Effects of aquatic physical exercise on neuropsychological factors in older people: A systematic review

Background. There is a lack of standardized protocols and clinical trials for older adults involving neuropsychological factors in the literature. Furthermore, no systematic review has been published investigating this theme.Purpose. The purpose of this systematic review was to analyze the effects of aquatic physical exercise on neuropsychological factors in older adults.Methods. A systematic review (CRD42020176899) was conducted, using articles from Pubmed, Web of Science, Scopus, Cochrane Library, Science Direct and Medline published until March 2020 (without limit of previous year). Eligibility criteria for selecting studies were: clinical trials; samples with a mean age of 65 years old and over; articles involving aquatic physical exercise; and presenting neuropsychological outcomes (behavior, cognition, psychological, mental health).Results and discussion. The search yielded 801 records and 16 studies were included, totaling: 1707 older adults, with a mean age of 71.3 years old (range of mean ages in the studies: 65.3 to 88.4 years old) and a predominance of women. Aquatic physical exercise showed positive results in the mental component of quality of life, fear of falling, mood, anxiety and internal health locus of control in healthy sedentary older adults. Only one study out of 5 carried out with older adults with osteoarthritis showed improvements in psychological well-being after aquatic intervention. Older women with osteopenia or osteoporosis showed improvements in the mental component of quality of life. Studies on dementia showed a significant improvement in behavioral and psychological symptoms after aquatic intervention and no effect on depressive symptoms.Conclusion. Based on the results of this systematic review, aquatic physical exercise has positive effects on quality of life, fear of falling, cognitive functions, mood, anxiety and internal health locus of control in sedentary community-dwelling older people. It can be a great resource for carrying out physical activities in this population.     

Survivorship Comparisons of Ultracongruent,Cruciate-Retaining and Posterior-Stabilized Tibial Inserts Using a Single Knee System Design: Results From the Australian Orthopedic Association National Joint Replacement Registry

BackgroundUltracongruent (UC) tibial inserts can increase knee replacement stability, but how survivorship compares to cruciate retaining (CR) or posterior stabilized (PS) inserts is unclear.MethodsData from a large joint registry were used to calculate the cumulative percent revision of a single popular knee design used with different inserts. There were 67,523 procedures, of which 12,434 were UC, 21,635 CR, and 33,454 PS. Revision rates and reasons for revision were analyzed.ResultsThe cumulative percent revision at 18 years was 8.3% for UC, 9.2% for CR, and 8.9% for PS. There was no difference when UC was compared to CR, but PS had a higher risk of revision. Revision reasons were similar.ConclusionCompared to the CR, an UC insert did not increase revision rates and was actually lower than a PS insert. An UC insert does not compromise long-term total knee arthroplasty survivorship in the Genesis II prosthesis.     

Inequalities in the Distribution of Childhood Adversity From Birth to 11 Years

ObjectiveExposure to early adversity carries long term harmful consequences for children's health and development. This study aims to 1) estimate the prevalence of childhood adversity for Australian children from infancy to 10–11 years, and 2) document inequalities in the distribution of adversity according to socioeconomic position (SEP), Indigenous status, and ethnicity.MethodsAdversity was assessed every 2 years from 0–1 to 10–11 years in the nationally representative birth cohort of the Longitudinal Study of Australian Children (N = 5107). Adversity included legal problems; family violence; household mental illness; household substance abuse; harsh parenting; parental separation/divorce; unsafe neighborhood; family member death; and bullying (from 4 to 5 years). Adversities were examined individually and summed for a measure of multiple adversity (2+ adverse experiences).ResultsBy 10–11 years, 52.8% (95% confidence interval [CI] 51.0–54.7) of children had been exposed to 2 or more adversities. When combined with low SEP, children from ethnic minority and from Indigenous backgrounds had 4 to 8 times the odds of exposure to 2 or more adversities than children from higher SEP Anglo-Euro backgrounds, respectively (odds ratio [OR] 4.3, 95% CI 2.8–6.6 and OR 8.1, 95% CI 4.4–14.8). Ethnic minority and Indigenous children from higher SEP backgrounds had increased odds of exposure to multiple adversity than similarly advantaged Anglo-Euro children (OR 1.8, 95% CI 1.4–2.3 and OR 2.3, 95% CI 1.3–4.3, respectively).ConclusionsAddressing early adversity is a significant opportunity to promote health over the life course, and reduce health inequalities experienced by marginalized groups of children.     

The Outcome of Cemented Acetabular Components in Total Hip Arthroplasty for Osteoarthritis Defines a Proficiency Threshold: Results of 22,956 Cases From the Australian Orthopaedic Association National Joint Replacement Registry

BackgroundThe declining popularity of cemented acetabular components is incongruous, given the published results of prostheses implanted using contemporary techniques. The outcome of arthroplasty has previously been demonstrated to correlate with surgeon experience and volume of practice. We aim to explore if surgeon volume alters outcomes of cemented acetabular components based on survivorship data from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).MethodsAn observational study was undertaken using a cohort of 22,956 patients with a primary diagnosis of osteoarthritis in the period 2003-2016 in whom cemented acetabular components were implanted. The cohort was stratified by age (greater than or less than 65 years) and annualized surgical volume of ≤10, >10-≤25, and >25 cases.ResultsStratified by age and volume, there was a protective benefit against revision conveyed at volume thresholds of 10 cases per annum and 25 cases per annum for patients ≥65 years of age and <65 years of age, respectively.ConclusionCemented total hip arthroplasty has excellent survivorship out to 15 years based on AOANJRR data. This survivorship is further improved if surgeons perform a higher volume of cases, with >25 cases conferring the greatest benefit. The AOANJRR data set is used to define best practice; surgeons who choose to utilize cemented acetabular fixation should be encouraged to perform this technique in adequate volumes to minimize revision risk and ensure the preservation of this important surgical skill set.     

Cementless Total Hip Arthroplasty for Adult Patients With Sequelae From Childhood Hip Infection: A Medium-Term Follow-Up Study

BackgroundThe aim of this study is to evaluate midterm clinical and radiographic results of total hip arthroplasties (THAs) with cementless implants for adult patients with sequelae from childhood hip infection.MethodsBetween 2002 and 2016, 165 patients (165 hips) who had a hip infection during childhood were treated with THAs with cementless implants. The average duration of follow-up was 93.5 months (range 26-206). Clinical results were evaluated via the Harris Hip Score and radiographic results were analyzed with postoperative serial X-rays.ResultsThe average Harris Hip Score increased from 27 (range 8-53) before surgery to 91 (range 45-100) at the latest follow-up examination (P < .001). At the latest follow-up evaluation, 9 cementless acetabular components demonstrated partial, nonprogressive radiolucencies. No subsidence of more than 2 mm or evidence of a radiolucent line was observed around the femoral components. Intraoperative periprosthetic fractures occurred in 11 hips, including 3 acetabular fractures, 2 fractures of greater trochanter, 1 femoral shaft fracture, and 5 fractures of femoral calcar. Postoperative complications included 3 cases of periprosthetic infection, 1 episode of dislocation, 1 case of a femoral periprosthetic fracture, 5 cases of sciatic nerve injury, 1 case of femoral nerve injury, and 1 case of squeaking from a ceramic bearing surface.ConclusionCementless THA for adult patients with sequelae from childhood hip infection presents significant technical challenges and a relatively high complication rate. With meticulous surgical planning and anticipation for the key technical challenges frequently encountered, the medium-term clinical and radiographic results of THA in this setting were good with high implant survivorship and patient satisfaction.