Ultra-Reiz Current Appears to be More Effective Modality than Interferential for People with Knee Osteoarthritis: A Randomized Block Clinical Trial

Abstract

Introduction: Today, increased degenerative disease of the knee, which reduces the efficiency of the activity and quality of life, is one of the most common causes of many population complaints. It is important to properly plan and carry out non-invasive and non-pharmacological therapies to treat the pain and its consequences. The question of which of methods effectively relieves pain, improve function and efficiently increases life quality led to a comparison of two methods, interferential and ultra-reiz (Träbert) currents therapy.
 Methods: Randomized Block clinical trial carried out at Taleghani general hospital Shahid Beheshti University of Medical Sciences from November 2017 to February 2019. The study included 104 patients of both sexes, aged 38-74 years, with knee osteoarthritis. They were selected based on exclusion and inclusion criteria. The patients were randomly assigned to two groups: A and B. Group A, n: 52 patients, were received ultra-reiz current, and group B, n: 52 patients, were subjected to interferential current. Parameters assessment were evaluated by the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire with 5 domains: pain, symptoms, ADL, sports/recreational activity, and quality of life. Data were collected at the 1st session and at the end of treatment (at least three times a week). The obtained results were subject to statistical analysis.
 Results: Data were analyzed in SPSS software by using paired and two independent sample t-test. The mean scores before and after treatment with p-value range 0.002~0.764 showed that there were differences in pain, other symptoms, ADL, sport/recreational activity, and quality of life status between ultra-reiz and IFT groups, but the results were statistically more significant in the ultra-reiz group (p < 0.0001).
 Conclusions: Our study showed that ultra-reiz and IFT were effective for patients with knee OA, but ultra-reiz became a more effective modality than IFT in OA patients.

Effectiveness of Träbert current in a physiotherapy program for the management of musculoskeletal pain: a systematic review and meta-analysis

“…Figure 3 shows the risk of bias for the RCTs: The randomisation process bias was rated as a low risk at 85.7% [18,19,[32][33][34][35]; bias due to deviations from planned interventions was rated as some concern at 71.4% [19,[33][34][35][36]; bias due to missing outcome data was assessed as low [18,32,35] and high risk alike at 42.8% [33,34,36]; bias for outcome measurement was rated as some concern 42.8% [19,32,36]; bias associated with the selection of the reported outcome was rated as some concern at 71.4% [18,[33][34][35][36]; and the overall bias was rated as low-risk with 57.1% bias [18,19,32,35].…”

“…The total population included 413 participants, with a mean age of 52.8, including 303 females and 110 males. it was observed that the main conditions treated included knee osteoarthritis (oA) pain [19,32,36], epicondylalgia [33,34], and low back pain (LBP) [18,35]. A total of 274 participants received TC alone [18,33,35,36] or accompanied by interventions such as therapeutic exercises or acupuncture [19,32,34], while 139 participants were treated with other physical therapy interventions: electrotherapy (TENS or interferential currents) in patients with knee oA [19,32,36], massage therapy in patients with LBP [35], or therapeutic exercises in patients with knee oA [18,19,32].…”

“…on the other hand, Chwieśko-Minarowska et al [19] reports applications between 15 and 25 mA without specifying the electrical sensation of the participants, while dakowicz et al [35] and Nurachma et al [36] do not report the intensity used. The treatment times most commonly used were 15 minutes (4 studies) [18,[33][34][35], while Ahangari et al [18] and Sen et al [32] used 20 and 30 minutes of treatment, respectively, although in Sen's study the time was divided into 10 minutes of longitudinal application (EL iV) and 20 minutes of local application. Most of the clinical trials report several 10-15 treatment sessions carried out between two and three weeks [18,19,[32][33][34][35], while only the study by Nurachma et al [36] used five sessions once a week for five weeks of treatment.…”

“…All studies used instruments such as the visual analogue scale (VAS) [33][34][35], the numerical pain rating scale (NPRS) [19], the osteoarthritis index section A of WoMAC [32,36], and the pain intensity section (questions 1 to 9) of KooS [18] to assess the intensity of rest pain as the primary outcome measure. Furthermore, studies considered changes in disability before and after treatment using instruments such as the WoMAC index (participants with knee oA) [32,36], the Barthel index (participants with lateral epicondylalgia) [33,34], Ahangari (2020) [18] Nurachma et al ( 2021) [36] and the Roland-Morris Questionnaire (RMQ) and odi (participants with LBP) [19,35]. All studies evaluated changes in outcome measures at two time points, before and after treatment, with a mean treatment time of 2 to 3 weeks [18,19,32,[33][34][35], whereas only one study evaluated changes in outcome measures at five points (one per week) for a treatment time of five weeks [36].…”

“…However, a lot of equipment offers lesser-known modalities, especially in the low-frequency range (1-1000 Hz), with biophysical properties that differ from traditional modalities [16,17]. The Träbert current (TC), also known as the 2-5 current Hz or Ultra-Reiz current, is a low-frequency current with analgesic effects described at the beginning of the 20 th century before the appearance of TENS [17][18][19]. it is characterised by rectangular pulses of 2 milliseconds (ms) and 5 ms intervals with a fixed frequency of 143 Hz, characteris-tics that allow it to combine the galvanic and sensitive properties of TENS [17].…”