Comparison of different rehabilitation approaches effectiveness in individuals with knee osteoarthritis

Yıl 2019, Cilt: 6 Sayı: 1, 32 - 41, 12.04.2019

Elif Baysal Miray Budak Esra Atılgan Devrim Tarakcı

Öz

Purpose: To investigate the effects of different rehabilitation practices on the range of motion, muscle strength, pain, physical function and quality of life in patients with knee Osteoarthritis (OA).

Methods: Thirty patients between the ages of 40-65 with knee OA were included in the study and divided into 3 groups. Transcutaneous Electrical Nerve Stimulation (TENS), ultrasound, hotpack/coldpack and home exercise program were given to the Group 1 (N=10) for 15 days. Group 2 (N=10) received three doses of Platelet-Rich Plasma (PRP) followed by home exercise program for 15 days. The Control Group (N=10) received only home exercise program for 15 days. All individuals were evaluated using goniometer for range of motion (ROM), manual muscle test for M. Quadriceps femoris muscle strength, Visual Analogue Scale for pain, The Western Ontario and McMaster Universities Arthritis (WOMAC) Scale for physical function and Short Form-12 Quality of Life Scale Mental (SF-12 - MC) and Physical Component (SF-12 - PC) for quality of life at baseline and end of treatment.

Results: Statistically significant difference was found at pain and WOMAC score at the time of activity in all groups. Statistically significant difference was found at ROM and SF-12 MC score in group 1 and 2, at resting pain and SF-12 PC score in control group (p<0.05).

Conclusion: Electrotherapy treatment and PRP approach as an adjunct to knee OA to knee OA treatment, it is thought that home exercise program can be used to relieve symptoms and improve quality of life in knee OA.

Anahtar Kelimeler

Osteoarthritis, Electrotherapy, Exercise therapy, Platelet-rich plasma

Diz osteoartritli bireylerde farklı rehabilitasyon uygulamalarının etkinliklerinin karşılaştırılması

Öz

Amaç: Diz osteoartritli (OA) bireylerde farklı rehabilitasyon uygulamalarının, eklem hareket açıklığı, kas kuvveti, ağrı, fiziksel fonksiyon ve yaşam kalitesi üzerine etkilerini araştırmaktır.

Yöntem: Diz OA tanılı 40-65 yaş aralığında 30 hasta çalışmaya dahil edildi ve 3 gruba ayrıldı. Elektroterapi uygulanan 1. gruba (N=10) 15 seans Transkutanöz Elektriksel Sinir Uyarımı (TENS), ultrason, sıcak/soğuk uygulama ve 15 gün boyunca ev egzersiz programı verildi. 2. gruba (N=10) üç doz Plateletten Zengin Plazma (PRP) uygulaması sonrası 15 gün boyunca ev egzersiz programı verildi. Kontrol grubuna (N=10) 15 gün boyunca sadece ev egzersiz programı verildi. Tedavinin başlangıcında ve sonunda tüm bireylerin, eklem hareket açıklığı (EHA) gonyometre ile, M. Quadriceps femoris kas kuvveti manuel kas testi ile, ağrı Vizüel Analog Skalası ile, fiziksel fonksiyon The Western Ontario and McMaster Universities Arthritis (WOMAC) Skalası ile ve yaşam kalitesi Kısa Form-12 Mental (KF-12 MK) ve Fiziksel Komponent (KF-12 FK) ile değerlendirildi.

Bulgular: Tüm gruplarda aktivite anındaki ağrı ve WOMAC skorunda istatistiksel olarak anlamlı fark bulundu (p<0,05). 1. ve 2. grupta EHA ve KF-12 MK; kontrol grubunda istirahat anındaki ağrı ve KF-12 FK skorunda istatistiksel olarak anlamlı fark bulundu (p<0,05).

Sonuç: Diz OA tedavisinde elektroterapi tedavisi ve PRP uygulamasına ek olarak ev egzersiz programının, diz OA’da hastalığın semptomlarını gidermek ve yaşam kalitesini artırmak için kullanılabileceği düşünülmektedir.

Anahtar Kelimeler

Elektroterapi, Osteoartrit, Egzersiz terapisi, Plateletten zengin plazma

Kaynakça

• 1. Caamano MD, Garcia-Padilla S, Duarte-Vazquez MA, et al. Double-blind, active-controlled clinical trial of sodium bicarbonate and calcium gluconate in the treatment of bilateral osteoarthritis of the knee. Clin Med Insights Arthritis Musculoskelet Disord. 2017;10:1179544116688899.
• 2. Huang GL, Hua S, Yang TM, et al. Platelet-rich plasma shows beneficial effects for patients with knee osteoarthritis by suppressing inflammatory factors. Exp Ther Med. 2018;15:3096-3102.
• 3. Sharma L. Osteoarthritis year in review 2015: clinical. Osteoarthr Cartilage. 2016;24:36-48.
• 4. Alnahdi AH, Zeni JA, Snyder-Mackler L. The effect of progressive strengthening programs on function and gait mechanics after unilateral total knee arthroplasty: a randomized clinical trial. Osteoarthr Cartilage. 2012;20:104-105.
• 5. Segal NA, Glass NA, Felson DT, et al. Effect of quadriceps strength and proprioception on risk for knee osteoarthritis. Med Sci Sports Exerc. 2010;42:2081-2088.
• 6. Von Porat A, Roos EM, Roos H. High prevalence of osteoarthritis 14 years after an anterior cruciate ligament tear in male soccer players: a study of radiography and patient relevant outcomes. Ann Rheum Dis. 2004;63:269-273.
• 7. Zhang W, Moskowitz R, Nuki G, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthr Cartilage. 2007;15:981-1000.
• 8. Qiestad B, Juhl C, Eitzen I, et al. Knee extensor muscle weakness is a risk factor for development of knee osteoarthritis. A systematic review and meta-analysis. Osteoarthr Cartilage. 2015; 23:171-177.
• 9. Segal NA, Glass NA. Is quadriceps muscle weakness a risk factor for incident or progressive knee osteoarthritis? Phys Sportsmed. 2011;39:44-50.
• 10. Kovar PA, Allegrante JP, MacKenzie CR, et al. Supervised fitness walking in patients with osteoarthritis of the knee. A randomized, controlled trial. Ann Intern Med. 1992;116:529-534.
• 11. Smyth NA, Haleem AM, Ross KA, et al. Platelet-rich plasma may improve osteochondral donor site healing in a rabbit model. Cartilage. 2016;7:104-111.
• 12. Tang H, He S, Zhang X, et al. A network pharmacology approach to uncover the pharmacological mechanism of yanhusuo powder on osteoarthritis. Evidence-based Complementary and Alternative Medicine. 2016;1-10.
• 13. Fu CJ, Sun JB, Bi ZG, et al. Evaluation of platelet-rich plasma and fibrin matrix to assist in healing and repair of rotator cuff injuries: a systematic review and meta-analysis. Clin Rehabil. 2017;31:158-172.
• 14. Hu Y, Guo D, Fan Z, et al. An improved algorithm for imbalanced data and small sample size classification. Journal of Data Analysis and Information Processing. 2015;3:27-33.
• 15. Reese NB, Bandy WD. Joint Range of Motion and Muscle Length Testing. Philadelphia: Elsevier Health Sciences; 2016.
• 16. Otman S, Köse N. Tedavi Hareketlerinde Temel Değerlendirme Prensipleri. Ankara: Hipokrat Kitabevi; 2008.
• 17. Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45-56.
• 18. Tuzun EH, Eker L, Aytar A, et al. Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. Osteoarthr Cartilage. 2005;13:28-33.
• 19. Hurst N, Ruta D, Kind P. Comparison of the MOS short form-12 (SF 12) health status questionnaire with the SF 36 in patients with rheumatoid arthritis. Br J Rheumatol. 1998;37:862-869.
• 20. Huang L, Guo B, Xu F, et al. Effects of quadriceps functional exercise with isometric contraction in the treatment of knee osteoarthritis. Int J Rheum Dis. 2017;21:952-959.
• 21. Palmer S, Domaille M, Cramp F, et al. Transcutaneous electrical nerve stimulation as an adjunct to education and exercise for knee osteoarthritis: a randomized controlled trial. Arthritis Care Res. 2014;66:387-94.
• 22. Rayegani SM, Raissadat SA, Taheri MS, et al. Does intra articular platelet rich plasma injection improve function, pain and quality of life in patients with osteoarthritis of the knee? A randomized clinical trial. Orthop Rev (Pavia). 2014;18;6:5405.
• 23. Huang PH, Wang CJ, Chou WY, et al. Short-term clinical results of intra-articular PRP injections for early osteoarthritis of the knee. Int J Surg. 2017;42:117-122.
• 24. Martini LI, Via AG, Fossati C, et al. Single platelet-rich plasma injection for early stage of osteoarthritis of the knee. Joints. 2017;5:2-6.
• 25. Gobbi A, Lad D, Karnatzikos G. The effects of repeated intra-articular PRP injections on clinical outcomes of early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2015;23:2170-2177.
• 26. Angoorani H, Mazaherinezhad A, Marjomaki O, et al. Treatment of knee osteoarthritis with platelet-rich plasma in comparison with transcutaneous electrical nerve stimulation plus exercise: a randomized clinical trial. Med J Islam Repub Iran. 2015;27; 29:223.