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Shih-Wei Huang
Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City

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Review
Published: 18 August 2021 in Clinical Rehabilitation
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Objective: Rheumatoid arthritis and age are associated with high sarcopenia risk. Exercise is an effective treatment for preventing muscle mass loss in older adult populations. It remains unclear whether exercise affects muscle mass in people with rheumatoid arthritis. Thus, this meta-analysis investigated the effect of exercise on muscle mass gain in patients with rheumatoid arthritis. Data sources: PubMed, EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), the China Knowledge Resource Integrated Database, and Google Scholar were systematically searched until June 2021. Methods: The present study was conducted according to the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Randomized controlled trials (RCTs) that reported the effects of exercise on muscle mass for rheumatoid arthritis were identified. The included RCTs were subject to meta-analysis and risk of bias assessment. Subgroup and random-effects meta-regression analyses were performed to identify any heterogeneity ( I2) of treatment effects across studies. Results: We included nine RCTs with a median PEDro score of 6/10 (range: 4/10–8/10). The weighted mean effect size for muscle mass was 0.77 (95% CI: 0.30–1.24; P = 0.001; I2 = 77%). Meta-regression analyses indicated that the disease duration significantly explained variance of treatment effects across studies (β = −0.006, R2 = 69.7%, P = 0.005). Conclusions: Exercise therapy effectively increased muscle mass in patients with rheumatoid arthritis. Treatment effects may be attenuated in those who have had rheumatoid arthritis for a relatively long time.

ACS Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials. Clinical Rehabilitation 2021, 1 .

AMA Style

Chun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials. Clinical Rehabilitation. 2021; ():1.

Chicago/Turabian Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2021. "Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis and meta-regression of randomized controlled trials." Clinical Rehabilitation , no. : 1.

Research article
Published: 30 June 2021 in PLOS ONE
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Critical shoulder angle (CSA) is the angle between the superior and inferior bone margins of the glenoid and the most lateral border of the acromion and is potentially affected during a rotator cuff tear (RCT). Acromioplasty is generally performed to rectify the anatomy of the acromion during RCT repair surgery. However, limited information is available regarding the changes in the CSA after anterolateral acromioplasty. We hypothesized that CSA can be decreased after anterolateral acromioplasty. Data were retrospectively collected from 712 patients with RCTs and underwent arthroscopic rotator cuff repair between January 2012 and December 2018, of which 337 patients were included in the study. The presurgical and postsurgical CSA were then determined and compared using a paired samples t test. Because previous study mentioned CSA more than 38 degrees were at risk of rotator cuff re-tear, patients were segregated into two groups: CSA < 38° and CSA ≥ 38°; these groups were compared using an independent-samples t test. These 337 participants (160 male and 177 female) presented a CSA of 38.4° ± 6.0° before anterolateral acromioplasty, which significantly decreased to 35.8° ± 5.9° after surgery (P < .05). Before surgery, 172 patients were present in the CSA ≥ 38° group and 57 were preset in the CSA < 38° group after surgery. The CSA decreased significantly in the CSA ≥ 38° group rather than in the CSA < 38° group (P < .05). In conclusion, the CSA can be effectively decreased through anterolateral acromioplasty, and this reduction in the CSA is more significant among individuals with CSA ≥ 38° than among those with CSA < 38°, indicating that acromioplasty is recommended along with RCT repair especially among individuals with a wide presurgical CSA.

ACS Style

Che-Li Lin; Li-Fong Lin; Tzu-Herng Hsu; Lien-Chieh Lin; Chueh-Ho Lin; Shih-Wei Huang. Acromioplasty reduces critical shoulder angle in patients with rotator cuff tear. PLOS ONE 2021, 16, e0253282 .

AMA Style

Che-Li Lin, Li-Fong Lin, Tzu-Herng Hsu, Lien-Chieh Lin, Chueh-Ho Lin, Shih-Wei Huang. Acromioplasty reduces critical shoulder angle in patients with rotator cuff tear. PLOS ONE. 2021; 16 (6):e0253282.

Chicago/Turabian Style

Che-Li Lin; Li-Fong Lin; Tzu-Herng Hsu; Lien-Chieh Lin; Chueh-Ho Lin; Shih-Wei Huang. 2021. "Acromioplasty reduces critical shoulder angle in patients with rotator cuff tear." PLOS ONE 16, no. 6: e0253282.

Review
Published: 10 June 2021 in Nutrients
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Aging and osteoarthritis are associated with high risk of muscle mass loss, which leads to physical disability; this loss can be effectively alleviated by diet (DI) and exercise (ET) interventions. This study investigated the relative effects of different types of diet, exercise, and combined treatment (DI+ET) on muscle mass and functional outcomes in individuals with obesity and lower-limb osteoarthritis. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of DI, ET, and DI+ET in patients with obesity and lower-extremity osteoarthritis. The included RCTs were analyzed through network meta-analysis and risk-of-bias assessment. We finally included 34 RCTs with a median (range/total) Physiotherapy Evidence Database score of 6.5 (4–8/10). DI plus resistance ET, resistance ET alone, and aerobic ET alone were ranked as the most effective treatments for increasing muscle mass (standard mean difference (SMD) = 1.40), muscle strength (SMD = 1.93), and walking speed (SMD = 0.46). Our findings suggest that DI+ET is beneficial overall for muscle mass in overweight or obese adults with lower-limb osteoarthritis, especially those who are undergoing weight management.

ACS Style

Shu-Fen Chu; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang; Chun-De Liao. Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients 2021, 13, 1992 .

AMA Style

Shu-Fen Chu, Tsan-Hon Liou, Hung-Chou Chen, Shih-Wei Huang, Chun-De Liao. Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients. 2021; 13 (6):1992.

Chicago/Turabian Style

Shu-Fen Chu; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang; Chun-De Liao. 2021. "Relative Efficacy of Weight Management, Exercise, and Combined Treatment for Muscle Mass and Physical Sarcopenia Indices in Adults with Overweight or Obesity and Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials." Nutrients 13, no. 6: 1992.

Journal article
Published: 09 April 2021 in International Journal of Environmental Research and Public Health
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Burn injuries cause disability and functional limitations in daily living. In a 2015 fire explosion in Taiwan, 499 young people sustained burn injuries. The construction of an effective and comprehensive rehabilitation program that enables patients to regain their previous function is imperative. The International Classification of Functioning, Disability, and Health (ICF) includes multiple dimensions that can contribute to meeting this goal. An ICF core set was developed in this study for Taiwanese patients with burns. A consensus process using three rounds of the Delphi technique was employed. A multidisciplinary team of 30 experts from various institutions was formed. The questionnaire used in this study comprised 162 ICF second-level categories relevant to burn injuries. A 5-point Likert scale was used, and participants assigned a weight to the effect of each category on daily activities after burns. The consensus among ratings was assessed using Spearman’s ρ and semi-interquartile range indices. The core set for post-acute SCI was developed from categories that attained a mean score of ≥4.0 in the third round of the Delphi exercise. The core ICF set contained 68 categories. Of these, 19 comprised the component of body functions, 5 comprised body structures, 37 comprised activities and participation, and 7 comprised environmental factors. This preliminary core set offers a comprehensive system for disability assessment and verification following burn injury. The core set provides information for effective rehabilitation strategy setting for patients with burns. Further feasibility and validation studies are required in the future.

ACS Style

Yu-Ru Lin; Jr-Yi Wang; Shun-Cheng Chang; Kwang-Hwa Chang; Hung-Chou Chen; Reuben Escorpizo; Shih-Wei Huang; Tsan-Hon Liou. Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries. International Journal of Environmental Research and Public Health 2021, 18, 3970 .

AMA Style

Yu-Ru Lin, Jr-Yi Wang, Shun-Cheng Chang, Kwang-Hwa Chang, Hung-Chou Chen, Reuben Escorpizo, Shih-Wei Huang, Tsan-Hon Liou. Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries. International Journal of Environmental Research and Public Health. 2021; 18 (8):3970.

Chicago/Turabian Style

Yu-Ru Lin; Jr-Yi Wang; Shun-Cheng Chang; Kwang-Hwa Chang; Hung-Chou Chen; Reuben Escorpizo; Shih-Wei Huang; Tsan-Hon Liou. 2021. "Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries." International Journal of Environmental Research and Public Health 18, no. 8: 3970.

Journal article
Published: 09 February 2021 in International Journal of Environmental Research and Public Health
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Osteoarthritis is one of the leading causes of disability. Total knee arthroplasty (TKA) is a surgical intervention for patients with severe osteoarthritis. Post TKA rehabilitation is crucial for improving patient’s quality of life. However, traditional rehabilitation has only focused on physical function; a systemic analysis of other dimensions such as social participation and environmental factors of post TKA rehabilitation is lacking. The aim of this study was to develop a core set from the International Classification of Functioning, Disability and Health (ICF) to create a comprehensive rehabilitation program for patients with osteoarthritis post TKA. Before the Delphi-based consensus process, a literature review process was performed for related ICF categories selection. We used a three-round Delphi-based consensus among 20 physical therapists with orthopedic rehabilitation expertise in a university-based hospital. A five-point Likert scale was used to rate the importance of each item. The consensus of ratings was analyzed using Spearman’s rho and semi-interquartile range indices. The ICF core set for post TKA rehabilitation was determined based on a high level of consensus and a mean score of ≥4.0 in the third Delphi-based consensus round. The ICF core set comprised 32 categories, with 13 regarding body function, four regarding body structures, nine regarding activities and participation, four regarding environmental factors, and two regarding personal factors. Our ICF core set for post TKA rehabilitation can provide information on effective rehabilitation strategies and goal setting for patients post TKA. However, further validation and feasibility assessments are warranted.

ACS Style

Shih-Wei Huang; Yi-Wen Chen; Reuben Escorpizo; Chun-De Liao; Tsan-Hon Liou. Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan. International Journal of Environmental Research and Public Health 2021, 18, 1630 .

AMA Style

Shih-Wei Huang, Yi-Wen Chen, Reuben Escorpizo, Chun-De Liao, Tsan-Hon Liou. Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan. International Journal of Environmental Research and Public Health. 2021; 18 (4):1630.

Chicago/Turabian Style

Shih-Wei Huang; Yi-Wen Chen; Reuben Escorpizo; Chun-De Liao; Tsan-Hon Liou. 2021. "Development International Classification of Functioning, Disability and Health Core Set for Post Total Knee Replacement Rehabilitation Program: Delphi-Based Consensus Study in Taiwan." International Journal of Environmental Research and Public Health 18, no. 4: 1630.

Journal article
Published: 04 February 2021 in Experimental Gerontology
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Osteosarcopenic adiposity (OSA), which is described as the concurrent occurrence of osteopenia, sarcopenia, and adiposity, can lead to frailty and increase the risk of physical disability in elderly women. Progressive elastic band resistance exercise training (peRET) is considered a safe and feasible exercise intervention for elderly women with sarcopenic obesity. This study investigated the effects of elastic band resistance exercise on the physical capacity and body composition of elderly women with osteosarcopenic adiposity. A total of 15 and 12 women were randomly assigned to the experimental (12 weeks of resistance exercise) and control groups (no exercise intervention), respectively. Lean mass (measured using a dual-energy X-ray absorptiometer) and physical capacity assessments (such as timed up and go test and single leg stance tests) were conducted at baseline, 12 weeks (end of intervention), and 6 months after the intervention. Outcome differences within the study and control groups were analyzed using repeated-measures analysis of variance with a post-hoc test. The Mann–Whitney U test was used to examine differences between groups at different time points. After the intervention, no body composition changes in muscle mass and fat were observed between the study and control groups. Moreover, muscle mass and fat body composition did not significantly differ at different time points. The bone density was higher in the study group, with a higher T-score than their baseline values, but did not significantly differ compared with the control group. The study group exhibited more improved physical function than the control group, but the effect did not last after 6 months of follow-up. A 12-week progressive elastic band resistance training program effectively increased the physical capacity and improved the bone density; however, without persistent training, the positive effect diminished at 6-month follow-up.

ACS Style

Yu-Hao Lee; Pi-Hsia Lee; Li-Fong Lin; Chun-De Liao; Tsan-Hon Liou; Shih-Wei Huang. Effects of progressive elastic band resistance exercise for aged osteosarcopenic adiposity women. Experimental Gerontology 2021, 147, 111272 .

AMA Style

Yu-Hao Lee, Pi-Hsia Lee, Li-Fong Lin, Chun-De Liao, Tsan-Hon Liou, Shih-Wei Huang. Effects of progressive elastic band resistance exercise for aged osteosarcopenic adiposity women. Experimental Gerontology. 2021; 147 ():111272.

Chicago/Turabian Style

Yu-Hao Lee; Pi-Hsia Lee; Li-Fong Lin; Chun-De Liao; Tsan-Hon Liou; Shih-Wei Huang. 2021. "Effects of progressive elastic band resistance exercise for aged osteosarcopenic adiposity women." Experimental Gerontology 147, no. : 111272.

Research article
Published: 01 January 2021 in Therapeutic Advances in Musculoskeletal Disease
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Introduction: Knee osteoarthritis (KOA) is associated with an increased risk of sarcopenia, and aging-related muscle deterioration continues after total knee replacement (TKR). Low skeletal muscle mass index may influence postoperative rehabilitation outcomes. Through this study, we aimed to investigate the impact of preoperative sarcopenia on clinical outcomes after postoperative rehabilitation in older Asian adults. Methods: A total of 190 older adults (39 men, 151 women) were enrolled from two previous trials and were classified as having no sarcopenia, class I sarcopenia, or class II sarcopenia according to definitions provided by the Asian Working Group for Sarcopenia (AWGS) and the European Working Group on Sarcopenia in Older People (EWGSOP). All patients were retrospectively analyzed before (T0) and after (T1) TKR rehabilitation and 10 months after surgery (T2). The outcome measures included the timed up-and-go test (TUGT), gait speed (GS), timed chair rise (TCR), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical difficulty (WOMAC-PF). With patient characteristics and T0 scores as covariates, an analysis of variance was performed to identify intergroup differences in changes of all outcome measures at T1 and T2. Results: According to the definitions of both the AWGS and EWGSOP, patients with class I and class II sarcopenia exhibited minor changes in TUGT, GS, TCR, and WOMAC-PF at T1 and T2 (all p < 0.05), compared with those without sarcopenia. For patients classified as having sarcopenia based on AWGS and EWGSOP definitions, no significant intergroup differences in WOMAC pain score was observed at T1 or T2 (all p > 0.05). Conclusions: Sarcopenia independently had negative impacts on the treatment effects of rehabilitation on physical mobility but not on pain outcome after TKR in older adults with KOA.

ACS Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis. Therapeutic Advances in Musculoskeletal Disease 2021, 13, 1 .

AMA Style

Chun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis. Therapeutic Advances in Musculoskeletal Disease. 2021; 13 ():1.

Chicago/Turabian Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2021. "Impact of sarcopenia on rehabilitation outcomes after total knee replacement in older adults with knee osteoarthritis." Therapeutic Advances in Musculoskeletal Disease 13, no. : 1.

Journal article
Published: 15 December 2020 in International Journal of Environmental Research and Public Health
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The aim of this study was to explore the association between employment status and World Health Organization Disability Assessment Schedule, Second Edition (WHODAS 2.0) scores of working-age subjects with hearing impairment. The data of 18,573 working-age subjects (age ≥ 18 and <65 years) with disabling hearing impairment were obtained from the Taiwan Data Bank of Persons with Disability (TDPD) for the period from 11 July 2012 to 31 October 2018. Demographic data and WHODAS 2.0 scores for each domain were analyzed to identify their relationship with employment status. Unemployed subjects with disabling hearing impairment had higher WHODAS 2.0 scores in all domains compared with the employed subjects. Binary logistic regression revealed that older age, female sex, lower educational level, institutional residence, rural residence, lower family income, and moderate to severe impairment were more strongly associated with unemployment status. The data in this large population-based study offer comprehensive information on important factors associated with the employment status of people with disabling hearing impairment. Early identification of risks of unemployment of patients with hearing impairment can raise awareness for aggressive community and government campaigns regarding public health to improve the self-confidence, social participation, and related psycho-social wellbeing of people.

ACS Style

Pin-Zhir Chao; Shih-Wei Huang; Reuben Escorpizo; Wen-Chou Chi; Chia-Feng Yen; Hua-Fang Liao; Yi-Wen Chen; Tsan-Hon Liou. Effects of Hearing Disability on the Employment Status Using WHODAS 2.0 in Taiwan. International Journal of Environmental Research and Public Health 2020, 17, 9374 .

AMA Style

Pin-Zhir Chao, Shih-Wei Huang, Reuben Escorpizo, Wen-Chou Chi, Chia-Feng Yen, Hua-Fang Liao, Yi-Wen Chen, Tsan-Hon Liou. Effects of Hearing Disability on the Employment Status Using WHODAS 2.0 in Taiwan. International Journal of Environmental Research and Public Health. 2020; 17 (24):9374.

Chicago/Turabian Style

Pin-Zhir Chao; Shih-Wei Huang; Reuben Escorpizo; Wen-Chou Chi; Chia-Feng Yen; Hua-Fang Liao; Yi-Wen Chen; Tsan-Hon Liou. 2020. "Effects of Hearing Disability on the Employment Status Using WHODAS 2.0 in Taiwan." International Journal of Environmental Research and Public Health 17, no. 24: 9374.

Journal article
Published: 11 July 2020 in Journal of Clinical Medicine
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(1) Background: Knee osteoarthritis (KOA) and aging are associated with high sarcopenia risk; sarcopenia may further affect outcomes after total knee replacement (TKR). Elastic resistance exercise training (RET) limits muscle attenuation in older adults. We aimed to identify the effects of post-TKR elastic RET on lean mass (LM) and functional outcomes in overweight and obese older women with KOA by using the brief International Classification of Functioning, Disability and Health Core Set for osteoarthritis (Brief-ICF-OA). (2) Methods: Eligible women aged ≥60 years who had received unilateral primary TKR were randomly divided into an experimental group (EG), which received postoperative RET twice weekly for 12 weeks, and a control group (CG), which received standard care. The primary and secondary outcome measures were LM and physical capacity, respectively, and were linked to the Brief-ICF-OA. The assessment time points were 2 weeks prior to surgery (T0) and postoperative at 1 month (T1; before RET) and 4 months (T2; upon completion of RET) of follow-up. An independent t test with an intention-to-treat analysis was conducted to determine the between-group differences in changes of outcome measures at T1 and T2 from T0. (3) Results: Forty patients (age: 70.9 ± 7.3 years) were randomly assigned to the EG (n = 20) or CG (n = 20). At T2, the EG exhibited significantly greater improvements in leg LM (mean difference (MD) = 0.86 kg, p = 0.004) and gait speed (MD = 0.26 m/s, p = 0.005) compared with the CG. Furthermore, the EG generally obtained significantly higher odds ratios than the CG for treatment success for most Brief-ICF-OA categories (all p < 0.001). Conclusions: Early intervention of elastic RET after TKR yielded positive postoperative outcomes based on the Brief-ICF-OA. The findings of this study may facilitate clinical decision-making regarding the optimal post-TKR rehabilitation strategy for older women with KOA.

ACS Style

Chun-De Liao; Yen-Shuo Chiu; Jan-Wen Ku; Shih-Wei Huang; Tsan-Hon Liou. Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial. Journal of Clinical Medicine 2020, 9, 2194 .

AMA Style

Chun-De Liao, Yen-Shuo Chiu, Jan-Wen Ku, Shih-Wei Huang, Tsan-Hon Liou. Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial. Journal of Clinical Medicine. 2020; 9 (7):2194.

Chicago/Turabian Style

Chun-De Liao; Yen-Shuo Chiu; Jan-Wen Ku; Shih-Wei Huang; Tsan-Hon Liou. 2020. "Effects of Elastic Resistance Exercise on Postoperative Outcomes Linked to the ICF Core Sets for Osteoarthritis after Total Knee Replacement in Overweight and Obese Older Women with Sarcopenia Risk: A Randomized Controlled Trial." Journal of Clinical Medicine 9, no. 7: 2194.

Journal article
Published: 13 March 2020 in Journal of Clinical Medicine
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Patients with axial spondyloarthritis (ax-SpA) present with inflammation invading the axial skeleton. Symptoms of ax-SpA interfere with patients’ quality of life, and peripheral symptoms are also noted. Human leukocyte antigen B27 was associated with adhesive capsulitis. However, epidemiological studies investigating the associated incidence and risk factors for patients with ax-SpA with adhesive capsulitis are limited. The data of patients with ax-SpA were recorded during the 2004–2008 period and followed to the end of 2010. The control cohort comprised age- and sex-matched non-ax-SpA subjects. A Cox multivariate proportional hazards model was applied to analyze the risk factors for adhesive capsulitis. The hazard ratio (HR) and adjusted hazard ratio (aHR) were estimated between the study and control cohorts after confounders were adjusted for. Effects of sulfasalazine (SSZ), methotrexate (MTX), and hydroxychloroquine (HCQ) use on adhesive capsulitis risk were also analyzed. We enrolled 2859 patients with ax-SpA in the study cohort and 11,436 control subjects. A higher incidence of adhesive capsulitis was revealed in the ax-SpA cohort: The crude HR was 1.63 (95% CI, 1.24–2.13; p < 0.001), and the aHR was 1.54 (95% CI, 1.16–2.05; p = 0.002). For patients with ax-SpA using SSZ or HCQ, no difference in aHR was noted compared with control participants, but patients with ax-SpA treated with MTX had higher HR and aHR than controls. Patients with ax-SpA are at risk for adhesive capsulitis. When these patients receive SSZ or HCQ, the risk of adhesive capsulitis can be lowered compared with that of the control cohort.

ACS Style

Shih-Wei Huang; Jr-Yi Wang; Che-Li Lin; Chi-Chang Huang; Tsan-Hon Liou; Hui-Wen Lin. Patients with Axial Spondyloarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan. Journal of Clinical Medicine 2020, 9, 787 .

AMA Style

Shih-Wei Huang, Jr-Yi Wang, Che-Li Lin, Chi-Chang Huang, Tsan-Hon Liou, Hui-Wen Lin. Patients with Axial Spondyloarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan. Journal of Clinical Medicine. 2020; 9 (3):787.

Chicago/Turabian Style

Shih-Wei Huang; Jr-Yi Wang; Che-Li Lin; Chi-Chang Huang; Tsan-Hon Liou; Hui-Wen Lin. 2020. "Patients with Axial Spondyloarthritis Are at Risk of Developing Adhesive Capsulitis: Real-World Evidence Database Study in Taiwan." Journal of Clinical Medicine 9, no. 3: 787.

Journal article
Published: 17 December 2019 in Clinical Nutrition
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The beneficial effects of protein supplementation on aerobic exercise-induced gains in patients with stroke are currently unknown. This study evaluated the feasibility and potential value of protein supplementation with aerobic exercise among stroke survivors. This double-blinded randomized controlled pilot study included 20 ambulatory persons with chronic (>6 months) stroke randomly assigned to either the protein (PRO) or carbohydrate (CHO) group. All participants received three 40-min cycling ergometric training sessions a week for 8 weeks. Training intensity at 60%∼80% heart rate reserve was determined using cardiopulmonary exercise pretests. Immediately before and after each session, the PRO group received a 20-g protein-rich supplement, and the CHO group received a 20-g calorie-matched carbohydrate-rich supplement. Outcomes included changes in body composition, cardiopulmonary capacity, and clinical functional performance. Those completing the protocol (n=18) received 18∼24 cycling training sessions, achieving target training intensity without major adverse effects. Of the two groups, the PRO group tended to obtain greater aerobic capacity (effect size [ES]>0.5 in every cardiopulmonary index), greater improvements in functional performance (0.25

ACS Style

Yu-Hsuan Cheng; Li Wei; Wing P. Chan; Chih-Yang Hsu; Shih-Wei Huang; Heng Wang; Yen-Nung Lin. Effects of protein supplementation on aerobic training-induced gains in cardiopulmonary fitness, muscle mass, and functional performance in chronic stroke: A randomized controlled pilot study. Clinical Nutrition 2019, 39, 2743 -2750.

AMA Style

Yu-Hsuan Cheng, Li Wei, Wing P. Chan, Chih-Yang Hsu, Shih-Wei Huang, Heng Wang, Yen-Nung Lin. Effects of protein supplementation on aerobic training-induced gains in cardiopulmonary fitness, muscle mass, and functional performance in chronic stroke: A randomized controlled pilot study. Clinical Nutrition. 2019; 39 (9):2743-2750.

Chicago/Turabian Style

Yu-Hsuan Cheng; Li Wei; Wing P. Chan; Chih-Yang Hsu; Shih-Wei Huang; Heng Wang; Yen-Nung Lin. 2019. "Effects of protein supplementation on aerobic training-induced gains in cardiopulmonary fitness, muscle mass, and functional performance in chronic stroke: A randomized controlled pilot study." Clinical Nutrition 39, no. 9: 2743-2750.

Review
Published: 18 October 2019 in Arthritis Care & Research
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Objective To investigate the effect of muscle strength exercise training (MSET) on lean mass (LM) gain and muscle hypertrophy in older patients with lower limb osteoarthritis (OA). Methods A comprehensive search of online databases was performed until April 20, 2019. Randomized controlled trials (RCTs) that reported the effects of MSET on LM, muscle thickness, and cross‐sectional area (CSA) in older patients with OA were identified. A risk of bias assessment and meta‐analysis were performed for the included RCTs. Results We included 19 RCTs with a median PEDro score of 6 (range: 3–7) out of 10. In total, 1195 patients (65% women, 85% with knee OA) with a mean age of 62.1 (range: 40–86) years were analyzed. MSET resulted in significantly higher LM gain (standard mean difference [SMD]: 0.49; 95% confidence interval [CI]: 0.28, 0.71; P < 0.00001) than did the nonexercise controls. Meta‐analysis results revealed significantly positive effects of MSET on muscle thickness (SMD: 0.82; 95% CI: 0.20, 1.43; P = 0.009) and CSA (SMD: 0.80; 95% CI: 0.25, 1.35; P = 0.004) compared with nonexercise controls. No significant effects in favor of MSET were observed for any muscle outcome compared with exercise controls. Five RCTs reported nonsevere adverse events in response to MSET, whereas no RCTs reported severe events. Conclusion MSET is effective in increasing LM and muscle size in older adults with OA. Clinicians should incorporate MSET into their management of patients at risk of low muscle mass to maximize health status, particularly for older individuals with OA.

ACS Style

Chun‐De Liao; Hung‐Chou Chen; Yu‐Chi Kuo; Jau‐Yih Tsauo; Shih‐Wei Huang; Tsan‐Hon Liou. Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis. Arthritis Care & Research 2019, 72, 1703 -1718.

AMA Style

Chun‐De Liao, Hung‐Chou Chen, Yu‐Chi Kuo, Jau‐Yih Tsauo, Shih‐Wei Huang, Tsan‐Hon Liou. Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis. Arthritis Care & Research. 2019; 72 (12):1703-1718.

Chicago/Turabian Style

Chun‐De Liao; Hung‐Chou Chen; Yu‐Chi Kuo; Jau‐Yih Tsauo; Shih‐Wei Huang; Tsan‐Hon Liou. 2019. "Effects of Muscle Strength Training on Muscle Mass Gain and Hypertrophy in Older Adults With Osteoarthritis: A Systematic Review and Meta‐Analysis." Arthritis Care & Research 72, no. 12: 1703-1718.

Review
Published: 10 October 2019 in Nutrients
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Note: In lieu of an abstract, this is an excerpt from the first page. We thank Chen et al

ACS Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713". Nutrients 2019, 11, 2420 .

AMA Style

Chun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713". Nutrients. 2019; 11 (10):2420.

Chicago/Turabian Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2019. "Reply to: "Comment on the Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials, Nutrients 2019, 11, 1713"." Nutrients 11, no. 10: 2420.

Review
Published: 25 July 2019 in Nutrients
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Aging and frailty are associated with a high risk of lean mass (LM) loss, which leads to physical disability and can be effectively alleviated by protein supplementation (PS) and muscle strengthening exercise (MSE). In this study, the associations between LM gain and PS + MSE efficacy (measured using physical outcomes) in elderly patients with a high risk of sarcopenia or frailty were identified. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) reporting the efficacy of PS + MSE in elderly patients with sarcopenia or frailty. The included RCTs were analyzed using meta-analysis and risk of bias assessment. We finally included 19 RCTs in this meta-analysis with a median (range/total) Physiotherapy Evidence Database score of 7/10 (5-9/10). The PS + MSE group exhibited significant improvements in the whole-body LM (standard mean difference (SMD) = 0.66; p < 0.00001), appendicular LM (SMD = 0.35; p < 0.00001), leg strength (SMD = 0.65; p < 0.00001), and walking capability (SMD = 0.33; p = 0.0006). Meta-regression analyses showed that changes in appendicular LM were significantly associated with the effect sizes of leg strength (β = 0.08; p = 0.003) and walking capability (β = 0.17; p = 0.04), respectively. Our findings suggest that LM gain after PS + MSE significantly contributes to the efficacy of the intervention in terms of muscle strength and physical mobility in elderly patients with a high risk of sarcopenia or frailty.

ACS Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Nutrients 2019, 11, 1713 .

AMA Style

Chun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou. The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials. Nutrients. 2019; 11 (8):1713.

Chicago/Turabian Style

Chun-De Liao; Hung-Chou Chen; Shih-Wei Huang; Tsan-Hon Liou. 2019. "The Role of Muscle Mass Gain Following Protein Supplementation Plus Exercise Therapy in Older Adults with Sarcopenia and Frailty Risks: A Systematic Review and Meta-Regression Analysis of Randomized Trials." Nutrients 11, no. 8: 1713.

Randomized controlled trial
Published: 01 July 2019 in European Journal of Physical and Rehabilitation Medicine
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For patients with chronic shoulder pain and supraspinatus tendinopathy, ultrasound-guided hypertonic dextrose injections can provide relief from pain, disability, and shoulder range of motion for up to 2 weeks after intervention.

ACS Style

Che-Li Lin; Chi-Chang Huang; Shih-Wei Huang. Effects of hypertonic dextrose injection in chronic supraspinatus tendinopathy of the shoulder: a randomized placebo-controlled trial. European Journal of Physical and Rehabilitation Medicine 2019, 55, 480 -487.

AMA Style

Che-Li Lin, Chi-Chang Huang, Shih-Wei Huang. Effects of hypertonic dextrose injection in chronic supraspinatus tendinopathy of the shoulder: a randomized placebo-controlled trial. European Journal of Physical and Rehabilitation Medicine. 2019; 55 (4):480-487.

Chicago/Turabian Style

Che-Li Lin; Chi-Chang Huang; Shih-Wei Huang. 2019. "Effects of hypertonic dextrose injection in chronic supraspinatus tendinopathy of the shoulder: a randomized placebo-controlled trial." European Journal of Physical and Rehabilitation Medicine 55, no. 4: 480-487.

Journal article
Published: 26 April 2019 in International Journal of Environmental Research and Public Health
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Patients with traumatic brain injury (TBI) often present with disabilities associated with a high burden of care for caregivers or family members at home. When family members cannot afford to care for patients with TBI, they are often required to find them residence in long-term care institutions. To date, there are no quantitative assessment tools developed to predict institutionalization. Therefore, this study analyzed the accuracy of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for predicting the institutionalization of patients with TBI. We designed a cross-sectional study using a nationwide disability database. We analyzed the data of 8630 patients with TBI with injury for more than six months from the Taiwan Data Bank of Persons with Disability during July 2012-October 2018. The demographic data and WHODAS 2.0 standardized scores of patients with TBI who resided in community and long-term care institutions were analyzed. Receiver operating characteristic curve (ROC) analysis was performed to investigate the predictive accuracy of WHODAS 2.0 for being institutionalized, and the optimal cut-off point was determined using the Youden index. Binary logistic regression was employed to determine the predictors of the participants being institutionalized. The WHODAS 2.0 scores in each domain were lower in the community group than in the institutionalized group. ROC analysis revealed the highest accuracy for the summary scores of WHODAS 2.0 (area under the curve = 0.769). Binary logistic regression revealed that age, gender, work status, urbanization level, socioeconomic status, severity of impairment, and WHODAS 2.0 domain scores were factors associated with the institutionalization status of patients with TBI. Our results suggest that WHODAS 2.0 may be a feasible assessment tool for predicting the institutionalization of patients with TBI.

ACS Style

Shih-Wei Huang; Kwang-Hwa Chang; Reuben Escorpizo; Feng-Hang Chang; Tsan-Hon Liou. WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury. International Journal of Environmental Research and Public Health 2019, 16, 1484 .

AMA Style

Shih-Wei Huang, Kwang-Hwa Chang, Reuben Escorpizo, Feng-Hang Chang, Tsan-Hon Liou. WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury. International Journal of Environmental Research and Public Health. 2019; 16 (9):1484.

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Shih-Wei Huang; Kwang-Hwa Chang; Reuben Escorpizo; Feng-Hang Chang; Tsan-Hon Liou. 2019. "WHODAS 2.0 Can Predict Institutionalization among Patients with Traumatic Brain Injury." International Journal of Environmental Research and Public Health 16, no. 9: 1484.

Review
Published: 24 April 2019 in Clinical Rehabilitation
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Objective:This study determined the clinical efficacy of extracorporeal shockwave therapy and the predictors of its efficacy for knee osteoarthritis.Data Sources:Electronic databases and search engines, namely MEDLINE, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Academic Journals Full-text Database, and Google Scholar, were searched until 5 March 2019, for randomized controlled trials without restrictions on language and publication year.Review Methods:Eligible trials and extracted data were identified by two independent investigators. The included articles were subjected to a meta-analysis and risk of bias assessment. Outcomes of interest included treatment success rate, pain, and physical function outcomes. A meta-regression analysis was performed to determine the predictors of treatment outcomes following shockwave therapy.Results:We included 50 trials (4844 patients) with a median (range) PEDro score of 6 (5–9). Meta-analyses results revealed an overall significant effect favoring shockwave therapy on the treatment success rate (odds ratio 3.22, 95% confidence interval (CI) 2.21–4.69, P < 0.00001; heterogeneity ( I2) = 62%), pain reduction (standardized mean difference (SMD) −2.02, 95% CI −2.38 to −1.67, P < 0.00001; I2= 95%), and Western Ontario and McMaster Universities Osteoarthritis Index function outcome (SMD −2.71, 95% CI −3.50 to −1.92, P < 0.00001; I2= 97%). Follow-up duration and energy flux density were independent significant predictors of shockwave efficacy.Conclusion:Shockwave therapy is beneficial for knee osteoarthritis. Shockwave dosage, particularly the energy level and intervention duration, may have different contributions to treatment efficacy.

ACS Style

Chun-De Liao; Jau-Yih Tsauo; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang. Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials. Clinical Rehabilitation 2019, 33, 1419 -1430.

AMA Style

Chun-De Liao, Jau-Yih Tsauo, Tsan-Hon Liou, Hung-Chou Chen, Shih-Wei Huang. Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials. Clinical Rehabilitation. 2019; 33 (9):1419-1430.

Chicago/Turabian Style

Chun-De Liao; Jau-Yih Tsauo; Tsan-Hon Liou; Hung-Chou Chen; Shih-Wei Huang. 2019. "Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials." Clinical Rehabilitation 33, no. 9: 1419-1430.

Review
Published: 12 April 2019 in Clinical Rehabilitation
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Objective: The aim of this study is to investigate the effectiveness of electrical stimulation in arm function recovery after stroke. Methods: Data were obtained from the PubMed, Cochrane Library, Embase, and Scopus databases from their inception until 12 January 2019. Only randomized controlled trials (RCTs) reporting the effects of electrical stimulation on the recovery of arm function after stroke were selected. Results: Forty-eight RCTs with a total of 1712 patients were included in the analysis. The body function assessment, Upper-Extremity Fugl-Meyer Assessment, indicated more favorable outcomes in the electrical stimulation group than in the placebo group immediately after treatment (23 RCTs ( n = 794): standard mean difference (SMD) = 0.67, 95% confidence interval (CI) = 0.51–0.84) and at follow-up (12 RCTs ( n = 391): SMD = 0.66, 95% CI = 0.35–0.97). The activity assessment, Action Research Arm Test, revealed superior outcomes in the electrical stimulation group than those in the placebo group immediately after treatment (10 RCTs ( n = 411): SMD = 0.70, 95% CI = 0.39–1.02) and at follow-up (8 RCTs ( n = 289): SMD = 0.93, 95% CI = 0.34–1.52). Other activity assessments, including Wolf Motor Function Test, Box and Block Test, and Motor Activity Log, also revealed superior outcomes in the electrical stimulation group than those in the placebo group. Comparisons between three types of electrical stimulation (sensory, cyclic, and electromyography-triggered electrical stimulation) groups revealed no significant differences in the body function and activity. Conclusion: Electrical stimulation therapy can effectively improve the arm function in stroke patients.

ACS Style

Jheng-Dao Yang; Chun-De Liao; Shih-Wei Huang; Ka-Wai Tam; Tsan-Hon Liou; Yu-Hao Lee; Chia-Yun Lin; Hung-Chou Chen. Effectiveness of electrical stimulation therapy in improving arm function after stroke: a systematic review and a meta-analysis of randomised controlled trials. Clinical Rehabilitation 2019, 33, 1286 -1297.

AMA Style

Jheng-Dao Yang, Chun-De Liao, Shih-Wei Huang, Ka-Wai Tam, Tsan-Hon Liou, Yu-Hao Lee, Chia-Yun Lin, Hung-Chou Chen. Effectiveness of electrical stimulation therapy in improving arm function after stroke: a systematic review and a meta-analysis of randomised controlled trials. Clinical Rehabilitation. 2019; 33 (8):1286-1297.

Chicago/Turabian Style

Jheng-Dao Yang; Chun-De Liao; Shih-Wei Huang; Ka-Wai Tam; Tsan-Hon Liou; Yu-Hao Lee; Chia-Yun Lin; Hung-Chou Chen. 2019. "Effectiveness of electrical stimulation therapy in improving arm function after stroke: a systematic review and a meta-analysis of randomised controlled trials." Clinical Rehabilitation 33, no. 8: 1286-1297.

Review
Published: 13 March 2019 in Clinical Rehabilitation
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The aim of this study was to evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on the post-stroke recovery of lower limb motor function. We searched the databases of PubMed, Cochrane Library, and Embase. The randomized controlled trials were published by 25 January 2019. We included randomized controlled trials that evaluated the effects of rTMS on lower limb motor recovery in patients with stroke. Two reviewers independently screened the searched records, extracted data, and assessed the risk of bias. The treatment effect sizes were pooled in a meta-analysis by using the RevMan 5.3 software. The internal validity was assessed using topics suggested by the Physiotherapy Evidence Database (PEDro). Eight studies with 169 participants were included in the meta-analysis. Pooled estimates demonstrated that rTMS significantly improved the body function of the lower limbs (standardized mean difference (SMD) = 0.66; P < 0.01), lower limb activity (SMD = 0.66; P < 0.01), and motor-evoked potential (SMD = 1.13; P < 0.01). The subgroup analyses results also revealed that rTMS improved walking speed (SMD = 1.13) and lower limb scores on the Fugl-Meyer Assessment scale (SMD = 0.63). We found no significant differences between the groups in different mean post-stroke time or stimulation mode over lower limb motor recovery. Only one study reported mild adverse effects. rTMS may have short-term therapeutic effects on the lower limbs of patients with stroke. Furthermore, the application of rTMS is safe. However, this evidence is limited by a potential risk of bias.

ACS Style

Yi-Chun Tung; Chien-Hung Lai; Chun-De Liao; Shih-Wei Huang; Tsan-Hon Liou; Hung-Chou Chen. Repetitive transcranial magnetic stimulation of lower limb motor function in patients with stroke: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation 2019, 33, 1102 -1112.

AMA Style

Yi-Chun Tung, Chien-Hung Lai, Chun-De Liao, Shih-Wei Huang, Tsan-Hon Liou, Hung-Chou Chen. Repetitive transcranial magnetic stimulation of lower limb motor function in patients with stroke: a systematic review and meta-analysis of randomized controlled trials. Clinical Rehabilitation. 2019; 33 (7):1102-1112.

Chicago/Turabian Style

Yi-Chun Tung; Chien-Hung Lai; Chun-De Liao; Shih-Wei Huang; Tsan-Hon Liou; Hung-Chou Chen. 2019. "Repetitive transcranial magnetic stimulation of lower limb motor function in patients with stroke: a systematic review and meta-analysis of randomized controlled trials." Clinical Rehabilitation 33, no. 7: 1102-1112.

Rheumatology
Published: 25 February 2019 in BMJ Open
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Objectives Autoimmune connective tissue diseases (ACTDs) commonly involve the shoulder joint; however, clinical epidemiological studies investigating their association with tendons are scant. Rotator cuff (RC) tears can cause shoulder disability, and surgical intervention is usually required. The study investigated RC repair surgery risk in ACTD patients. The effect of anti-inflammatory medication on RC repair surgery risk was also investigated. Methods We conducted a retrospective cohort study with a 7-year longitudinal follow-up period. Patients with systemic lupus erythematosus, systemic sclerosis, sicca syndrome, dermatomyositis and polymyositis diagnoses between 2004 and 2008 were enrolled. The control cohort comprised age- and sex-matched controls. The HR and adjusted HR (aHR) were estimated for the risk of RC surgery between ACTD and control cohorts after adjustment for confounders. Furthermore, the effects of steroid and non-steroidal anti-inflammatory drug (NSAID) use on the HR and aHR of RC surgery risk were analysed. Results We enrolled 5019 ACTD patients and 25 095 controls in the ACTD and control cohorts, respectively. RC surgery incidence was 49 and 24 per 100 000 person-years in the ACTD and control cohorts, respectively. In the ACTD cohort, the crude HR for RC surgery was 2.08 (95% CI , 1.08 to 4.02, p<0.05), and the aHR was 1.97 (95% CI, 1.01 to 3.82, p<0.05). The ACTD patients who used NSAIDs had an aHR of 3.13 (95% CI, 1.21 to 8.07, p<0.05) compared with the controls, but the ACTD patients who used steroids did not have a significantly higher aHR than the controls. Conclusions ACTD patients had an increased risk of RC repair surgery. However, no difference was found in RC surgery risk when steroids were used compared with the control cohort. This could indicate that inflammation control may be a strategy for managing subsequent RC lesions.

ACS Style

Shih-Wei Huang; Che-Li Lin; Li-Fong Lin; Chi-Chang Huang; Tsan-Hon Liou; Hui-Wen Lin. Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study. BMJ Open 2019, 9, e023848 .

AMA Style

Shih-Wei Huang, Che-Li Lin, Li-Fong Lin, Chi-Chang Huang, Tsan-Hon Liou, Hui-Wen Lin. Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study. BMJ Open. 2019; 9 (2):e023848.

Chicago/Turabian Style

Shih-Wei Huang; Che-Li Lin; Li-Fong Lin; Chi-Chang Huang; Tsan-Hon Liou; Hui-Wen Lin. 2019. "Autoimmune Connective Tissue Diseases and the Risk of Rotator Cuff Repair Surgery: A Population-Based Retrospective Cohort Study." BMJ Open 9, no. 2: e023848.