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Diz osteoartritli hastalarda plateletten zengin plazma enjeksiyonu sonrası fizyoterapinin ağrı, fiziksel fonksiyon ve fonksiyonel performans üzerine etkisinin incelenmesi: bir pilot çalışma

Year 2021, Volume: 8 Issue: 1, 1 - 9, 07.05.2021

Abstract

Amaç: Bu çalışma, diz osteoartritli (OA) hastalarda plateletten zengin plazma (PRP) enjeksiyonu sonrası fizyoterapinin ağrı,
fiziksel fonksiyon ve fonksiyonel performans üzerine etkisini incelemek amacı ile planlandı.

Yöntem: Çalışmaya Kellgren-Lawrence sınıflamasına göre evre I-III arasında olan ve diz OA nedeniyle dizine PRP enjeksiyonu
yapılmış olan 11 kadın hasta dahil edildi. Hastaların yaş ortalaması 54,09±4,59 yıl; vücut kütle indeksi ortalaması ise
28,69±5,01 kg/m2 idi. Hastaların başlangıç ölçümleri enjeksiyondan sonra 3-5 gün içerisinde yapıldı. Katılımcıların aktivite
sırasındaki ağrı şiddetleri Görsel Analog Skalası (GAS) ile, fiziksel fonksiyonları Western Ontario and McMaster Universities
Osteoarthritis Index (WOMAC) ile değerlendirildi. Fonksiyonel performansı değerlendirmek için süreli kalk yürü testi (SKY) ve
basamak çıkma testi kullanıldı. Tüm değerlendirmeler tedavi öncesi ve sonrası yapıldı. Fizyoterapi programı kapsamında, her
seans 45-60 dk, haftada 2 gün, 6 hafta süresince aynı fizyoterapist tarafından lateral yapıları gevşetmek ve patellar
mobilizasyonu içeren manuel terapi, diz ve kalça çevresi kaslara kuvvetlendirme ve fonksiyonel egzersizler uygulandı.

Bulgular: Çalışmaya katılan bireylerin yaş ortalamaları 54,0±4,5 yıl; vücut kütle indeksi ortalamaları 28,69±5,01 kg/m2 idi.
Fizyoterapi sonrası ağrı değerlerinde (p=0,003), WOMAC skorlarında (p=0,003), SKY testi skorlarında (p=0,003) ve basamak
çıkma inme testi skorlarında (p=0,003) tedavi öncesine göre istatistiksel olarak anlamlı azalma bulundu.

Sonuç: Çalışmamızın sonucunda PRP enjeksiyonu sonrası uygulanan fizyoterapi programının diz OA’li hastaların ağrı,
fonksiyon ve performansını iyileştirmede etkili olduğu bulundu.

References

  • 1. Pinals RS. Mechanisms of joint destruction, pain and disability in osteoarthritis. Drugs. 1996;52:14-20.
  • 2. Nüesch E, Dieppe P, Reichenbach S, et al. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. Bmj. 2011;342:d1165.
  • 3. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015;49:1554-7.
  • 4. Zhang W, Moskowitz R, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16:137-62.
  • 5. Bennell KL, Hunt MA, Wrigley TV, et al. Role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am. 2008;34:731-54.
  • 6. Kujala UM, Kettunen J, Paananen H, et al. Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheumatol. 1995;38:539-46.
  • 7. Brandt KD, Dieppe P, Radin EL, editors. Commentary: is it useful to subset" primary" osteoarthritis? A critique based on evidence regarding the etiopathogenesis of osteoarthritis. Semin Arthritis Rheum; 2009.
  • 8. Laudy AB, Bakker EW, Rekers M, et al. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-72.
  • 9. van Buul GM, Koevoet WL, Kops N, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. The Am J Sports Med. 2011;39:2362-70.
  • 10. Dai W-L, Zhou A-G, Zhang H, et al. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 2017;33:659-70. e1.
  • 11. McAlindon TE, Bannuru RR, Sullivan M, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22:363-88.
  • 12. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2015;1.
  • 13. Sah RLY, Kim YJ, Doong JYH, et al. Biosynthetic response of cartilage explants to dynamic compression. J Orthop Res. 1989;7:619-36.
  • 14. Sonker A, Dubey A, Bhatnagar A, et al. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft. Asian J Transfus Sci. 2015;9:155.
  • 15. Boonstra AM, Preuper HRS, Reneman MF, et al. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31:165-169.
  • 16. Tüzün E, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis cartilage. 2005;13:28-33.
  • 17. Dobson F, Hinman RS, Roos EM, et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis cartilage. 2013;21:1042-52.
  • 18. Osthoff A-KR, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018;77:1251-60.
  • 19. Fernandes L, Hagen KB, Bijlsma JW, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72:1125-35.
  • 20. Hadler NM. Knee pain is the malady—not osteoarthritis. American College of Physicians; 1992.
  • 21. McAlindon T, Cooper C, Kirwan J, et al. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993;52(4):258-62.
  • 22. Filardo G, Kon E, Buda R, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:528-35.
  • 23. Cerza F, Carnì S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822-7.
  • 24. Lin K-Y, Yang C-C, Hsu C-J, et al. Intra-articular injection of platelet-rich plasma is superior to hyaluronic acid or saline solution in the treatment of mild to moderate knee osteoarthritis: a randomized, double-blind, triple-parallel, placebo-controlled clinical trial. Arthroscopy. 2019;35:106-17.
  • 25. Montañez-Heredia E, Irízar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritic knee pain: a randomized clinical trial in the context of the Spanish National Health Care System. Int J Mol Sci. 2016;17:1064.
  • 26. Umakanth G, Naik K. A Study on the effects of injection of platelet rich plasma (Autologous) in the management of osteoarthritis of knee joints. Int J Orthop. 2020;6:1003-10.
  • 27. Terwee C, Mokkink L, Steultjens M, et al. Performance-based methods for measuring the physical function of patients with osteoarthritis of the hip or knee: a systematic review of measurement properties. Rheumatology. 2006;45:890-902.
  • 28. Dobson F, Hinman RS, Hall M, et al. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthritis cartilage. 2012;20:1548-62.
  • 29. Hernández‐Molina G, Reichenbach S, Zhang B, et al. Effect of therapeutic exercise for hip osteoarthritis pain: Results of a meta‐analysis. Arthritis Care Res. 2008;59:1221-8.
  • 30. Jan M-H, Lin J-J, Liau J-J, et al. Investigation of clinical effects of high-and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2008;88:427-36.
  • 31. Deyle GD, Allison SC, Matekel RL, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85:1301-1317

Investigation of the effect of physiotherapy on pain, physical function, and functional performance in patients with knee osteoarthritis after platelet rich plasma injection: a pilot study

Year 2021, Volume: 8 Issue: 1, 1 - 9, 07.05.2021

Abstract

Purpose: This study was planned to investigate the effect of physiotherapy on pain, physical function, and functional
performance after platelet rich plasma (PRP) injection in patients with knee osteoarthritis (OA).

Methods: The study included 11 female patients who were between stage I-III according to the Kellgren-Lawrence
classification and injected with PRP due to knee OA. The mean age of patients was 54.09±4.59 years and mean body mass
index was 28.69±5.01 kg/m2. The initial measurements of the patients were made within 3-5 days after the injection. The
Pain intensity of the participants during the activity was evaluated using the Visual Analog Scale (VAS); and their physical
functions were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The Timed-up
and go test (TUG) and climb up and down stairs tests were used to assess the functional performance. All evaluations were
applied before and after treatment. Within the scope of the physiotherapy program, manual therapy including relaxation of the
lateral structures and patellar mobilization, strengthening and functional exercises to the muscles around the knee and hips
were performed by the same physiotherapist with each session 45-60 minutes, 2 days a week for 6 weeks.

Results: The average age of the individuals was 54.0±4.5 years; mean body mass index was 28.69±5.01 kg/m2. There was a
statistically significant decrease in pain values (p=0.003), WOMAC scores (p=0,003), TUG test scores (p=0.003) and climd
up and down stairs test scores (p=0.003) after physiotherapy compared to pretreatment.

Conclusion: As a result of our study, it was found that physiotherapy program applied after PRP injection was effective in
improving pain, function, and performance of patients with knee OA.

References

  • 1. Pinals RS. Mechanisms of joint destruction, pain and disability in osteoarthritis. Drugs. 1996;52:14-20.
  • 2. Nüesch E, Dieppe P, Reichenbach S, et al. All cause and disease specific mortality in patients with knee or hip osteoarthritis: population based cohort study. Bmj. 2011;342:d1165.
  • 3. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee: a Cochrane systematic review. Br J Sports Med. 2015;49:1554-7.
  • 4. Zhang W, Moskowitz R, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. 2008;16:137-62.
  • 5. Bennell KL, Hunt MA, Wrigley TV, et al. Role of muscle in the genesis and management of knee osteoarthritis. Rheum Dis Clin North Am. 2008;34:731-54.
  • 6. Kujala UM, Kettunen J, Paananen H, et al. Knee osteoarthritis in former runners, soccer players, weight lifters, and shooters. Arthritis Rheumatol. 1995;38:539-46.
  • 7. Brandt KD, Dieppe P, Radin EL, editors. Commentary: is it useful to subset" primary" osteoarthritis? A critique based on evidence regarding the etiopathogenesis of osteoarthritis. Semin Arthritis Rheum; 2009.
  • 8. Laudy AB, Bakker EW, Rekers M, et al. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015;49:657-72.
  • 9. van Buul GM, Koevoet WL, Kops N, et al. Platelet-rich plasma releasate inhibits inflammatory processes in osteoarthritic chondrocytes. The Am J Sports Med. 2011;39:2362-70.
  • 10. Dai W-L, Zhou A-G, Zhang H, et al. Efficacy of platelet-rich plasma in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trials. Arthroscopy. 2017;33:659-70. e1.
  • 11. McAlindon TE, Bannuru RR, Sullivan M, et al. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014;22:363-88.
  • 12. Fransen M, McConnell S, Harmer AR, et al. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev 2015;1.
  • 13. Sah RLY, Kim YJ, Doong JYH, et al. Biosynthetic response of cartilage explants to dynamic compression. J Orthop Res. 1989;7:619-36.
  • 14. Sonker A, Dubey A, Bhatnagar A, et al. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft. Asian J Transfus Sci. 2015;9:155.
  • 15. Boonstra AM, Preuper HRS, Reneman MF, et al. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. Int J Rehabil Res. 2008;31:165-169.
  • 16. Tüzün E, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthritis cartilage. 2005;13:28-33.
  • 17. Dobson F, Hinman RS, Roos EM, et al. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis cartilage. 2013;21:1042-52.
  • 18. Osthoff A-KR, Niedermann K, Braun J, et al. 2018 EULAR recommendations for physical activity in people with inflammatory arthritis and osteoarthritis. Ann Rheum Dis. 2018;77:1251-60.
  • 19. Fernandes L, Hagen KB, Bijlsma JW, et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis. Ann Rheum Dis. 2013;72:1125-35.
  • 20. Hadler NM. Knee pain is the malady—not osteoarthritis. American College of Physicians; 1992.
  • 21. McAlindon T, Cooper C, Kirwan J, et al. Determinants of disability in osteoarthritis of the knee. Ann Rheum Dis. 1993;52(4):258-62.
  • 22. Filardo G, Kon E, Buda R, et al. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19:528-35.
  • 23. Cerza F, Carnì S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med. 2012;40:2822-7.
  • 24. Lin K-Y, Yang C-C, Hsu C-J, et al. Intra-articular injection of platelet-rich plasma is superior to hyaluronic acid or saline solution in the treatment of mild to moderate knee osteoarthritis: a randomized, double-blind, triple-parallel, placebo-controlled clinical trial. Arthroscopy. 2019;35:106-17.
  • 25. Montañez-Heredia E, Irízar S, Huertas PJ, et al. Intra-articular injections of platelet-rich plasma versus hyaluronic acid in the treatment of osteoarthritic knee pain: a randomized clinical trial in the context of the Spanish National Health Care System. Int J Mol Sci. 2016;17:1064.
  • 26. Umakanth G, Naik K. A Study on the effects of injection of platelet rich plasma (Autologous) in the management of osteoarthritis of knee joints. Int J Orthop. 2020;6:1003-10.
  • 27. Terwee C, Mokkink L, Steultjens M, et al. Performance-based methods for measuring the physical function of patients with osteoarthritis of the hip or knee: a systematic review of measurement properties. Rheumatology. 2006;45:890-902.
  • 28. Dobson F, Hinman RS, Hall M, et al. Measurement properties of performance-based measures to assess physical function in hip and knee osteoarthritis: a systematic review. Osteoarthritis cartilage. 2012;20:1548-62.
  • 29. Hernández‐Molina G, Reichenbach S, Zhang B, et al. Effect of therapeutic exercise for hip osteoarthritis pain: Results of a meta‐analysis. Arthritis Care Res. 2008;59:1221-8.
  • 30. Jan M-H, Lin J-J, Liau J-J, et al. Investigation of clinical effects of high-and low-resistance training for patients with knee osteoarthritis: a randomized controlled trial. Phys Ther. 2008;88:427-36.
  • 31. Deyle GD, Allison SC, Matekel RL, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85:1301-1317
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Sibel Bozgeyik 0000-0003-4156-6900

Levend Karaçoban 0000-0003-1198-196X

Feza Korkusuz 0000-0001-9486-3541

Zafer Erden 0000-0002-5112-4754

Publication Date May 7, 2021
Submission Date May 22, 2020
Published in Issue Year 2021 Volume: 8 Issue: 1

Cite

Vancouver Bozgeyik S, Karaçoban L, Korkusuz F, Erden Z. Diz osteoartritli hastalarda plateletten zengin plazma enjeksiyonu sonrası fizyoterapinin ağrı, fiziksel fonksiyon ve fonksiyonel performans üzerine etkisinin incelenmesi: bir pilot çalışma. JETR. 2021;8(1):1-9.