Association between HLA-B*15:02 allele and antiepileptic drug-induced severe cutaneous reactions in Hong Kong Chinese: a population-based study.

Objectives: To examine the effectiveness and feasibility of a community-based aquatic exercise programme for elders with osteoarthritis of the knee. Design: Prospective intervention study, with a before-and-after design. Setting: Community elders. Participants: Twenty elders aged 65 years or above (mean, 72 years) attending four Elderly Health Centres of the Department of Health who had suffered from osteoarthritis of the knee for at least 3 years and with mild-to-severe knee pain. Intervention: A 10-week aquatic exercise programme designed and led by physiotherapists. Main outcome measures: Range of motion and power of extension of the knees, functional reach test, repeated sit-to-stand test, and the Chinese Arthritis Impact Measurement Scales 2. Results: There was an improvement in the median range of knee flexion from 115° to 125° (P<0.01) and the median strength of the quadriceps from 9 kg to 21 kg (P<0.001). The median score of the functional reach test increased from 20 cm to 28 cm (P<0.001) and the repeated sit-to-stand test from 10 to 14 repetitions (P<0.001). Also, there Physiotherapist-designed aquatic exercise programme for community-dwelling elders with osteoarthritis of the knee: a Hong Kong pilot study New knowledge added by this study • This physiotherapist-designed aquatic exercise (PDAE) programme significantly improves knee functions, symptoms, and psycho-social functioning of the Hong Kong Chinese knee osteoarthritis (OA) sufferers. • The PDAE programme was effective and feasible in community settings. Implications for clinical practice or policy • This study showed that OA knee sufferers can improve in terms of knee symptoms and functioning by means of the PDAE programme used in a community setting. • The findings support the application of PDAE programme as a form of long-term self-management for OA knee. Hong Kong Med J 2014;20:16–23 DOI: 10.12809/hkmj133931 Mary CK Lau *, Joseph KS Lam, Eva Siu, Carmen SW Fung, Kevin TY Li, Margaret WF Lam MCK Lau *, MHM, Prof Dip Phty JKS Lam, Prof Dip Phty E Siu, MPH, Prof Dip Phty CSW Fung, MScHC(PT), Prof Dip Phty KTY Li, MHEH the prevalence rates in women were higher, being 24% and 13%, respectively.1 Elderly Health Centres (EHCs) of the Department of Health provide comprehensive primary health care for persons aged 65 years and above. Among attendees of EHCs, OA knee contributes to approximately one third of all physiotherapy referrals.2 Physiotherapy in the form of an exercise # Physiotherapist-designed aquatic exercise programme # 17 Hong Kong Med J ⎥ Volume 20 Number 1 ⎥ February 2014 ⎥ www.hkmj.org prescription (eg hydrotherapy), other treatment modalities (eg heat therapy, transcutaneous electrical nerve stimulation), as well as the prescription of mobility aids for improving ambulation are examples of recommended non-pharmacological therapies for the OA. These are in addition to patient education and self-management programmes.3 There are many studies documenting the efficacy and effectiveness of aquatic exercises (or hydrotherapy programmes) for reducing pain and improving function in patients with OA or rheumatoid arthritis.4-8 When one exercises in water, the buoyancy of water decreases loading on lower limb joints. On the other hand, the hydrodynamic resistance and turbulence helps to strengthen muscles and increase proprioception and balance. Hydrostatic pressure also helps to control oedema in the immersed body parts. This study aimed to examine the effectiveness and feasibility of a community-based aquatic exercise programme for elders with OA knee. The programme, a physiotherapist-designed aquatic exercise (PDAE), was developed by the physiotherapists of the Elderly Health Service (EHS) of the Department of Health. Methods Subjects Subjects were recruited by convenience sampling of the elders aged 65 years and above attending any one of the four EHCs in Kowloon, Hong Kong. Inclusion and exclusion criteria Elders who were recruited had to have a clinical diagnosis of OA knee made by EHC doctors, knee pain for at least 3 years, and a self-perceived pain level of at least ‘mild’ in the affected knee joint(s) during the preceding 1 month. Unstable heart disease, hypertension, or any other medical contra-indication to mild-tomoderate physical activity were grounds for exclusion. Other exclusion criteria were physical barriers to exercising in water, such as marked postural deformity, blindness, or deafness; severe cognitive impairment; depression not responding to treatment; neurological diseases like Parkinson’s disease and stroke; and inability to walk independently. Subjects who had already received active interventions for OA knee during the preceding 2 months or who had scheduled knee operations in the following 6 months were also excluded. Interventions The PDAE consisted of individual and group exercises (Table 1), and was delivered twice a week for 10 weeks in a public indoor swimming pool by registered physiotherapists of the EHS. All subjects attended a health educational seminar on OA knee and the PDAE before the 劉昭君、林建成、邵伊華、馮仕為、李統宇、林華鳳 目的:探討為患有膝關節炎的社區老人開展的水中運動班的效用和可 行性。