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Knee Exam

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13281. Obtaining reliable measurements of knee extensor torque produced during maximal voluntary contractions: an experimental investigation. (Abstract)

isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; eccentric isokinetic contractions at velocities of 30 degrees, 90 degrees, 120 degrees, and 180 degrees/s; and isometric contractions at 40 and 60 degrees of knee flexion. The peak torques produced were examined to determine on which day and during which contraction subjects produced the greatest torques for each condition. This information was used to develop a practice protocol. Fifteen different subjects (...) Obtaining reliable measurements of knee extensor torque produced during maximal voluntary contractions: an experimental investigation. The purpose of this study was to develop and test a protocol that could be used to obtain reliable measurements of knee extensor torque produced during maximal voluntary contractions. On each of 3 days, 10 subjects performed six consecutive maximal voluntary contractions, in the same randomized order, for each of the following 10 conditions: concentric

1992 Physical therapy Controlled trial quality: uncertain

13282. Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training. (Abstract)

Specific adaptations of neuromuscular control and knee joint stiffness following sensorimotor training. The aim of this study was to examine how fixations of the ankle joint during sensorimotor training (SMT) influence adaptations in mechanical stiffness and neuromuscular control of the knee joint. Sixty-three healthy subjects were randomly assigned to three training groups that differed in their degree of ankle joint fixation, which was either barefooted, with an ankle brace or with a ski boot (...) . Mechanical knee joint stiffness and reflex control of m. vastus medialis, m. vastus lateralis, m. biceps femoris, and m. semitendinosus were tested during force controlled anterior tibial displacements. This force was applied as both a fast and a slow stimulus. After the training period the group that trained barefooted showed an increase in mechanical stiffness of the knee joint from 79 +/- 21 (Mean +/- SD) N/mm to 110 +/- 38 N/mm (p < 0.05) in the fast stimulus. The training group that trained with ski

2006 International Journal of Sports Medicine Controlled trial quality: uncertain

13283. Time dependence of iopamidol and iodixanol in arthrography of the knee. (Abstract)

Time dependence of iopamidol and iodixanol in arthrography of the knee. The safety and diagnostic efficacy of iodixanol (Visipaque) 270 mg I/ml was compared to that of iopamidol (Iopamiron) 300 mg I/ml in knee arthrography.This trial was a bi-center double-blind trial including 128 patients (iodixanol/iopamidol 64/64 patients). Efficacy was evaluated by blinded grading of the diagnostic quality of the p.a. images taken 0, 12 and 25 min after contrast administration by the examining radiologist (...) and later at a consensus evaluation by two experienced skeletal radiologists. Adverse events were recorded.No patient experienced any adverse event. The proportion of better images at both 12 and 25 min after injection was higher in the iodixanol group compared to the iopamidol group both by the examining radiologist and at the consensus evaluation.In the knee joint iodixanol is a safe contrast medium. The contrast effect of iodixanol lasted longer than that of iopamidol, which can be important when

1999 Acta radiologica (Stockholm, Sweden : 1987) Controlled trial quality: uncertain

13284. Intra-articular morphine and/or bupivacaine after total knee replacement. (Abstract)

Intra-articular morphine and/or bupivacaine after total knee replacement. The postoperative analgesic effects of intra-articular injections of bupivacaine and/or morphine were examined prospectively in 437 patients who had total knee replacement for osteoarthritis. They were divided randomly into four groups. Group I received 10 mg of morphine (1 ml) and 9 ml of saline, group II received 10 ml of bupivacaine (2.5 mg/ml), group III received 10 ml of saline, and group IV received 10 mg

1999 The Journal of Bone and Joint Surgery British Volume Controlled trial quality: uncertain

13285. Hyaluronic acid in the treatment of osteoarthritis of the knee. (Abstract)

Hyaluronic acid in the treatment of osteoarthritis of the knee. We examined the efficacy, safety and patient satisfaction of intra-articular hyaluronic acid (HA) in patients with osteoarthritis of the knee.One hundred patients with mild to moderate osteoarthritis of the knee entered a randomized blind-observer trial of 6 months HA vs placebo. Primary efficacy criteria were pain on walking, measured with a visual analogue scale, and the Lequesne Index.For pain on walking, a significant (...) of the knee with a symptomatic benefit which persisted for 6 months.

1999 Rheumatology (Oxford, England) Controlled trial quality: uncertain

13286. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. (Abstract)

Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. Glucosamine products have been used extensively for the management of pain in osteoarthritis (OA). We investigated the efficacy of the hydrochloride salt of glucosamine on pain and disability in knee OA.At Week -2, subjects were examined, randomized, and instructed to take only prescribed acetaminophen for pain. At Week 0 patients were examined, prescribed acetaminophen, and either placebo or glucosamine (...) significant difference in WOMAC pain score between Week 0 and Week 8) was not met. However, positive trends were noted for the glucosamine group in 23 of 24 WOMAC questions. A significant difference was noted from Week 5 through Week 8 in the knee examination (p = 0.026) and in the response to a daily diary pain question (p = 0.018). However, responding to the question, "Are you better than at the start of the trial?", 40% of placebo and only 49% of glucosamine subjects answered in the affirmative (p

1999 The Journal of rheumatology Controlled trial quality: uncertain

13287. Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. (Abstract)

Use of tranexamic acid for an effective blood conservation strategy after total knee arthroplasty. We have investigated the effect of treatment with tranexamic acid, an inhibitor of fibrinolysis, on blood loss, blood transfusion requirements and blood coagulation in a randomized, double-blind, placebo-controlled study of 42 patients after total knee arthroplasty. Tranexamic acid 15 mg kg-1 (n = 21) or an equivalent volume of normal saline (n = 21) was given 30 min before surgery (...) and subsequently every 8 h for 3 days. Coagulation and fibrinolysis values, blood loss and blood units administered were measured before administration of tranexamic acid, 8 h after the end of surgery and at 24 and 72 h after operation. Coagulation profile was examined (bleeding time, platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), plasminogen, beta-thromboglobulin and fibrinogen). Fibrinolysis was evaluated by measurement of concentrations of D-dimer and fibrinogen

1999 British Journal of Anaesthesia Controlled trial quality: uncertain

13288. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. (Abstract)

community with chronic pain and radiographic DJD of the knee or low back were randomized. A summary disease score incorporated results of pain and functional questionnaires, physical examination scores, and running times. Changes were presented as a percentage of the patient's average score.Knee osteoarthritis symptoms were relieved as demonstrated by the summary disease score (-16.3%; p = 0.05), patient assessment of treatment effect (p = 0.02), visual analog scale for pain recorded at clinic visits (...) (-26.6%; p = 0.05) and in a diary (-28.6%; p = 0.02), and physical examination score (-43.3%; p = 0.01). Running times did not change. The study neither demonstrated, nor excluded, a benefit for spinal DJD. Side effect frequency was similar to that at baseline. There were no hematologic effects.The combination therapy relieves symptoms of knee osteoarthritis. A larger data set is needed to determine the value of this therapy for spinal DJD. Short-term combination therapy appears safe in this setting.

1999 Military medicine Controlled trial quality: uncertain

13289. Preoperative education for total hip and knee replacement patients. (Abstract)

Preoperative education for total hip and knee replacement patients. Psychoeducational preparation is known to improve postoperative outcome. We tested two common psychoeducational procedures in elderly orthopedic patients, examining how best to match interventions to patients by psychological type.Two hundred twenty-two elderly patients undergoing total hip or knee replacement were randomly assigned to 1) a slide-tape with information on the postoperative, in-hospital rehabilitation experience (...) , or 2) training in Benson's Relaxation Response with a bedside audiotape, in a 2 x 2 factorial design.The relaxation response did not influence postoperative outcomes. The educational intervention reduced length of stay and pain medication use for patients who exhibited most denial (tendency to avoid thinking about unpleasant events), and reduced postoperative anxiety and cognitive errors on the Mini-Mental State Exam for patients with most baseline anxiety. There was no effect on postoperative

1998 Arthritis care and research : the official journal of the Arthritis Health Professions Association Controlled trial quality: uncertain

13290. Intra-articular primatised anti-CD4: efficacy in resistant rheumatoid knees. A study of combined arthroscopy, magnetic resonance imaging, and histology. Full Text available with Trip Pro

, examining its mode of action using a combined imaging approach of arthroscopy, magnetic resonance imaging (MRI), and histology.Thirteen RA patients with active, resistant knee synovitis, were randomised to intra-articular injection of placebo (n=3), 0.4 mg (n=3) or 40 mg (n=7) of anti-CD4 after sequential dynamic gadolinium enhanced MRI, followed by same day arthroscopy and synovial membrane biopsy. Imaging and arthroscopic synovial membrane sampling were repeated at six weeks. This study used a unique (...) Intra-articular primatised anti-CD4: efficacy in resistant rheumatoid knees. A study of combined arthroscopy, magnetic resonance imaging, and histology. CD4+ T cells sustain the chronic synovial inflammatory response in rheumatoid arthritis (RA). SB-210396/CE 9.1 is an anti-CD4 monoclonal antibody that has documented efficacy in RA when given intravenously. This study aimed to establish the safety and efficacy of the intra-articular administration of SB-210396/CE 9.1 compared with placebo

1999 Annals of the rheumatic diseases Controlled trial quality: uncertain

13291. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. (Abstract)

postoperative maximal amplitude of knee flexion was measured during continuous passive motion at 24 h and 48 h and compared with the target levels prescribed by the surgeon. To evaluate functional outcome, the maximal amplitudes were measured again on postoperative day 5, at hospital discharge (day 7), and at 1- and 3-month follow-up examinations. When the patients left the surgical ward, they were admitted to a rehabilitation center, where their length of stay depended on prospectively determined discharge (...) Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Continuous passive motion after major knee surgery optimizes the functional prognosis but causes severe pain. The authors tested the hypothesis that postoperative analgesic techniques influence surgical outcome and the duration of convalescence.Before standardized general anesthesia, 56 adult scheduled for major knee surgery were randomly assigned to one of three groups

1999 Anesthesiology Controlled trial quality: uncertain

13292. Knee flexor torque and perceived exertion: a gender and reliability analysis. (Abstract)

Knee flexor torque and perceived exertion: a gender and reliability analysis. The objectives of the present study were to examine gender differences and between-day variability of isometric hamstring muscle peak torque and perceived exertion.Subjects included 20 healthy, college-aged male (N = 10) and female (N = 10) volunteers. Each subject completed five maximal voluntary isometric hamstring muscle contractions (MVC), in a prone position, with their knee at 30 degrees flexion. Subjects (...) then completed, in random order, isometric contractions at 10, 20, 30, 40, 50, 60, 70, 80, and 90% of their three highest averaged MVC. Perceived exertion was measured with a modified Borg CR-10 scale after each contraction. Ten randomly chosen subjects were asked to return approximately 1 wk after the initial evaluation to repeat the same procedure. Peak hamstring muscle torque was examined in absolute (N.m), relative (N.m.kg-1), and allometric-scaled (N.m.kg-n) units. Perceived exertion across

2003 Medicine and science in sports and exercise Controlled trial quality: uncertain

13293. Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females. (Abstract)

Perceived exertion and maximal quadriceps femoris muscle strength during dynamic knee extension exercise in young adult males and females. The objectives of the present study were to: (1) examine perceived exertion across different target voluntary-contraction intensities; (2) compare perceived exertion ratings with actual target intensities, and (3) compare perceived exertion ratings between males and females. Subjects for this study included 30 healthy, college-aged male (n=15) and female (n (...) =15) volunteers. All subjects were free of orthopedic, cardiopulmonary, systemic and neurological disease. Subjects were evaluated for their one-repetition maximum (1-RM) during inertial knee extension exercise. All subjects then completed, in a random order, two sub-maximal inertial contractions at 20%, 30%, 40%, 50%, 60%, 70%, 80%, and 90% of their 1-RM. Perceived exertion was measured by asking subjects to provide a number that corresponded to the feelings in their quadriceps after completion

2003 European journal of applied physiology Controlled trial quality: uncertain

13294. Optimal stimulation duration of tens in the management of osteoarthritic knee pain. (Abstract)

Optimal stimulation duration of tens in the management of osteoarthritic knee pain. This study examined the optimal stimulation duration of transcutaneous electrical nerve stimulation (TENS) for relieving osteoarthritic knee pain and the duration (as measured by half-life) of post-stimulation analgesia.Thirty-eight patients received either: (i) 20 minutes (TENS20); (ii) 40 minutes (TENS40); (iii) 60 minutes (TENS60) of TENS; or (iv) 60 minutes of placebo TENS (TENS(PL)) 5 days a week for 2 (...) for the TENS40 (256 minutes) and TENS60 (258 minutes) groups was more prolonged than in the other 2 groups (TENS20 = 168 minutes, TENS(PL) = 35 minutes) by Day10 (p < 0.000). However, the TENS40 group produced the longest pain relief period by the follow-up session.40 minutes is the optimal treatment duration of TENS, in terms of both the magnitude (VAS scores) of pain reduction and the duration of post-stimulation analgesia for knee osetoarthritis.

2003 Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine Controlled trial quality: uncertain

13295. The effects of preoperative inflammation on the analgesic efficacy of intraarticular piroxicam for outpatient knee arthroscopy. (Abstract)

The effects of preoperative inflammation on the analgesic efficacy of intraarticular piroxicam for outpatient knee arthroscopy. We conducted a double-blinded study in 90 patients undergoing elective arthroscopic knee surgery to determine whether there is a role of inflammation in the analgesic efficacy of intraarticular piroxicam. Standardized general anesthetic techniques were used for all patients. At the end of the operation, after harvesting synovial biopsies, patients were randomized (...) into three intraarticular groups equally. Group 1 received 25 mL saline, Group 2 received 25 mL 0.25% bupivacaine, and Group 3 received 25 mL 0.25% bupivacaine and piroxicam 20 mg. After microscopic examination of the synovial materials, the patients were divided into two subgroups, inflammation positive (I+) and inflammation negative (I-). Preoperatively and postoperatively at 1, 2, 4, and 6 h, pain levels, analgesic duration, and postoperative analgesic consumption were recorded. Analgesic duration

2003 Anesthesia and analgesia Controlled trial quality: uncertain

13296. Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial. (Abstract)

Physiotherapy, including quadriceps exercises and patellar taping, for knee osteoarthritis with predominant patello-femoral joint involvement: randomized controlled trial. To design and carry out a randomized controlled trial of a complex, physical therapy based intervention for patello-femoral joint (PFJ) osteoarthritis (OA) of the knee, examining medium to longterm outcomes.The participants, who had knee pain and predominant PFJ OA, were recruited from a large population based study (...) . The study design was a controlled trial using prerandomization and a blind observer, comparing the intervention package with standard nonphysiotherapy treatment. The physiotherapy intervention was delivered in local community health centers and clinics and comprised education, quadriceps and functional exercises, and patellar taping delivered by a single physiotherapist in nine 30-minute sessions over 10 weeks, with advice to continue thereafter. The outcome measures were pain in the worse knee by 100

2003 The Journal of rheumatology Controlled trial quality: predicted high

13297. [Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. (Abstract)

[Reduced pain from osteoarthritis in hip joint or knee joint during treatment with calcium ascorbate. A randomized, placebo-controlled cross-over trial in general practice]. Although vitamin C is essential for the formation of collagen and proteoglycan and has been shown to minimise surgically induced arthritis in guinea pigs, no controlled trial has examined its effect on human osteoarthritis.The trial was a multicenter, double-blind, randomised, placebo-controlled, crossover-trial performed (...) by ten general practitioners. The Declaration of Helsinki and the European guidelines for good clinical practice were strictly followed. One hundred and thirty-three patients with radiographically verified symptomatic osteoarthritis of the hip joints and/or the knee joints were treated with one gram of calcium ascorbate or identically looking placebo tablets. The calcium ascorbate tablets and the placebo tablets should be swallowed daily for 14 +/- 3 days respectively, separated by 7 +/- 3 days wash

2003 Ugeskrift for laeger Controlled trial quality: predicted high

13298. The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study. (Abstract)

tonification exercises (group I) (n = 30), or only closed kinetic chain tonification exercises (group II) (n = 30). Assessment of an aspect of neuromotor control was obtained by measuring the reflex response times of VMO and VL at the time of initial clinical examination, at the end of the exercise period (five weeks), and three months after the completion of the exercise period. At these evaluation occasions, the intensity and the number of times that the patients experienced anterior knee pain during (...) The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study. The purpose of this prospective randomized intervention study was to evaluate the effect of two exercise protocols on reflex response time of vastus medialis obliquus (VMO), vastus lateralis (VL), in patients with anterior knee pain. Sixty patients were randomized into a 5-week treatment program, which consisted of only open kinetic chain

2003 Scandinavian journal of medicine & science in sports Controlled trial quality: uncertain

13299. Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain. (Abstract)

Sensory stimulation (acupuncture) for the treatment of idiopathic anterior knee pain. A randomized controlled study was conducted to evaluate the effect of acupuncture treatment in idiopathic anterior knee pain, a pain syndrome without known aetiology. Fifty-eight patients, clinically and radiologically examined, were randomly assigned to either deep or minimal superficial acupuncture treatment. The patients were treated twice weekly for a total of 15 treatments. The main outcome measurements (...) decreased after sensory stimulation, neither the ability to jump on one leg, the functional score nor the skin temperature changed. This study shows that patients with idiopathic anterior knee pain benefit from both electroacupuncture treatment and subcutaneous needling. The pain-relieving effect remains for at least 6 months. Central pain inhibition, caused by either afferent stimulation or by non-specific therapeutic (placebo) effects, is a plausible explanation behind the treatment effects.

2002 Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine Controlled trial quality: uncertain

13300. Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. (Abstract)

Obese, older adults with knee osteoarthritis: weight loss, exercise, and quality of life. This study examined the effects of dietary weight loss and exercise on the health-related quality of life (HRQL) of overweight and obese, older adults with knee osteoarthritis. A total of 316 older men and women with documented evidence of knee osteoarthritis were randomly assigned to 1 of 4 18-month interventions: dietary weight loss, exercise, dietary weight loss and exercise, or healthy lifestyle

2002 Health psychology : official journal of the Division of Health Psychology, American Psychological Association Controlled trial quality: uncertain

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