To investigate whether sarcopenic obesity may contribute to knee osteoarthritis or not.In this study, we assessed 140 community-dwelling adult patients. Their demographic data were recorded along with comorbidities. Anterior mid-thigh muscle thickness in the axial plane was measured on the dominant leg using ultrasound midway between the anterior superior iliac spine and the upper end of patella in millimeter. Then, the sonographic thigh adjustment ratio was calcu- lated by dividing this thickness by body mass index. ISarcoPRM algorithm was used for the diagnosis of sarcopenia. Kellgren-Lawrence grading was used for knee osteoarthritis . Functional evaluation was performed using chair stand test, gait speed, and grip strength.There were 50 patients with knee osteoarthritis and 90 age- and gender-similar control sub- jects. When compared with controls, anterior thigh muscle thickness, gait speed, and grip strength were found to be similar between the groups, whereas body mass index and chair stand test val- ues were higher in the knee osteoarthritis group (both P < .05). In addition, sarcopenic obesity was observed in 12 (13.3%) of control subjects and in 14 (28%) of osteoarthritis patients. When age, gen- der, exercise, smoking, and body composition type (i.e., nonsarcopenic nonobese, sarcopenic only, obese only, and sarcopenic obesity) were taken into binary logistic regression analyses, only sarcope- nic obesity [relative risk ratio = 2.705 (95% CI: 1.079-6.779)] was independently related with the knee osteoarthritis (P < .05).Our preliminary study has shown that neither sarcopenia nor obesity but sarcopenic obe- sity seems to be independently related to the knee osteoarthritis. Further longitudinal studies with larger samples are required for investigating the effects of obesity and sarcopenia on the develop- ment of knee osteoarthritis.
ABSTRACT The fascial system has recently gained attention for its potential role in various painful disorders. With the advancement of our understanding regarding the rich innervation of the fascia, it has emerged as a potential pain generator and a target for treatment in many cases. The superficial fascia presents a rich plexiform intrinsic neural network and runs within the subcutaneous fat tissue. It is pierced by several cutaneous nerves originating from the spine and reaching the dermo‐epidermal complex along the posterior surface of the trunk. Unlike the deep fascia that envelopes the paraspinal muscles and for which several interventional techniques have been described, poor scientific data about ultrasound‐guided procedures targeting the paravertebral superficial fascia are available. In this sense, this brief report describes three relevant cases whereby hydro‐dissection of the cervical superficial fascia has been performed under ultrasound guidance to manage myofascial pain non‐responsive to first‐line conservative treatments. Likewise, we discuss the potential role of this often‐forgotten anatomical structure in chronic cervical myofascial pain, cervicogenic dizziness, and paresthesias with non‐dermatomal distribution of the cervical and periscapular region.
The objective of this review is to describe the major impairments resulting from acquired brain injury (ABI) and their rehabilitation interventions resulting in better functional outcomes. Because of the nature of deficits and treatment cost, these patients may be lost to follow up. Comprehensive rehabilitation services integrated with neurosciences units are scarce in Pakistan. Keeping in view the diversity and chronicity of impairments, the follow up needs to be well planned in terms of duration and patient convenience. The rehabilitation needs of these patients go beyond physiotherapy alone, which is considered as the only form of rehabilitation in Pakistan. We focus only on the major impairments most seen after ABI. The rehabilitation team members providing their services and the possibilities are comprehensively explained in the review. These types of services need to be run by government and funded by government, with parallel efforts to make national guidelines and registry to keep a track of patients suffering from ABI. The proposed ABI rehabilitation pathway will not only improve the clinical care and continued support delivered by health services to adults with ABI but will also facilitate community reintegration and support their families and care givers.
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