This study was conducted to evaluate the efficacy of intraarticular injection of hyaluronic acid for the treatment of knee osteoarthritis. Patients with knee osteoarthritis were followed for a period of six months to assess the efficacy of intra-articular injection of hyaluronic acid given three times in three consecutive weeks. Fifty patients were reviewed at two, eight and 24 weeks post-injection. The average age was 60.9 years and female to male ratio was 3:1. Patients were assessed using the Lequesne Algofunctional Index for function, and the visual analogue score for pain and side effects. We found that the knee pain reduced and the function improved in most patients and these beneficial effects maintain till the last follow up. The only side effect noted was one case of acute non-septic joint effusion after the 3rd injection. We concluded that intra-articular injection of hyaluronic acid can produce pain relief and functional improvement for up to 6 months.
Introduction: The 2-Minute Walk Test (2MWT) is a simple, practical, and less time consuming test. Patients do not get fatigued while performing this test as a part of routine physical examination. 2MWT shows an excellent correlation with other walk tests and can be used as an alternative test in patients with multiple co- morbidities. The reliability of a test is a must for its recommendation to be used in clinics as well as research. Measurement properties have been reported in different populations for 2MWT. However, no data exist for 2MWT in patients with Knee Osteoarthritis (KOA). Aim: To establish the test-retest reliability and Minimal Detectable Change (MDC) scores for the 2MWT in patients with bilateral KOA. Materials and Methods: A prospective test-retest research study designed to assess the reliability of 2MWT. Eighty-two patients with KOA (27 males and 55 females) were included in the study. Health status was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The Numeric Pain Rating Scale (NPRS) and WOMAC were assessed on two consecutive days. Participants performed 2MWT on two different occasions with 48 hours difference in between. Both sessions were conducted for 45 minutes each on a 30 meter walking pathway. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows (SPSS Inc., Chicago, IL, USA). Results: 2MWT showed an excellent test-retest reliability. Intraclass Correlation Coefficient (ICC) for 2MWT were 0.98. Test-retest reliability assessed by two trials of 2MWT showed 1st trial mean±SD of 154.33±19.59 m and 2nd trial mean±SD of 156.69±19.68 m. Mean difference±SD between both trials was 2.36±2.74, which was statistically significant (p<0.001). The Standard Error of Measurement (SEM) and Minimal Detectable Change at 95% confidence level (MDC95) for 2MWT were 2.76 and 5.52 meters, respectively. Conclusion: The study recommends that 2MWT can be used as a test for assessing walking capacity among patients with KOA. A change of more than 5.52 meters can be considered as change-free of error. It can be used as an alternative to 6MWT in patients with KOA who cannot tolerate a higher duration/intensity walk test.
Background: Evidence-based practice in the field of physiotherapy is of utmost importance and is the way ahead. Physiotherapists' knowledge of evidence in terms of assessment and management of knee OA may influence the implementation of evidence-based practice. However, physiotherapist’s practice patterns are usually based on their professional experience or expert opinions. The present study aimed to explore the evidence awareness among Indian physiotherapists and identify their practice patterns in patients with knee OA. Methods: An online cross-sectional survey was conducted among Indian physiotherapists. The survey was designed using current clinical practice guidelines and previously published similar studies. The survey consisted of three sections: (1) demographic details, (2) questions related to evidence awareness, (3) questions related to the practice patterns of Indian physiotherapists. The evidence awareness and practice patterns of physiotherapists were explored. Results: A total of 165 responses were received and analyzed. Most participants perceived footwear modifications (21.2%) and resistance exercises (44.2%) as having very strong evidence. Range of motion assessment and functional assessment was regarded as a must during the patient's initial visit. In terms of management strategies majority of the participants considered patient education (n=122), strengthening exercises (n=81), and therapeutic ultrasound (n=79) as their treatment of choice. Conclusion: Most physiotherapist assessment strategies were aimed at identifying impairments in patients. In line with the clinical practice guidelines, most physiotherapists use patient education and strengthening exercises to treat patients with knee OA. However, treatment modalities like ultrasound, TENS, and dry needling, which lack scientific support, are still being used by the physiotherapist. There is a lack of coherence between physiotherapists' evidence awareness and their choice of management strategies. KEY WORDS: Knee, Osteoarthritis, Survey, Resistance exercises.
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