Hydrotherapy and Tai Chi effects on Osteoarthritis

As I was looking around for arthritis related topics to blog on, I came upon an interesting study that looked at two different activities and their effect on symptoms of OA.

The study done in 2007 ran a 12 week test, with a 12 week follow up, on 152 elderly sufferers of osteoarthritis of the hip or knee. Subjects needed to be about 70 years of age and classified as inactive. 55 subjects were placed in a 12 week hydrotherapy class, 56 subjects were placed in a 12 week Tai Chi course and, 41 were placed in a control (wait list). Each session was 1 hour long and held twice a week, making a total of 24 classes.
Results showed a decrease in joint pain for patients in both hydrotherapy and Tai Chi groups based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores. Physical function also improved in these two groups and was tested using the "Up and Go" test, 50-foot walk time, and timed stair climb. The "Up and Go test" is a measure of a patient's ability to get up out of a chair without arm support, walk several paces out and back, and sit back down without arm support. These improvements were sustained by most subjects for an additional 12 weeks after the classes.


http://www.arthritiswa.org.au/documents/PAFORMmainresultsACR.pdf

The article "What A Pain," from The Boston Globe, referenced the Arthritis Foundation a few times, so I decided to learn more about it. I went to the website and found that it was actually very helpful and informative about arthritis. The website has information about many types of arthritis, events to raise awareness, and current research.

One of the topics that is currently being researched that I found interesting was in an article called, "Clarifying the Role of Fat in Osteoarthritis." It mentions how obesity is thought to increase the risk of arthritis due to increased weight and force on joints. The article goes on to say, "excess fat may take a toll in another way, too. Fat is a metabolically active tissue that secretes cytokines, or signaling molecules, that can trigger inflammation. An increase in cytokines may help to explain why, for example, obesity increases the risk not only for osteoarthritis in the knees, which would be directly impacted by the increased load, but also in the wrist, which is not a weight-bearing joint."

Research is currently being done on this topic. Here is the website to the Arthritis Foundation webpage
http://www.arthritis.org/

Different Categories of Crohn's Disease

Interestingly I stumbled on a website that contained alot of really interesting information about Crohn's Disease. A lot of the material was, more or less, a review of things that we have seen in the various papers we have read; however, I did find a couple of interesting things that we have not really talked about. The first is different categories of Crohn's. The following table was taken from the website Crohns.net and lays out various forms of the disease mostly based on the origin of the symptoms.

Subcategory	Area Affected
Ileocolitis	The most common form of Crohn's Disease, affecting the ileum and colon
Ileitis	Affects only the ileum; fistulas or inflammatory abscesses possible
Gastroduodenal Crohn's Disease	Affects the stomach and duodenum; bowel obstruction possible
Jejunoileitis	Patchy areas of inflammation in the jejunum; fistulas possible
Crohn's (Granulomatous) Colitis	Affects only the colon and anus; anal fistulas, abscesses, and ulcers possible

Adapted from Crohn's and Colitis Foundation of America, Inc. 2004
http://www.ccfa.org/research/info/aboutch

There is also some interesting information about diseases that can arise from Crohn's. Of these one of the most common is osteoporosis. This comes about for two reasons; the first is a lack of nutritional absorption of vitamins d and k and the second is the treatment of the disease with corticosteroids. Both of these lead to decreased bone density and thus the condition of osteoporosis. Some other major medical problems that could occur either as a result of the different therapies or the disease state itself are colorectal cancer, infertility, bacterial infections, even a higher possibility of ischemic stroke. The increase in risk for stroke is thought to be because of a vitamin B deficiency and a hypercoaguable state brought on as an effect of the disease.

If you would like to to read more about this or see more about Crohn's in general visit crohns.net.

Information taken from
http://www.crohns.net/Miva/education/articles/Potential_Sequelae_of_Crohns_Disease.shtml\
http://www.crohns.net/Miva/education/articles/Crohns_Disease_Table_1.shtml

Stress and IBD

There was an interesting correlation mentioned while I was researching about inflammatory bowel disease (IBD). This article examined the association between stress and IBD. In the past, there were several studies done that illustrated how IBD is affected by psychological components such as stress. With recent findings, research has shown that stress does not induce IBD; however, because of the past association between stress and IBD, the general public believes this false correlation. Often times, diseases such as IBD bring about stress and manifest effects through symptoms. In IBD, irritability, depression, or panic attacks can occur due to stress making IBD worse.

Another article I found on PubMed looked into the psychological aspects of inflammatory diseases and mentioned that stress does play a factor in IBD. Not only does it aggravate IBD, some believe that stress can cause IBD. Stress can affect the functions of secretion, vascular structure, and motility of the GI tract.

To examine if stress is associated with IBD, another case study evaluated stress by life even occurrences in Crohn’s disease and ulcerative colitis patients along with two control groups. Various questionnaires were utilized to assess stress in patients. It was concluded in this paper that stress such as life event is not considered an independent risk factor for the cause of IBD.

It appears to me that there is varying knowledge of the association of stress and IBD. The general public seems to relate the two as one causing the other while medical researchers do not categorize it as a risk factor but a factor that aggravates onset of the disease.

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3765643&ordinalpos=237&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=3765643&ordinalpos=237&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum