Mårtensson, Andreas, Lyimo, John, Maiga, Hamma, Sasi, Philip, Nahum, Alain, Bassat, Quique, Juma, Elizabeth, Otieno, Lucas, Björkman, Anders, Beck, Hans Peter, Andriano, Kim, Cousin, Marc, Lefèvre, Gilbert, Ubben, David, and Premji, Zulfikarali

Published
2008
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50. Contributors

Author

Abzug, Joshua M., Acker, Daniel, Adams, Julie E., Algar, Lori, Amadio, Peter C., Ashworth, Sarah, Bachoura, Abdo, Baker, Kathryn L., Barbe, Mary F., Barrett, Nora, Barron, Carrie, Bastan, Mark T., Beasley, Jeanine, Belair, Jeffrey A., Belsky, Mark R., Beredjiklian, Pedro K., Biafora, Sam J., Birkenmeier, Rebecca L., Björkman, Anders, Blackmore, Susan, Botte, Michael J., Bozentka, David, Bryden, Anne M., Burn, Matthew B., Butler, Katherine, Byl, Nancy N., Cannon, Nancy M., Carrillo, Patti, Case, Alexandria L., Chan, Kevin, Chan, Wayne W., Chang, Edward S., Chang, James, Chapman, Ted, Cheema, Adnan N., Chen, Neal C., Cheng, Michael K., Chung, Kevin C., Conyers, Dan, Corbin, Shanna, Culp, Randall W., Darbandi, Farhad, Day, Joseph M., DeTullio, Lauren M., Ditwiler, Rebecca Edgeworth, Dodge, Carole, Duff, Susan V., Eckenrode, Brian, Edwards, Scott, Elhassan, Bassem T., Elliott, Melanie B., Emerson, Susan A., Erickson, Mia, Estilow, Timothy, Evans, Roslyn B., Fedorczyk, Frank, Fedorczyk, Jane M., Feehan, Lynne M., Feldscher, Sheri B., Fess, Elaine Ewing, Finch, Denise, Franzen, Annalisa, Gallagher, Kara Gaffney, Garcia-Elias, Marc, Gart, Michael S., Gaspar, Michael P., Gaston, R. Glenn, Gaunt, Bryce W., Gerg, Michael J., Gillespie, Bryce T., Gillon, Thomas J., Giordano, Rachael, Glynn, Sarah, Gonzalez, Ronald, Gonzalez-Hernandez, Eduardo, Gordon, Joshua A., Gottschalk, Michael B., Graham, David J., Graham, Thomas J., Hagert, Elisabet, Haladay, Douglas E., Hamer, M. Jake, Hanel, Douglas P., Hannah, Susan D., Hardwick, Dustin, Hardy, Maureen, Hay, David C., Holly, Janet, Howell, Julianne Wright, Hoyen, Harry, Hurst, Larry, Hussain, Haroon, Hutchinson, David, Jacoby, Sidney M., Jegapragasan, Kathleen Kollitz, Jerosch-Herold, Christina, Jones, Neil F., Kakar, Sanjeev, Kane, Patrick M., Karagiannopoulos, Christos, Kashani, Parivash, Kaskutas, Vicki, Katolik, Leonid I., Kearns, Joseph R., Kearns, Kenneth, Keith, Michael W., Kelley, Martin J., Klein, Jason S., Koman, L. Andrew, Kozin, Scott H., Kretschmer, Jonathan, Kuntz, Andrew F., Lalonde, Donald, LaPierre, Justine, Lastayo, Paul C., Lawrence, Marsha, Lazinski, Matthew, Lazinski, Melissa, Le, Thanh, Lee, Marilyn P., Lee, Michael J., Lee, Steve K., Leggin, Brian G., Leibman, Matthew I., Levin, L. Scott, Levy, Todd J., Li, Zhongyu, Loeffler, Bryan J., Lovy, Andrew J., Lubahn, John D., Lucado, Ann M., Lundborg, Göran, Lunsford, Dianna, Lutz, Cheryl, MacDermid, Joy C., MacGillis, Kyle, MacKenzie, Alexandra, Malkinski, Norah, Malone, Kevin, Marik, Tambra, McBride, Elizabeth Anne, McClure, Philip, McDaniel, Claire, McGee, Corey Weston, McKee, Pat, McKenzie, Alison, Means, Kenneth R., Jr., Mendenhall, Shaun D., Merritt, Wyndell H., Meyer, R. Scott, Midgley, Robyn, Miller, Nathan, Moore, Amy M., Moran, Steven L., Morrison, William B., Namdari, Surena, Naughton, Nancy, Nelson, Clayton, Niszczak, Jonathan, Novak, Christine B., O’Malley, Kevin, Osterman, A. Lee, Osterman, Meredith, Pacelli, Lorenzo L., Packham, Tara L., Parrish, Katherine R., Peljovich, Allan E., Pettengill, Karen M., Pham, Peter P., Piercey, Michael, Pierrie, Sarah N., Pisano, Katie, Plucknette, Benjamin F., Pontillo, Marisa, Poole, Janet L., Porretto-Loehrke, Ann, Power, Hollie A., Prager, Eliza M., Pratt, Neal E., Ramsey, Matthew L., Read, Christina M., Reich, Deborah K., Rein, Susanne, Rekant, Mark S., Ring, David, Rivard, Annette Marie, Rizzo, Marco, Rosén, Birgitta, Ross, Phillip, Ruchelsman, David E., Sabbag, Casey, Saporito, Chris, Saunders, Rebecca J., Scheker, Luis R., Schultz, Karen S., Seftchick, Jodi, Serghiou, Michael, Severance, Gayle, Shaffer, Michael A., Shah, Kshamata, Shin, Eon Kyu, Simpson, Roger L., Sinnott, Catherine J., Sirmon, Bryan, Skirven, Terri M., Smith, Beth Paterson, Smith, Heather F., Smith, Thomas L., Soika, Elizabeth, Spinelli, Bryan Anthony, Stagliano, Angela, Steinmann, Scott P., Stralka, Susan Watkins, Strohl, Adam B., Streeter, Natania, Sweet, Stephanie, Tang, Jin Bo, Taras, John S., Taylor, Kenneth A., Tellez, Raquel Cantero, Thompson, Michael A., Tomhave, Wendy, Tosti, Rick, Valdes, Kristin, Vincent, Joshua, Vranceanu, Ana-Maria, Waggy, Carol, Walsh, Laura, Walsh, Mark T., Walters, Lisa Smurr, Webb, Dana, Weesner, Heather, Weinik, Michael, Weiss, Lawrence, Whitten, Mary, Williams, Gerald R., Jr., Wilson, Matthew S., Wolf, Brian R., Wolfe, David M., Wolfe, Terri, Yancosek, Kathleen E., Yao, Jeffrey, Yousaf, Imran, Zelouf, David S., Zgonis, Miltiadis, and Zhang, Dafang

Published
2021
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