Article in PDF
How to Cite
Citation Manager
Readers' Comments (0)
Audio Visual Article Statistics
Link
to PUBMED
Print this Article
Send to a Friend
Advertisers
Access Statistics Resources
Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."
Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011
Dr. Shankar P.R.
"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."
Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011 Anuradha
Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.
Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020
Original article / research
Full Version
Impact of Knee Osteoarthritis on Physical Performance and Quality of Life in Obese Adults: A Cross-sectional Study
Correspondence Address :
Dr. R Angeline,
Faculty of Physiotherapy, Sri Ramachandra Institute of Higher Education and Research,
No. 1, Ramachandra Nagar, Porur, Chennai-600116, Tamil Nadu, India.
E-mail: angelinejobin75@gmail.com
Introduction: Obese subjects with Knee Osteoarthritis (KOA) demonstrate poor Physical Performance (PP) and impaired Quality Of Life (QOL). The burden of OA in obese subjects is not well understood.
Aim: To evaluate PP and QOL in obese subjects with KOA and in obese subjects without KOA.
Materials and Methods: A cross-sectional observational study was conducted at the Outpatient Physiotherapy Department, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India, from July 2017 to June 2018. Twenty-four obese subjects with and without KOA were included in the current study based on their BMI and American College of Rheumatological criteria for OA knee. The subjects were randomly allocated into two groups with; Obese KOA and Obese non KOA. All subjects were evaluated for anthropometric (BMI, Waist-Hip Ratio and Fat Percentage) and PP {30 Second Chair Stand Test (SCST), Stair Climb Test (SCT), 40 m Fast-Paced Walk Test (40 m FPWT), Timed up and Go test (TUGT), 6 Minute Walk Test (6 MWT)}. Additionally, all subjects responded to self-reported disability measures (KOA Outcome Score - KOOS) and Medical Outcome Study Short Form measure (SF-36).
Results: Intergroup statistical difference was found in both PP and QOL. The PP and QOL was significantly lower in obese KOA subjects when compared with their counterparts, {mean±SD; 30 SCST (8.58±1.62 vs 17.08±3.26), SCT (36.25±13.16 vs 9.58±1.62), 40 m FPWT (64.75±14.35 vs 29.92±3.99), TUGT (17.7±2.42 vs 7.58±1.51), 6 MWT (244.25±63.03 vs 508.83±76.42), KOOS (42.52±5.73 vs 91.42±4.58), SF-36- Physical, Mental Cumulative Health Score (36.23±5.7, 45.52±9.13 ; 53.80±2.15, 53.89±2.47); (p<0.05)}.
Conclusion: The KOA is a predictor for reduction of PP and QOL among obese subjects. Early physiotherapy intervention of obese subjects may prevent KOA and helps to progress or maintain PP and QOL in obese subjects.
Obesity, Physiotherapy, Six minute walk test, Timed up and go test
Obesity increases the risk of KOA, specifically in the patellofemoral and the tibiofemoral (1). The presence of KOA causes functional deficits, loss of independence in performing everyday Activities of Daily Living (ADL), depression, and social isolation, thereby increasing the risk of morbidity and mortality and impairing individuals’ lifestyles (2).
Obesity accelerates degeneration of the knee joint, and it is related to the degree of PP and QOL. Morbidly obese KOA adults face limitations in PP and express poor QOL. PP and QOL in obese adults with KOA are comparatively poor compared to non KOA obese adults (3),(4). Increased Body Mass Index (BMI) is associated with the progression of KOA. Thus, obesity is an obvious risk factor for the development of KOA also an essential determinant for the advancement of KOA (5). Obesity is significantly associated with arthritis and other systemic illness like diabetes, high cholesterol levels, asthma, and hypertension. More the BMI, the higher the risk for arthritis (6). Therefore, there is a generalised decrease in physical activity in obese subjects. The novelty of this research is that this study examines the relationship of PP, QOL in obese subjects with and without KOA. The burden of KOA in morbidity obese subjects is yet to be explored. The level of PP in morbidly obese KOA subjects remains unclear (7). It is crucial to find strategies to reduce the burden of KOA, especially in morbidly obese subjects. Obese subjects with KOA are at greater risk for mortality than obese non KOA counterparts. This study aims to evaluate the burden of KOA by measuring PP, QOL in obese subjects.
A cross-sectional observational study was conducted at the Outpatient Physiotherapy Department, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India, from July 2017 to June 2018, after obtaining approval (CSP/15/SEP/43/49) from Institutional Ethical Committee. Written informed consent was obtained from all the participants in both groups. Twenty-four obese adults with KOA and without KOA were included in the study from the rehabilitation centre of Sri Ramachandra Hospital.
Sample size calculation: G*Power 3 software was used to calculate the sample size. The sample size estimation was done with sample power (based on the PP test- 6 MWT). Considering a moderate effect size of 0.25, a power of 80%, and an alpha error of 5% (standard deviation=30 metres, clinically significant difference=60 metres). The calculations suggested that each group should contain ten participants atleast.
Inclusion criteria: Inclusion criteria for participation were as follows: obese subjects with BMI of ≥30 kg/m2 (8), numerical pain rating scale (Score less than or equal to 3 out of 10), fulfillment of the American College of Rheumatological criteria for OA knee (9), symptomatically and radiographically verified KOA with Kellgren-Lawrence grades 1-3 were included (10), sufficient cognition and communication skills to understand the nature of the study.
Exclusion criteria: The participants were excluded if they had: chronic, acute cardiac and pulmonary problems, acute and chronic systemic conditions, recent musculoskeletal lower extremity injuries and infections, any former orthopaedic surgeries or patients awaiting joint replacement surgery, neurological disorders that have a potential effect on ambulation, insulin-dependent diabetes, drug-induced fatigability and drowsiness (11).
Twelve obese non KOA subjects were included in the control group with a BMI ≥30 kg/m2 and age of 57.08±8.028 (Mean±SD) years. The groups were matched for gender, age, and BMI.
Measurements
Anthropometrics: Measurement of height was made using a clinical stadiometer, and body weight was measured using a calibrated scale. Using this method, BMI was derived (12). Waist-Hip ratio was measured using a measuring tape. According to the World Health Organisation (WHO), abdominal obesity is defined as a waist-to-hip ratio of at least 0.90 in men. For women, the ratio is at least 0.85. For either sex, a ratio greater than 1.0 indicates a substantially higher risk of health problems (13).
Minimal abdominal circumference was measured between the lower edge of the ribcage. Hip circumference was measured around the gluteal muscle below the iliac crest. Fat percentage was calculated using Omron Body Fat analyser (14). For all values, three mean readings were taken, and the average value was documented.
Physical Performance (PP)
The OARSI-recommended performance-based test was used to measure PP in both participant groups. (Table/Fig 1) describes the tests (15),(16),(17),(18),(19),(20),(21).
Osteoarthritis Related Disability
The KOOS questionnaire is a self-administered tool to assess the physical functioning of the individuals. The KOOS consist of five sub-categories- Pain, Symptoms, ADL, Sports and Recreational activities, Knee-related QOL (22).
Quality of Life (QOL): The SF-36 (Short Form-36) is a generic measure of health status, multipurpose with 36 questions. The SF-36 consists of questions based on both physical and mental health, categories under eight sub-scales. It is a self-administered questionnaire with questions targeting functional health and well-being. There are four sub-scales under physical and mental health each. The scores are calculated using Health Outcomes Scoring Software 5.1 (Quality Metric) (23).
Statistical Analysis
All statistical tests were performed using SPSS 10.0 Statistical Software. Results were presented as mean±standard deviation as appropriate. Normally distributed parametric variables (Performance tests and QOL) were compared using “independent t-test”. For all tests, statistical significance was set at 0.05 (two-tailed).
There was no difference between groups with regards to age, gender, height, weight, BMI, waist-hip ratio, fat percentage. (Table/Fig 2). There was significant difference between two groups with regards to 30 SCST, SCT, 40 m FPWT, TUGT, 6MWT. In addition, a significant difference was noted in SF-36 and KOOS (Table/Fig 3).
The study results showed that obese KOA subjects had lower PP and impaired QOL compared with their counterparts. Lower PP was associated with age, gender, BMI, hip-waist ratio, and fat percentage. The present study proves that KOA was related to low PP in obese subjects. Thirty SCST was used to measure lower extremity muscle strength and power. Obese KOA subjects demonstrated low repetitions in 30 SCST. One of the reasons for low repetition may be poor lower extremity muscle strength and degenerative changes (24).
The SCT was used to assess lower limb strength and dynamic balance. The statistical intergroup difference was found that the time taken to complete the test was higher in obese KOA than obese counterparts. Intergroup statistical difference was found in both SCT and 40 m FPWT. This is in accordance with the study findings of Khan SJ et al., 2020 (25). Khan SJ et al., demonstrated in their study that twenty KOA subjects have significantly higher SCT and 40 m FPWT than healthy normal subjects. There was an increase in time taken to ascend and descend stairs in obese KOA subjects with SCT. This may be because more muscle force was required in ascending/descending stairs than level walking (25). The TUG is a test for lower limb strength, agility, and dynamic balance that involves a series of transition phases-sitting-to-stand, walking a shorter distance, and changing direction. Obese KOA subjects took above 17 seconds to complete TUG than obese non KOA subjects. These results were similar to a study done by Shumway Cook A et al., which showed that adults who take longer than 14 s to complete the TUG have low dynamic balance (19).
In the present study, a statistical intergroup difference was found in 6 MWT. A 6 MWT was used to estimate the long-distance walking capacity of the subjects. It was significantly lower for obese KOA subjects. Walking was often affected as a direct result of obesity through excess weight-bearing. Walking capacity may be reduced due to mechanical complications such as KOA or lower extremity joint pain. Our obese healthy subjects walked a significantly longer distance in 6 MWT than obese patients with knee OA; this was in accordance with a study published by Sutbeyaz ST et al., 2007 (26).
The KOOS is a knee-specific instrument developed to measure patients’ opinions about their knees and related problems. In this study, obese KOA subjects showed lower scores than obese subjects. Results imply that the KOOS scores vary significantly with obese KOA than their counterparts (21),(27). Many studies have shown that obese KOA has poor QOL (27),(28),(29),(30),(31),(32). They conclude that KOA has a substantial impact on QOL. In KOA patients, QOL is also influenced by specific individual factors, including gender, body weight, physical activity, mental health, and education (32). Moreover, obese patients with KOA had significantly impaired health-related QOL, compared with obese counterparts, especially regarding the physical aspects of daily life, suggesting that obesity plus KOA might lead to further impaired QOL. The findings in the present study tend to confirm previous study findings that have shown the same (33),(34).
Several studies (19), (25),(26),(27),(28),(29),(30),(31),(32),(33),(34) have demonstrated that obese subjects have a low QOL. Moreover, the obese KOA subjects in the present study had significantly impaired physical and mental health compared to obese subjects. Hence, we conclude that obesity along KOA will lead to a further reduction in QOL. In summary, the present study proves that obesity with KOA will lead to PP deficits and reduce the QOL.
Limitation(s)
Smaller sample size, extensive age group range (subject age more than 55 years), physical activity, and occupational differences of subjects not considered.
Obese subjects with KOA show poor PP and QOL. The present study demonstrated that KOA further reduces PP and QOL in obese subjects. The current evidence points that KOA is a predictor for the reduction of PP and QOL among obese subjects.
DOI: 10.7860/JCDR/2022/52028.15924
Date of Submission: Aug 20, 2021
Date of Peer Review: Oct 29, 2021
Date of Acceptance: Dec 10, 2021
Date of Publishing: Jan 01, 2022
AUTHOR DECLARATION:
52028
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Aug 21, 2021
• Manual Googling: Aug 31, 2021
• iThenticate Software: Dec 09, 2021 (13%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com