Alireza Fazaeli

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease. Metabolic and mitochondrial dysregulation are critical causal factors in the pathogenesis and progression of RA. Mitochondrial dysfunction include abnormal energy metabolism, and excessive production of reactive oxygen species (ROS). This study aimed to investigate the adenosine triphosphate (ATP), mitochondrial membrane potential (ΔΨm), ROS, and mRNA expression level of ROMO1 (as ROS modulator) and OMA1 (as regulator mitochondrial dynamics) of peripheral blood mononuclear cells (PBMC) in RA patients. The study participants were 50 patients with RA and 50 sex‐ and age‐matched healthy volunteers. PBMC of all participant were isolated by Ficoll‐Paque. Alteration in ΔΨm and cellular ROS were measured using flow cytometry, ATP level was also assessed via luminometry, and ROMO1 and OMA1 mRNA expression via qRT‐PCR assay. A significant decrease in ATP (p = .005) and ΔΨm (p < .001) was observed in the PBMC of RA compared to control. The ROS levels were significantly higher in the PBMC of RA compared to the control (p < .001). ROMO1 and OMA1 mRNA expression was also significantly increased in RA patients compared to control (p < .001). The decrease in ATP is strongly associated with ROS increasing in PBMC of RA patients, denoting an inverse and negative relationship between ATP and ROS production. Also, a decrease in ΔΨm was observed. It seems that in line with mitochondrial dysfunction in PBMC, increased expression of ROMO1 and OMA1 genes could also be involved in the development of RA.

This study aimed to evaluate the effect of motivational interviewing (MI) and mindfulness (MF) added to neuromuscular (NM) exercises on improving pain, function, balance, and quality of life in patients with knee osteoarthritis (KOA). This randomized clinical trial was conducted on sixty patients who were randomly assigned to the MI + NM, MF + NM, and NM groups. The groups received four training sessions for six weeks. Physical function with Western Ontario and McMaster Universities Arthritis Index timed up and go, going up and down eight stairs, pain with visual analogue scale, quality of life with SF₃₆, and balance with Biodex were evaluated before and after interventions. Within-group comparisons showed that NM + MI, NM + MF, and NM groups experienced significant improvement in all factors after six-week (p < 0.05). However, between groups, comparisons in the post-test revealed that the MI + NM group had a more significant effect on pain, function, and static balance than the MF + NM group. Nevertheless, the MF + NM group improved the quality of life better than the MI + NM and NM groups (p < 0.05). Adding psychological interventions to physical exercises had a better effect on improving the symptoms of patients. Additionally, the MI showed more effectiveness in improving the symptoms of patients.IMPLICATIONS FOR REHABILITATIONAdding motivational interviewing to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.Adding mindfulness intervention to neuromuscular exercises has shown to reduce pain intensity and improved function, balance and quality of life in adults with knee osteoarthritis.Among the psychological interventions used, the motivational interviewing significantly showed more effectiveness in improving the pain, function, balance, and quality of life of patients with osteoarthritis.

Background: Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI). Methods: This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device. Results: Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior–posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior–posterior stability (p = 0.001), medial–lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p < 0.05). Conclusions: According to the results, there were significant differences between the mean pain scores, static and dynamic balance, and the rate of fall between the women with knee osteoarthritis with and without the KI index. Therefore, patients with knee osteoarthritis, which also has an index of KI, are more susceptible to falls, and proper strategies are required to reduce the level of KI in these patients.