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Musculoskeletal disorders (MSDs) are medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed. A major restriction of joint movement range was frequent in the shoulder but uncommon in other joints(1).
Types of Musculo-Skeletal disorders in elder(2)
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
7. Low back pain
Osteoarthritis (OA), a form of arthritis, is defined as a condition of as a result of aging causes of wear and tear on a joint, affecting over 25 million people in the United States in alone. University of Porto Medical School indicated that one must understand the differences in prevalence and incidence estimates of osteoarthritis (OA), according to case definition, in knee, hip and hand joints(3).
The characteristics of osteoarthritis are aching pain(5), stiffness(6), or difficulty of moving the joint or joints(7). The pain usually gets worse in change of weather, at night and in the advanced diseases, the pain can occur even at rest(8). Today management of osteoarthritis (OA) focuses on pain relief and improved physical function through pharmacological, non pharmacological, and surgical treatments(4).
B.3. The Preventive Minerals and Vitamins
According to Anatomisches Institut der CAU zu Kiel, Olshausenstr, diet supplemented with the vitamins E, C, A, B6, B2, play an important role in prevention or therapy of mechanically induced OA, due to the effects of their antioxidant activity(335).
3.1. Vitamin A
Intake of free radical scavengers and antioxidants such as carotenoids have been known for influence the development and progression of osteoarthritis (OA)(339), according to the Nagoya University Graduate School of Medicine, high serum values of beta-/gamma-tocopherols (Vitamin A) were found to be significantly associated with a reduced risk of OR for radiographic kneeosteoarthritis(338). In Race differentiation, according to the University of North Carolina at Chapel Hill, radiographic kneeosteoarthritis and tocopherol isoforms are complex and may vary by ethnicity and sex(340).
3.2. Vitamin C
In a case-control study enrolled 180 knee osteoarthritis (KOA), Low intake of dietary vitamin D and vitamin C has shown to induced a high risk factor of KOA(344)Vitamin C as an antioxidant has shown to reduce oxidative stress causes of dysfunction in chondrocytes and articular cartilage degradation in patient with OA(342) induced by H2O2 by regulating multiple regulatory pathways(341). Intake of vitamin C supplement has reduced risk of OA incidence but not in decreased progression of knee in patient with OA(343).
3.3. Vitamin E
In comparison of the effectiveness of vitamin E and B vitamin in patient with knee OA, Dr. Dehghan M said "decrease in total pain severity was reported higher in B vitamin group than E vitamin"(336).
In the study of the pro-oxidant and antioxidant status in patient with OA, high levels of serum of vitamin E is associated to reduced risk of oxidative stress causes of osteoarthritis through regulation in response to increased oxidative stress(345). The study of total otal cartilage degeneration in rat models, also insisted that Vitamin E expressed not only in hondroprotective activity but also exhibited a beneficial effects of HA on articular cartilage(346).
Unfortunately, a double blind, placebo controlled trial, 136 patients with knee OA from American College of Rheumatology clinical and radiographic criteria did not support the beneficial effect of Vitamin E in the management of knee OA, in improved cartilage volume loss or symptoms(347).
Vitamin D is associated to the development and progression of osteoarthritis, as l dietary vitamin D intake increases the risk of progression of knee ROA, effecting the bone density(348). Vitamin D deficiency also has found to induced risk of progression(349) and worsening of knee osteoarthritis in patient(350). According to the study of a total of 880 randomly selected subjects (mean age 61 years [range 51-79 years], 50% women) at baseline, conducted by the University of Tasmania, sunlight exposure and serum 25(OH)D levels are found to associate with decreased knee cartilage loss(351).
reduce knee pain, loss of knee cartilage volume, risk knee structural abnormalities and strengthen lower limb muscle strength(337).
According to the Shahrekord University of Medical Science, in the studyof mean score of WOMAC questionnaire at VASs of knee pain, total pain severity, knee joint stiffness, showed that the B vitamin decrease stiffness in knee joint(352). In deed, high consumption of the mixture of B vitamins and diclofenac have been found effectively in reduced pain and inflammation for patient with osteoarthritis and used in a total knee arthroplasty(353).
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(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed)
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) The effect of osteoarthritis definition on prevalence and incidence estimates: a systematic review by Pereira D1, Peleteiro B, Araújo J, Branco J, Santos RA, Ramos E.(PubMed)
(4) Effect of therapeutic aquatic exercise on symptoms and function associated with lower limb osteoarthritis: systematic review with meta-analysis by Waller B1, Ogonowska-Slodownik A2, Vitor M3, Lambeck J4, Daly D5, Kujala UM6, Heinonen A7.(PubMed)
(5) Effects of therapeutic ultrasound on pain, physical functions and safety outcomes in patients with kneeosteoarthritis: A systematic review and meta-analysis by Zhang C1, Xie Y2, Luo X3, Ji Q3, Lu C3, He C4, Wang P3.(PubMed)
(6) Oral intake of purple passion fruit peel extract reduces pain and stiffness and improves physical function in adult patients with knee osteoarthritis by Farid R1, Rezaieyazdi Z, Mirfeizi Z, Hatef MR, Mirheidari M, Mansouri H, Esmaelli H, Bentley G, Lu Y, Foo Y, Watson RR.(PubMed)
(7) Functional ability, mobility, and pain before and after knee replacement in patients aged 75 and older: a cross-sectional study by Limnell K1, Jämsen E, Huhtala H, Jäntti P, Puolakka T, Jylhä M.(PubMed)
(8) The symptoms of OA and the genesis of pain by David J. Hunter, MBBS PhD,1,2 Jason J. McDougall, BSc PhD,3 and Francis J. Keefe4(PubMed)
(335) Dietary vitamins and selenium diminish the development of mechanically induced osteoarthritis and increase the expression of antioxidative enzymes in the knee joint of STR/1N mice. by Kurz B1, Jost B, Schünke M.(PubMed)
(336) Comparative effectiveness of B and e vitamins with diclofenac in reducing pain due to osteoarthritis of the knee by Dehghan M1(PubMed).
(337) Vitamin D supplementation in the management of knee osteoarthritis: study protocol for a randomized controlled trial by Cao Y1, Jones G, Cicuttini F, Winzenberg T, Wluka A, Sharman J, Nguo K, Ding C.(PubMed)
(338) Association of serum carotenoids, retinol, and tocopherols with radiographic knee osteoarthritis: possible risk factors in rural Japanese inhabitants by Seki T1, Hasegawa Y, Yamaguchi J, Kanoh T, Ishiguro N, Tsuboi M, Ito Y, Hamajima N, Suzuki K.(PubMed)
(340) A case-control study of serum tocopherol levels and the alpha- to gamma-tocopherol ratio in radiographic kneeosteoarthritis: the Johnston County Osteoarthritis Project by Jordan JM1, De Roos AJ, Renner JB, Luta G, Cohen A, Craft N, Helmick CG, Hochberg MC, Arab L.(PubMed)
(341) Ascorbic acid provides protection for human chondrocytes against oxidative stress by Chang Z1, Huo L1, Li P1, Wu Y1, Zhang P1.(PubMed)
(342) Potential involvement of oxidative stress in cartilage senescence and development of osteoarthritis: oxidative stress induces chondrocyte telomere instability and downregulation of chondrocyte function by Yudoh K1, Nguyen vT, Nakamura H, Hongo-Masuko K, Kato T, Nishioka K.(PubMed)
(343) Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of the scientific evidenc by Laurent G Ameye1 and Winnie SS Chee1(PMC)
(344) Elucidation of dietary risk factors in osteoarthritis knee—a case-control study by Sanghi D1, Mishra A, Sharma AC, Raj S, Mishra R, Kumari R, Natu SM, Agarwal S, Srivastava RN.(PubMed)
(345) Status of lipid peroxidation, glutathione, ascorbic acid, vitamin E and antioxidant enzymes in patients withosteoarthritis by Surapaneni KM1, Venkataramana G.(PubMed)
(346) Intra-articular hyaluronate, tenoxicam and vitamin E in a rat model of osteoarthritis: evaluation and comparison of chondroprotective efficacy by Ozkan FU1, Uzer G2, Türkmen I3, Yildiz Y3, Senol S4, Ozkan K3, Turkmensoy F3, Ramadan S5, Aktas I1(PubMed)
(347) Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study by Wluka AE1, Stuckey S, Brand C, Cicuttini FM.(PubMed)
(348) Vitamin D status, bone mineral density, and the development of radiographic osteoarthritis of the knee: The Rotterdam Study by Bergink AP1, Uitterlinden AG, Van Leeuwen JP, Buurman CJ, Hofman A, Verhaar JA, Pols HA.(PubMed)
(349) Vitamin D deficiency is associated with progression of knee osteoarthritis by Zhang FF1, Driban JB2, Lo GH3, Price LL4, Booth S5, Eaton CB6, Lu B7, Nevitt M8, Jackson B9, Garganta C10, Hochberg MC11, Kwoh K12, McAlindon TE2.(PubMed)
(350) Low levels of vitamin D and worsening of knee osteoarthritis: results of two longitudinal studies by Felson DT1, Niu J, Clancy M, Aliabadi P, Sack B, Guermazi A, Hunter DJ, Amin S, Rogers G, Booth SL.(PubMed)
(351) Serum levels of vitamin D, sunlight exposure, and knee cartilage loss in older adults: the Tasmanian older adult cohort study by Ding C1, Cicuttini F, Parameswaran V, Burgess J, Quinn S, Jones G.(PubMed)
(352) Comparative effectiveness of B and e vitamins with diclofenac in reducing pain due to osteoarthritis of the knee by Dehghan M1.(PubMed)
(353) B-vitamin mixture improves the analgesic effect of diclofenac in patients with osteoarthritis: a double blind study by Magaña-Villa MC1, Rocha-González HI, Fernández del Valle-Laisequilla C, Granados-Soto V, Rodríguez-Silverio J, Flores-Murrieta FJ, Carrasco-Portugal MC,Reyes-García JG.(PubMed)