Thu0435 assesing the Effects of Pulsed Ultrasound Treatment on Pain, Functionality, Synovial Fluid and Cartilage Thickness, in Knee Osteoarthritis

Abstract

Background:Osteoarthritis (OA) is a progressive rheumatic disease which is the most common cause of musculoskeletal pain and functional impairment, particularly in the elderly group. Ultrasound therapy is one of the most commonly used physical modalities in the OA treatment. It has deep heating effect and increases tissue regeneration, blood flow and metabolic effects while reducing the inflammation. In addition, it increases the cartilage regeneration according to certain in vivo and in vitro studies (1).Objectives:To research the effect of pulsed ultrasound treatment on pain, functionality, synovial fluid and cartilage thickness in knee osteoarthritis.Methods:This study was a randomised-controlled and parallel group study. 96 patients (79 females and 17 males) were included to study who had knee pain, aged between 45-75 years. They also have diagnosed as knee osteoarthritis according to ACR diagnostic criteria and their Kellgren-Lawrence grades were ≤3. These patients were divided in two groups randomly: Treatment group (exercise + US), (9 male, 39 female), control group (exercise + Sham US), (8 male, 40 female). The patients in the treatment group were treated with a 1 MHz probe and a density of 1w/cm², 1: 4 for 10 minutes, and 3 sessions a week for 8 weeks. Sham US treatment was applied to each group at the same time. Both groups received a home exercise program including knee range of motion and isometric strengthening exercises. All patients were evaluated by ultrasonographic measurements and quality of life tests; VAS (Visuel Analog Scale) rest, VAS walking, Timed Up and Go Test, WOMAC Questionnaire scores (before treatment, after treatment, 3 months after treatment).Results:9 out of 48 patients in the treatment group and 12 out of 48 patients in the control group were excluded from the study because they did not continue treatment or come to the control. The distribution of groups was similar (Table-1). VAS rest, VAS walking, Timed up and go test, WOMAC questionnaire scores, were improved statistically significant in both groups (P<0.05), but group effect could not be demonstrated (P>0.05) There were no statistically significant results in terms of both synovial fluid and femoral cartilage thickness measurements (P>0.05) (Table 2).Abstract THU0435 –Table 1Conclusion:Therapeutic ultrasound treatment in addition to home exercise program has not been shown to be effective rest and walking pain, functionality, synovial fluid and femoral cartilage thickness in the treatment of knee osteoarthritis. This is the first study to evaluate the effect of therapeutic intermittent ultrasound on synovial fluid and cartilage thickness by ultrasonography. International collaborative studies and randomized clinical trials will help in clarifying these areas of uncertainty.References:[1] -Loyola-Sánchez, A. 2012.” Effect of low-intensity pulsed ultrasound on the cartilage repair in people with mild to moderate knee osteoarthritis: a double blinded, randomized, placebo-controlled pilot study”, Archives of Physical Medicine and...

Adjunctive electrophysical therapies used in addition to land-based exercise therapy for osteoarthritis of the hip or knee: A systematic review and meta-analysis

“…All studies, except one, which was a quasi-randomised trial [ 25 ], were RCTs and all trials employed a parallel group design. Nineteen studies compared the adjunctive EPT plus exercise therapy to a placebo EPT and exercise [ [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ], whilst 22 compared against exercise only [ 9 , 11 , 19 , 20 , 22 , [34] , [35] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [57] ].…”

“…Seventeen trials compared two groups [ 11 , 23 , 25 , [28] , [29] , [30] , 33 , 36 , 39 , 41 , [43] , [44] , [45] , 48 , 49 , 54 ], 15 included three groups [ 9 , 19 , 20 , 22 , 27 , 31 , 34 , 37 , 38 , 40 , 46 , 47 , 51 , 55 , 56 ], five compared four groups [ 21 , 24 , 42 , 50 , 52 ], one compared five groups [ 57 ] and one trial had six different arms, comparing three EPTs to placebo counterparts [ 26 ]. The number of groups eligible for inclusion is shown in Table 1 , with two groups included in 27 studies [ 11 , 19 , 20 , [23] , [24] , [25] , 28 , 30 , 33 , 36 , 39 , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , 53 , 54 , 57 , …”

“…Nine EPTs were investigated, including TENS [ 34 , 35 ], laser therapy [ 10 , [22] , [23] , [24] , 28 , 30 , 31 , 38 , 41 , 42 , 51 , 62 ], IFT [ 9 , 25 , 47 , 52 ], US [ 36 , 52 , 55 ], shortwave [ 26 , 45 , 47 , 52 ], shockwave [ 46 , 59 ], heat therapy [ 44 , 50 , 57 ], NMES [ 20 , 63 ] and EMG biofeedback [ 48 , 49 ]. Interventions varied between 8 and 60 treatments, delivered between 2 weeks and 11 months.…”