scholarly journals To Compare the Effects of UST and TENS with PNF Stretching To Increase the Mobility and Reduce Pain in OA - A Randomised Control Trial

Author(s):  
Dr Nidhi Agarwal

Abstract: Osteoarthritis is a chronic disorder which is degenerative in nature having a multifactorial etiology characterized by subchondral sclerosis, loss of the articular cartilage, hypertrophy of the marginal bone along with morphological and biochemical changes in the joint capsules and synovium. Knee osteoarthritis is the most common form of osteoarthritis. Knee OA is characterized by quadriceps muscle weakness, hamstring weakness, possible joint stiffness, effusion, loss of proprioception loss of range of motion and knee pain. Transcutaneous electrical nerve stimulation is the most widely used physical modalities for the management osteoarthritis knee. The benefits of TENS for relive chronic pain are well documented. The UST for the treatment of OA will lead to improvement of life by decreasing the swelling and reducing the pain at the knee joint. PNF relieves pain improves the ROM, restores proprioception as confirmed by clinical research. The aim of study to find out the effect of UST and TENS with PNF stretching to increase the mobility and reduce pain in OA Patients. Study duration is 6-week, source of data is Goldi masala factory, Kanpur. Sample size is 60 and method of data collection is random. Subjects were divided into two equal group, for group A we give PNF with ultrasound and for group B we give PNF with TENS for six consecutive weeks. After analysis of collected data result was null hypothesis is rejected and alternate hypothesis is accepted. In this way both technique is statistically significant. So, we concluded that both the technique i.e., PNF with UST and PNF with TENS is effective in treating the osteoarthritis patient with relieving pain and increasing range of motion. But statistically PNF with TENS is more significant over PNF with UST. Keywords: Osteoarthritis, proprioceptive neuromuscular facilitation, ultrasound therapy, transcutaneous electrical nerve stimulator, pain, range of motion, VAS scale, goniometer.

1970 ◽  
Vol 12 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Abul Kalam Azad ◽  
Golam Nabi ◽  
MA Shakoor ◽  
MD Moyeenuzzaman

A total of 106 patients of osteoarthritis of knee were selected for the study. Out of 106 patients 26.41% were male and 73.58% were female. The female and male ratio is 2.78: 1. Mean age was 49.68 ± 9.16 years and house wives were maximum in number 75 (70.8%). They were divided into two groups, 52 patients in group–A, were treated with NSAID plus Exercise and another 54 patients in group-B, were treated with NSAID only. In both group patients were treated for six weeks duration. The improvement was assessed with WOMAC scoring system. Student’s‘t’ test was to see the level of significance. In present study, the patients groups those who received NSAID plus Exercise, improved more significantly (p= 0.001) than those who received NSAID only. So it can be concluded that quadriceps muscle strengthening exercise is effective in the patients with OA knee. Keyword: Osteoarthritis, Knee, Exercise. DOI: http://dx.doi.org/10.3329/jom.v12i2.8418 JOM 2011; 12(2): 120-124


Biomedicine ◽  
2020 ◽  
Vol 40 (3) ◽  
pp. 381-385
Author(s):  
K. Kotteeswaran ◽  
P. Sindhura ◽  
P. Mohith Sesikiran ◽  
Vengata Subramani Manoharan

Introduction and Aim: Knee osteoarthritis is a common degenerative disease, with its prevalence increasing with age and with multifactorial aetiology. It is a common cause of disability worldwide. Aim of the study is to compare the effect of weight bearing exercises on wobble board and stable platform in improving balance and functional outcome by the pre and post analysis. Materials and Methods: Experimental study was conducted in Saveetha hospital, Chennai. Forty subjects including both males and females diagnosed with osteoarthritis knee within the age of 40 to 70 years were recruited and divided into two groups with 20 subjects in each group (Group A- 20 subjects, Group B- 20 subjects). Group A was given weight bearing exercises on wobble board along with interferential therapy, in 4 sets with 6 repetitions in each set and a rest interval of one minute between each set, 15 minutes per session, 3 days/week for 4 weeks and Group B was given weight bearing exercises on stable platform along with interferential therapy in 4 sets with 6 repetitions in each set and a rest interval of one minute between each set, 15 minutes per session, 3 days/week for 4 weeks. Results: At the end of the study, data was analysed and there was improvement in balance and functional outcome. Conclusion: This study concluded that patients with knee osteoarthritis had improvement in balance and functional outcome through weight bearing exercises given on wobble board along with interferential therapy compared to the patients who were given weight-bearing exercises on stable platform along with interferential therapy. Keywords: Osteoarthritis; wobble board; stable platform; interferential therapy.


2018 ◽  
Vol 30 (2) ◽  
pp. 13-19
Author(s):  
Md Tariqul Islam Khan ◽  
Badrunnesa Ahmed ◽  
AKM Salek ◽  
Fazlul Karim

Background: Knee osteoarthritis (OA) is the common form of disability in comparatively elderly patient. Lateral wedge shoe insole is an easy, simple and cost effective approach which can be applied as an adjunct to pharmacotherapy to treat the patients with OA knee. The objective of the study is to evaluate the effectiveness of using lateral wedge shoe insole on pain and physical functioning in patients with OA knee.Method: A randomized prospective study was carried out in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January, 2012 to March, 2012. Patients with OA knee by American College of Rheumatology Criteria were selected. Two intervention groups were compared. In patients of Group-A (32 patients) were treated with aceclofenac100mg and, omeprazole20mg bid, and daily instructions of activities of daily living (ADLs), isometric quadriceps muscle strengthening exercise. Patients of Group-B were given lateral wedge shoe insole along with above treatment. The change between two weeks post intervention and baseline WOMAC (Western Ontario and McMaster Universities) subscale and scores were calculated. There were 4 visits and in each visit, patients were assessed for pain, stiffness and physical function by WOMAC index.Results: A total 65 patients with OA knee were included in this study. The mean age was 56.5± 10 years. Male to female ratio was 1.32:1. Comparison of mean pretreatment and 8th week post treatment WOMAC physical function subscale score in Group A (4.9 ± 1.2 vs. 2.4 ± 0.8) showed significant improvement and in Group B (4.3 ± 1.2 vs. 1.9 ± 0.5) which also shows significant improvement more than group A. The result was compared and student t-test was done to see the level of significance. Method was found significant after treatment (p <0.05).Interpretation: Effects of use of lateral wedge shoe insole in patients with knee OA is beneficial.TAJ 2017; 30(2): 13-19


2018 ◽  
Vol 4 (4) ◽  
pp. 519-522
Author(s):  
Jeyakumar S ◽  
Jagatheesan Alagesan ◽  
T.S. Muthukumar

Background: Frozen shoulder is disorder of the connective tissue that limits the normal Range of motion of the shoulder in diabetes, frozen shoulder is thought to be caused by changes to the collagen in the shoulder joint as a result of long term Hypoglycemia. Mobilization is a therapeutic movement of the joint. The goal is to restore normal joint motion and rhythm. The use of mobilization with movement for peripheral joints was developed by mulligan. This technique combines a sustained application of manual technique “gliding” force to the joint with concurrent physiologic motion of joint, either actively or passively. This study aims to find out the effects of mobilization with movement and end range mobilization in frozen shoulder in Type I diabetics. Materials and Methods: 30 subjects both male and female, suffering with shoulder pain and clinically diagnosed with frozen shoulder was recruited for the study and divided into two groups with 15 patients each based on convenient sampling method. Group A patients received mobilization with movement and Group B patients received end range mobilization for three weeks. The outcome measurements were SPADI, Functional hand to back scale, abduction range of motion using goniometer and VAS. Results: The mean values of all parameters showed significant differences in group A as compared to group B in terms of decreased pain, increased abduction range and other outcome measures. Conclusion: Based on the results it has been concluded that treating the type 1 diabetic patient with frozen shoulder, mobilization with movement exercise shows better results than end range mobilization in reducing pain and increase functional activities and mobility in frozen shoulder.


Arthroplasty ◽  
2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Sanjay Bhalchandra Londhe ◽  
Ravi Vinod Shah ◽  
Amit Pankaj Doshi ◽  
Shubhankar Sanjay Londhe ◽  
Kavita Subhedar ◽  
...  

Abstract The aim of this retrospective cohort study was to compare home physiotherapy with or without supervision of physiotherapist for assessing manipulation under anaesthesia after total knee arthroplasty. Methods A total of 900 patients (including 810 females and 90 males) who had undergone total knee arthroplasty were divided into group A (n = 300) and group B (n = 600). Patients in group A had home physiotherapy on their own after discharge from hospital. The physiotherapist did not visit them at home. Patients in group B received home physiotherapy under supervision of physiotherapist for 6 weeks after discharge from hospital. Patients’ age, range of motion of the knee, and forgotten joint score-12 were assessed. A p < 0.05 was considered statistically significant. Results In group A, the mean age was 69.1 ± 14.3 years (range: 58 to 82 years); in group B, the mean age was 66.5 ± 15.7 years (range: 56 to 83 years) (p > 0.05). Preoperatively, the mean range of motion of the knee in group A and B was 95.8° ± 18.1° and 95.4° ± 17.8°, respectively (p > 0.05). The mean forgotten joint score-12 of group A and B were 11.90 ± 11.3 and 11.72 ± 12.1 (p > 0.05), respectively. Six weeks after total knee arthroplasty, the mean ROM of the knee in group A and B was 109.7° ± 22.3° and 121° ± 21.5°, respectively (p < 0.05). The mean postoperative forgotten joint score-12 of the group A and B was 24.5 ± 16.4 and 25.6 ± 17.4, respectively (p > 0.05). The rate of manipulation under anaesthesia was 3% in group A and 0.2% in group B (p < 0.05). Conclusion After total knee arthroplasty, frequent physiotherapist’s instruction helps the patients improve knee exercises and therefore decrease the risk of revision surgery. The home physiotherapy under supervision of physiotherapist lowers the rate of manipulation under anaesthesia. Level of evidence Therapeutic study, Level IIa.


2020 ◽  
pp. 1-4
Author(s):  
Himakshi Bhattacharya ◽  
Bhavna Gadhavi

Background: Osteoarthritis is a chronic degenerative disease. The major symptom of Knee Osteoarthritis Are Pain Decreased Range of Motion and Functional impairment. The purpose of the study is to evaluate the effect of backward cycling and forward cycling in subject with Knee Osteoarthritis. The traditional protocol for treating knee osteoarthritis shows inability to treat the pain, function and range of motion at primary level of treatment. This can eradicate the drawback of generalized protocol. Method: The subject assessed thoroughly would be divided in three group. Group A would be given Conventional Treatment and Forward Cycling. Group B would be given Conventional Treatment and Backward Cycling. Group C would be given only Conventional Treatment. Treatment Duration for all three groups would be for 4 weeks. Then improvement would be evaluated in pain, Function and ROM by taking Post data. Then Pre-and Post data would be compared for final Conclusion. Conclusion: According to the present study the alternative hypothesis is accepted and null hypothesis is rejected. Which suggest that backward cycling proves to manage the symptoms efficiently than forward cycling and single handed conventional protocols.


2021 ◽  
Vol 9 (4) ◽  
pp. 3863-3869
Author(s):  
Monika Dhiman ◽  
◽  
Maman Paul ◽  

Background: Altered postural behaviours result in Forward head posture and thoracic kyphosis making it amenable to correction. The biomechanical strain, in presence of reduced strength of the core stabilizing musculature, in particular, if it is repeated or prolonged, is the predominant explanation for symptoms associated with forward head posture and thoracic kyphosis i.e., neck pain and reduced cervical range of motion. Objective: The aim of the present study was to investigate and compare the effect of postural awareness and conventional exercises on the cervical range of motion in patients with thoracic kyphosis and forward head posture. Methodology: This experimental study was conducted on 60 subjects both male and female of age group 20-35yrs. Subjects were randomly divided into two groups consisting of 30 subjects each. Group A received hot pack and postural advice and Group B received hot pack and stretching and strengthening exercises. All the subjects received a total intervention of 4 days (alternate days) per week for 4 weeks. Results: Intra-group significant differences were obtained between pre- and post-treatment for all evaluated variables (p˂0.01) in both groups. The inter-group comparison showed significant differences (p˂0.01) between post-treatment variables of Group A and Group B where, Group B showed greater improvement than Group A. Conclusion: The treatment given to both the groups together can be used to improve cervical range of motion, thoracic kyphosis, and forward head posture. This study may serve as a guideline for physiotherapists when making decisions regarding possible interventions. KEY WORDS: Cervical range of motion, Craniovertebral angle, Forward head posture, Kyphosis index, Neck disability index, Thoracic kyphosis.


2021 ◽  
pp. 56-57
Author(s):  
Anupama Anupama

Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH. Materials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40 years with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum haemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group A (n=50) and placebo group or group B(n=50). Group A received 400µg of sublingual misoprostol after delivery of the baby, group B received placebo tablet at the same time. Primary outcome measures were blood loss from delivery of the placenta to the end of the caesarean section to 2 hours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration was noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum haemorrhage. Result – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were signicantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signicantly less than in the control group. (p<0.0001). Total amount of Oxytocin required was signicantly less in the study group (p=0.01). The number of women requiring other oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signicantly less in study group (p=0.0078). Conclusion – Sublingual misoprostol has been found to be effective in preventing PPH.


2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091112
Author(s):  
Jianda Xu ◽  
Yuxing Qu ◽  
Huan Li ◽  
Aixiang Zhu ◽  
Tao Jiang ◽  
...  

Background: Intra-articular corticosteroid injections have been widely used and are considered a mainstay in the nonoperative treatment of symptomatic knee osteoarthritis (OA). However, their increased use can have negative implications, including chondral toxicity and a high risk of infections. As a result, nonsteroidal anti-inflammatory drugs have been considered as an alternative. Purpose: To determine the pain relief and safety of ketorolac versus a corticosteroid to supplement an intra-articular sodium hyaluronate injection for the treatment of symptomatic knee OA. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 84 patients with unilateral symptomatic knee OA receiving 5 weekly injections were enrolled in this retrospective study. Group A (n = 42) received 3 weekly intra-articular corticosteroid injections (0.5% lidocaine, 25 mg of triamcinolone acetonide, and 25 mg of sodium hyaluronate, followed by 2 weekly injections of 0.5% lidocaine and 25 mg of sodium hyaluronate), while group B (n = 42) received 5 weekly ketorolac injections (0.5% lidocaine, 10 mg of ketorolac, and 25 mg of sodium hyaluronate). The following parameters were used to evaluate pain relief and safety: visual analog scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and side effects before the injection and at 1, 2, and 5 weeks after treatment commencement as well as 3 months after the last injection. Results: Patients from both groups had a significant improvement in VAS and WOMAC scores from the first injection to final follow-up at 3 months. In the first week, the VAS score was lower in group A ( P = .041), but no significant between-group differences were found for either the VAS or the WOMAC score at the other time points. Of the 42 patients in group A, 34 (81.0%) and 25 (59.5%) achieved successful outcomes at 5 weeks after treatment commencement and 3 months after the last injection, respectively. In group B, 32 (76.2%) and 24 (57.1%) patients achieved successful outcomes at 5 weeks after treatment commencement and 3 months after the last injection, respectively. At final follow-up, no significant difference was found in the successful treatment rate between the groups ( P = .825). Conclusion: The current study demonstrated that intra-articular ketorolac and corticosteroid injections produce the same pain relief and functional improvement.


2019 ◽  
Vol 7 (10) ◽  
pp. 232596711987912 ◽  
Author(s):  
Katherine Marino ◽  
Rachel Lee ◽  
Paul Lee

Background: Knee osteoarthritis (OA) affects an estimated 1 in 5 individuals older than 45 years of age in the United Kingdom. Previous studies have suggested that germanium-infused garments may provide improved clinical outcomes in OA. Germanium-embedded (GE) knee sleeves embrace this fabric technology. Purpose: To assess the outcomes of GE knee sleeves for patients with knee OA. Study Design: Cohort study; Level of evidence, 2. Methods: This study was undertaken at a hospital in the United Kingdom. Patients who had radiographic features of OA, experienced knee pain for at least 6 months, and opted for nonsurgical intervention were included. Patients were recruited over 3 months. The University of California, Los Angeles activity score, Lysholm score, visual analog scale (VAS) score, and Oxford Knee Score (OKS) were collected at monthly intervals for 6 months. Patients were followed to determine their compliance with wearing the knee sleeves at all times, as advised, and whether any adverse effects had occurred. Results: A total of 50 participants were recruited for the study; 4 participants were excluded due to pain and were converted to surgical management. Therefore, 46 patients were analyzed and placed into 2 groups according to severity of OA, as classified by the Kellgren-Lawrence system: group A had grade 1 or 2 OA, and group B had grade 3 or 4 OA. There were 25 patients in group A and 21 in group B. Improvements were seen in OKS, VAS, and Lysholm scores in both groups. Clinically significant improvements were seen in group A only for OKS (mean increase, 14), VAS (mean decrease, 4.1), and Lysholm (mean increase, 17.2) scores. These results were also statistically significant (OKS, P = 5.8 × 10-7; VAS, P = 7.7 × 10-12; Lysholm, P = 4.2 × 10-11). The data from this study demonstrated that GE knee sleeves gave better outcomes for patients with grades 1 and 2 OA compared with patients with more advanced disease, which is consistent with previous studies. A total of 3 patients reported skin irritation, which resolved with simple skin ointment application. No patients reported infection, deep vein thrombosis, or circulation problems. Conclusion: GE knee sleeves could play an important role in optimizing nonsurgical management of patients with knee OA, especially patients with grades 1 and 2 OA, as demonstrated by the clinically significant improvements.


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