Non-Pharmacological Approaches to the Treatment of Osteoarthritis

Öz

Osteoarthritis (OA) is a progressive degenerative joint disorder that impacts millions of people globally. Common symptoms of osteoarthritis include pain, swelling, stiffness, muscular weakness, crepitation, restricted movement, and tenderness. OA remains a significant health issue that has a detrimental impact on the quality of life of individuals and places a significant burden on the healthcare system, despite the recent advancements in medicine. The current treatment protocol for osteoarthritis consists of three stages: non-pharmacological, pharmacological, and surgical interventions. Non-pharmacological interventions are commonly employed in the management of osteoarthritis. OA exhibits favourable responses to early intervention. The optimal strategy for avoiding the progression of OA in its first stages is the implementation of non-pharmacological interventions, which exhibit minimal adverse effects. Our study provides substantial knowledge about non-pharmacological methods employed in the treatment of OA.

Anahtar Kelimeler

• Osteoarthritis
• Non-Pharmacological Approaches
• Physical Therapy

Osteoartrit Tedavisinde Farmakolojik Olmayan Yaklaşımlar

Öz

Osteoartrit (OA) tüm dünyada milyonlarca insanı etkileyen ilerleyici dejeneratif eklem hastalığıdır. Ağrı, şişlik, tutukluk, kas güçsüzlüğü, krepistasyon, hareket kısıtlılığı ve hassasiyet OA’nın yaygın bulgularıdır. Günümüzde tıp alanındaki gelişmelere rağmen, OA hala bireylerin yaşam kalitesini olumsuz etkileyen ve sağlık bakım sistemine muazzam bir yük bindiren önemli bir sağlık sorunudur. Osteoartrit için mevcut tedavi protokolü üç aşamadan oluşur: farmakolojik olmayan, farmakolojik ve cerrahi müdahaleler. Farmakolojik olmayan müdahaleler osteoartritin yönetiminde yaygın olarak kullanılmaktadır. OA erken tedaviye olumlu yanıt vermektedir. Hastalığın erken aşamalarında farmakolojik olmayan yaklaşımların etkin bir şekilde kullanılması OA’nın gelişiminin önlenmesinde yan etkisi en az olan seçenekler olarak karşımıza çıkmaktadır. Çalışmamız, OA tedavisinde kullanılan farmakolojik olmayan yöntemler hakkında önemli bilgiler sunmaktadır.

Anahtar Kelimeler

• Osteoartrit
• Farmakolojik Olmayan Yaklaşımlar
• Fizik Tedavi

Kaynakça

1. Abbott, J. H., Robertson, M. C., Chapple, C., Pinto, D., Wright, A. A., Leon de la Barra, S., . . . team, M. O. A. T. (2013). Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee: a randomized controlled trial. 1: clinical effectiveness. Osteoarthritis Cartilage, 21(4), 525-534. https://doi.org/10.1016/j.joca.2012.12.014
2. Ahmad, M. A., MS, A. H., & Yusof, A. (2022). Effects of low-level and high-intensity laser therapy as adjunctive to rehabilitation exercise on pain, stiffness and function in knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy, 114, 85-95. https://doi.org/10.1016/j.physio.2021.03.011
3. Ali, A., Rosenberger, L., Weiss, T. R., Milak, C., & Perlman, A. I. (2017). Massage Therapy and Quality of Life in Osteoarthritis of the Knee: A Qualitative Study. Pain Med, 18(6), 1168-1175. https://doi.org/10.1093/pm/pnw217
4. Assis, L., Milares, L. P., Almeida, T., Tim, C., Magri, A., Fernandes, K. R., . . . Renno, A. C. (2016). Aerobic exercise training and low-level laser therapy modulate inflammatory response and degenerative process in an experimental model of knee osteoarthritis in rats. Osteoarthritis Cartilage, 24(1), 169-177. https://doi.org/10.1016/j.joca.2015.07.020
5. Bartels, E. M., Juhl, C. B., Christensen, R., Hagen, K. B., Danneskiold-Samsøe, B., Dagfinrud, H., & Lund, H. (2016). Aquatic exercise for the treatment of knee and hip osteoarthritis. Cochrane Database Syst Rev, 3(3), Cd005523. https://doi.org/10.1002/14651858.CD005523.pub3
6. Beaudreuil, J., Bendaya, S., Faucher, M., Coudeyre, E., Ribinik, P., Revel, M., & Rannou, F. J. J. B. S. (2009). Clinical practice guidelines for rest orthosis, knee sleeves, and unloading knee braces in knee osteoarthritis. 76(6), 629-636.
7. Bender, T., Bálint, G., Prohászka, Z., Géher, P., & Tefner, I. K. (2014). Evidence-based hydro- and balneotherapy in Hungary--a systematic review and meta-analysis. Int J Biometeorol, 58(3), 311-323. https://doi.org/10.1007/s00484-013-0667-6
8. Bennell, K., Hunt, M., Wrigley, T., Hunter, D., McManus, F., Hodges, P., . . . cartilage. (2010). Hip strengthening reduces symptoms but not knee load in people with medial knee osteoarthritis and varus malalignment: a randomised controlled trial. 18(5), 621-628. Bennell, K. L., Hinman, R. S. J. J. o. s., & sport, m. i. (2011). A review of the clinical evidence for exercise in osteoarthritis of the hip and knee. 14(1), 4-9.

9. Bilge, A., Ulusoy, R. G., Üstebay, S., & Öztürk, Ö. J. K. J. o. M. S. (2018). Osteoartrit. 8(1), 133-142. Bjordal, J. M., Johnson, M. I., Lopes-Martins, R. A., Bogen, B., Chow, R., & Ljunggren, A. E. (2007). Short-term efficacy of physical interventions in osteoarthritic knee pain. A systematic review and meta-analysis of randomised placebo-controlled trials. BMC Musculoskelet Disord, 8, 51. https://doi.org/10.1186/1471-2474-8-51
10. Bliddal, H., Leeds, A. R., & Christensen, R. (2014). Osteoarthritis, obesity and weight loss: evidence, hypotheses and horizons - a scoping review. Obes Rev, 15(7), 578-586. https://doi.org/10.1111/obr.12173 Braun, H. J., & Gold, G. E. (2012). Diagnosis of osteoarthritis: imaging. Bone, 51(2), 278-288. https://doi.org/10.1016/j.bone.2011.11.019
11. Brosseau, L., Judd, M. G., Marchand, S., Robinson, V. A., Tugwell, P., Wells, G., & Yonge, K. (2003). Transcutaneous electrical nerve stimulation (TENS) for the treatment of rheumatoid arthritis in the hand. Cochrane Database Syst Rev, 2003(3), Cd004377. https://doi.org/10.1002/14651858.Cd004377
12. Brosseau, L., Taki, J., Desjardins, B., Thevenot, O., Fransen, M., Wells, G. A., . . . Gallardo, I. C. Á. J. C. r. (2017). The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part one: introduction, and mind-body exercise programs. 31(5), 582-595.
13. Brosseau, L., Yonge, K. A., Robinson, V., Marchand, S., Judd, M., Wells, G., & Tugwell, P. (2003). Thermotherapy for treatment of osteoarthritis. Cochrane Database Syst Rev, 2003(4), Cd004522. https://doi.org/10.1002/14651858.Cd004522
14. Bruce-Brand, R. A., Walls, R. J., Ong, J. C., Emerson, B. S., O'Byrne, J. M., & Moyna, N. M. (2012). Effects of home-based resistance training and neuromuscular electrical stimulation in knee osteoarthritis: a randomized controlled trial. BMC Musculoskelet Disord, 13, 118. https://doi.org/10.1186/1471-2474-13-118
15. Burgess, L. C., Taylor, P., Wainwright, T. W., & Swain, I. D. (2021). Lab-based feasibility and acceptability of neuromuscular electrical stimulation in hip osteoarthritis rehabilitation. J Rehabil Assist Technol Eng, 8, 2055668320980613. https://doi.org/10.1177/2055668320980613
16. Chard, J., & Dieppe, P. (2001). The case for nonpharmacologic therapy of osteoarthritis. Curr Rheumatol Rep, 3(3), 251-257.
17. Cho, Y., Jeong, S., Kim, H., Kang, D., Lee, J., Kang, S. B., & Kim, J. H. (2021). Disease-modifying therapeutic strategies in osteoarthritis: current status and future directions. Exp Mol Med, 53(11), 1689-1696. https://doi.org/10.1038/s12276-021-00710-y
18. Chooi, Y. C., Ding, C., & Magkos, F. (2019). The epidemiology of obesity. Metabolism, 92, 6-10. https://doi.org/10.1016/j.metabol.2018.09.005
19. D'Angelo, D., Coclite, D., Napoletano, A., Fauci, A. J., Latina, R., Gianola, S., . . . Iannone, P. (2021). The efficacy of balneotherapy, mud therapy and spa therapy in patients with osteoarthritis: an overview of reviews. Int J Biometeorol, 65(7), 1255-1271. https://doi.org/10.1007/s00484-021-02102-3 Dantas, L. O., Breda, C. C., da Silva Serrao, P. R. M., Aburquerque-Sendín, F., Serafim Jorge, A. E., Cunha, J. E., . . . Salvini, T. F. (2019). Short-term cryotherapy did not substantially reduce pain and had unclear effects on physical function and quality of life in people with knee osteoarthritis: a randomised trial. J Physiother, 65(4), 215-221. https://doi.org/10.1016/j.jphys.2019.08.004
20. Dantas, L. O., Salvini, T. F., & McAlindon, T. E. (2021). Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther, 25(2), 135-146. https://doi.org/10.1016/j.bjpt.2020.08.004
21. de Oliveira Melo, M., Pompeo, K. D., Baroni, B. M., & Vaz, M. A. (2016). Effects of neuromuscular electrical stimulation and low-level laser therapy on neuromuscular parameters and health status in elderly women with knee osteoarthritis: A randomized trial. J Rehabil Med, 48(3), 293-299. https://doi.org/10.2340/16501977-2062
22. Di Domenica, F., Sarzi-Puttini, P., Cazzola, M., Atzeni, F., Cappadonia, C., Caserta, A., . . . Mele, G. (2005). Physical and rehabilitative approaches in osteoarthritis. Semin Arthritis Rheum, 34(6 Suppl 2), 62-69. https://doi.org/10.1016/j.semarthrit.2004.03.016
23. Ettinger, W. H., Burns, R., Messier, S. P., Applegate, W., Rejeski, W. J., Morgan, T., . . . Monu, J. J. J. (1997). A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis: the Fitness Arthritis and Seniors Trial (FAST). 277(1), 25-31.
24. Eyigor, S. J. C. r. (2004). A comparison of muscle training methods in patients with knee osteoarthritis. 23, 109-115. Field, T. (2016). Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: a review. Complement Ther Clin Pract, 22, 87-92.
25. Field, T. (2016). Massage therapy research review. Complement Ther Clin Pract, 24, 19-31. https://doi.org/10.1016/j.ctcp.2016.04.005
26. Fini, M., Giavaresi, G., Carpi, A., Nicolini, A., Setti, S., & Giardino, R. (2005). Effects of pulsed electromagnetic fields on articular hyaline cartilage: review of experimental and clinical studies. Biomed Pharmacother, 59(7), 388-394. https://doi.org/10.1016/j.biopha.2005.02.002
27. Fokmare, P. S., Jr., & Phansopkar, P. (2022). A Review on Osteoarthritis Knee Management via Contrast Bath Therapy and Physical Therapy. Cureus, 14(7), e27381. https://doi.org/10.7759/cureus.27381
28. Fransen, M., McConnell, S., Harmer, A. R., Van der Esch, M., Simic, M., & Bennell, K. L. (2015). Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev, 1(1), Cd004376. https://doi.org/10.1002/14651858.CD004376.pub3
29. Gálvez, I., Torres-Piles, S., & Ortega-Rincón, E. (2018). Balneotherapy, Immune System, and Stress Response: A Hormetic Strategy? Int J Mol Sci, 19(6). https://doi.org/10.3390/ijms19061687
30. Gaynor, J. S., Hagberg, S., & Gurfein, B. T. (2018). Veterinary applications of pulsed electromagnetic field therapy. Res Vet Sci, 119, 1-8. https://doi.org/10.1016/j.rvsc.2018.05.005
31. Geenen, R., Overman, C. L., Christensen, R., Asenlof, P., Capela, S., Huisinga, K. L., . . . Bergman, S. (2018). EULAR recommendations for the health professional's approach to pain management in inflammatory arthritis and osteoarthritis. Ann Rheum Dis, 77(6), 797-807. https://doi.org/10.1136/annrheumdis-2017-212662
32. Ghouri, A., & Conaghan, P. G. (2019). Treating osteoarthritis pain: recent approaches using pharmacological therapies. Clin Exp Rheumatol, 37 Suppl 120(5), 124-129.
33. Grimmer, K. (1992). A controlled double blind study comparing the effects of strong Burst Mode TENS and High Rate TENS on painful osteoarthritic knees. Aust J Physiother, 38(1), 49-56. https://doi.org/10.1016/S0004-9514(14)60551-1
34. Haider, M. Z., Bhuiyan, R., Ahmed, S., Zahid-Al-Quadir, A., Choudhury, M. R., Haq, S. A., & Zaman, M. M. (2022). Risk factors of knee osteoarthritis in Bangladeshi adults: a national survey. BMC Musculoskelet Disord, 23(1), 333. https://doi.org/10.1186/s12891-022-05253-5 Huang, Z., Chen, J., Ma, J., Shen, B., Pei, F., & Kraus, V. B. (2015). Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthritis Cartilage, 23(9), 1437-1444. https://doi.org/10.1016/j.joca.2015.04.005
35. Hunter, D. J., Arden, N., Conaghan, P. G., Eckstein, F., Gold, G., Grainger, A., . . . Zhang, W. (2011). Definition of osteoarthritis on MRI: results of a Delphi exercise. Osteoarthritis Cartilage, 19(8), 963-969. https://doi.org/10.1016/j.joca.2011.04.017
36. Hurley, M., Dickson, K., Hallett, R., Grant, R., Hauari, H., Walsh, N., . . . Oliver, S. J. C. D. o. S. R. (2018). Exercise interventions and patient beliefs for people with hip, knee or hip and knee osteoarthritis: a mixed methods review. (4). Hurley, M., & Walsh, N. (2001). Physical, functional and other non-pharmacological interventions for osteoarthritis. Best Pract Res Clin Rheumatol, 15(4), 569-581. https://doi.org/10.1053/berh.2001.0174
37. Ieran, M., Zaffuto, S., Bagnacani, M., Annovi, M., Moratti, A., & Cadossi, R. (1990). Effect of low frequency pulsing electromagnetic fields on skin ulcers of venous origin in humans: a double-blind study. J Orthop Res, 8(2), 276-282. https://doi.org/10.1002/jor.1100080217
38. Jamtvedt, G., Dahm, K. T., Christie, A., Moe, R. H., Haavardsholm, E., Holm, I., & Hagen, K. B. (2008). Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. Phys Ther, 88(1), 123-136. https://doi.org/10.2522/ptj.20070043
39. Jamtvedt, G., Dahm, K. T., Christie, A., Moe, R. H., Haavardsholm, E., Holm, I., & Hagen, K. B. J. P. t. (2008). Physical therapy interventions for patients with osteoarthritis of the knee: an overview of systematic reviews. 88(1), 123-136. Johnson, M. I., Claydon, L. S., Herbison, G. P., Jones, G., & Paley, C. A. (2017). Transcutaneous electrical nerve stimulation (TENS) for fibromyalgia in adults. Cochrane Database Syst Rev, 10(10), Cd012172. https://doi.org/10.1002/14651858.CD012172.pub2
40. Jordan, K. M., Arden, N. K., Doherty, M., Bannwarth, B., Bijlsma, J. W., Dieppe, P., . . . Dougados, M. (2003). EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis, 62(12), 1145-1155. https://doi.org/10.1136/ard.2003.011742
41. Kelly, T., Yang, W., Chen, C. S., Reynolds, K., & He, J. (2008). Global burden of obesity in 2005 and projections to 2030. Int J Obes (Lond), 32(9), 1431-1437. https://doi.org/10.1038/ijo.2008.102
42. Kholvadia, A., Constantinou, D., & Gradidge, P. J. (2019). Exploring the efficacy of low-level laser therapy and exercise for knee osteoarthritis. S Afr J Sports Med, 31(1), v31i31a6058. https://doi.org/10.17159/2078-516X/2019/v31i1a6058
43. Kirkley, A., Webster-Bogaert, S., Litchfield, R., Amendola, A., MacDonald, S., McCalden, R., & Fowler, P. (1999). The effect of bracing on varus gonarthrosis. J Bone Joint Surg Am, 81(4), 539-548. https://doi.org/10.2106/00004623-199904000-00012
44. Kirwan, J. R., & Elson, C. J. (2000). Is the progression of osteoarthritis phasic? Evidence and implications. J Rheumatol, 27(4), 834-836. http://www.ncbi.nlm.nih.gov/pubmed/10782803
45. Lee, A. C., Driban, J. B., Price, L. L., Harvey, W. F., Rodday, A. M., & Wang, C. J. T. J. o. P. (2017). Responsiveness and minimally important differences for 4 patient-reported outcomes measurement information system short forms: physical function, pain interference, depression, and anxiety in knee osteoarthritis. 18(9), 1096-1110.
46. Lee, Y. H., Park, B. N., & Kim, S. H. (2011). The effects of heat and massage application on autonomic nervous system. Yonsei Med J, 52(6), 982-989. https://doi.org/10.3349/ymj.2011.52.6.982
47. Lespasio, M. J., Piuzzi, N. S., Husni, M. E., Muschler, G. F., Guarino, A., & Mont, M. A. (2017). Knee Osteoarthritis: A Primer. Perm J, 21, 16-183. https://doi.org/10.7812/tpp/16-183
48. Lespasio, M. J., Sultan, A. A., Piuzzi, N. S., Khlopas, A., Husni, M. E., Muschler, G. F., & Mont, M. A. (2018). Hip Osteoarthritis: A Primer. Perm J, 22, 17-084. https://doi.org/10.7812/tpp/17-084
49. Letizia Mauro, G., Scaturro, D., Gimigliano, F., Paoletta, M., Liguori, S., Toro, G., . . . Moretti, A. (2021). Physical Agent Modalities in Early Osteoarthritis: A Scoping Review. Medicina (Kaunas), 57(11). https://doi.org/10.3390/medicina57111165
50. Li, M. H., Xiao, R., Li, J. B., & Zhu, Q. (2017). Regenerative approaches for cartilage repair in the treatment of osteoarthritis. Osteoarthritis Cartilage, 25(10), 1577-1587. https://doi.org/10.1016/j.joca.2017.07.004
51. Lim, W. B., & Al-Dadah, O. (2022). Conservative treatment of knee osteoarthritis: A review of the literature. World J Orthop, 13(3), 212-229. https://doi.org/10.5312/wjo.v13.i3.212
52. Litwic, A., Edwards, M. H., Dennison, E. M., & Cooper, C. (2013). Epidemiology and burden of osteoarthritis. Br Med Bull, 105, 185-199. https://doi.org/10.1093/bmb/lds038
53. Maeda, T., Yoshida, H., Sasaki, T., & Oda, A. (2017). Does transcutaneous electrical nerve stimulation (TENS) simultaneously combined with local heat and cold applications enhance pain relief compared with TENS alone in patients with knee osteoarthritis? J Phys Ther Sci, 29(10), 1860-1864. https://doi.org/10.1589/jpts.29.1860
54. Mahmoudian, A., Lohmander, L. S., Mobasheri, A., Englund, M., & Luyten, F. P. (2021). Early-stage symptomatic osteoarthritis of the knee - time for action. Nat Rev Rheumatol, 17(10), 621-632. https://doi.org/10.1038/s41584-021-00673-4
55. Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgrad Med, 127(1), 57-65. https://doi.org/10.1080/00325481.2015.992719
56. Maly, M. R., Marriott, K. A., & Chopp-Hurley, J. N. (2020). Osteoarthritis year in review 2019: rehabilitation and outcomes. Osteoarthritis Cartilage, 28(3), 249-266. https://doi.org/10.1016/j.joca.2019.11.008
57. Mandl, L. A. (2019). Osteoarthritis year in review 2018: clinical. Osteoarthritis Cartilage, 27(3), 359-364. https://doi.org/10.1016/j.joca.2018.11.001
58. Martimbianco, A. L. C., Porfírio, G. J., Pacheco, R. L., Torloni, M. R., & Riera, R. (2019). Transcutaneous electrical nerve stimulation (TENS) for chronic neck pain. Cochrane Database Syst Rev, 12(12), Cd011927. https://doi.org/10.1002/14651858.CD011927.pub2
59. Meiri, R., Rosenbaum, T. Y., & Kalichman, L. (2014). Sexual Function before and after Total Hip Replacement: Narrative Review. Sex Med, 2(4), 159-167. https://doi.org/10.1002/sm2.35
60. Messina, O. D., Vidal Wilman, M., & Vidal Neira, L. F. (2019). Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res, 31(6), 807-813. https://doi.org/10.1007/s40520-019-01191-w
61. Michael, J. W., Schlüter-Brust, K. U., & Eysel, P. (2010). The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Dtsch Arztebl Int, 107(9), 152-162. https://doi.org/10.3238/arztebl.2010.0152
62. Minor, M., Hewett, J., Webel, R., Dreisinger, T., & Kay, D. J. T. J. o. r. (1988). Exercise tolerance and disease related measures in patients with rheumatoid arthritis and osteoarthritis. 15(6), 905-911.
63. Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. https://doi.org/10.3389/fimmu.2022.907750 Negm, A., Lorbergs, A., & Macintyre, N. J. (2013). Efficacy of low frequency pulsed subsensory threshold electrical stimulation vs placebo on pain and physical function in people with knee osteoarthritis: systematic review with meta-analysis. Osteoarthritis Cartilage, 21(9), 1281-1289. https://doi.org/10.1016/j.joca.2013.06.015
64. Ogura Dantas, L., Serafim Jorge, A. E., Regina Mendes da Silva Serrão, P., Aburquerque-Sendín, F., & de Fatima Salvini, T. (2020). Cryotherapy associated with tailored land-based exercises for knee osteoarthritis: a protocol for a double-blind sham-controlled randomised trial. BMJ Open, 10(6), e035610. https://doi.org/10.1136/bmjopen-2019-035610
65. Okuyan, H. M., & Begen, M. A. (2022). LncRNAs in Osteoarthritis. Clin Chim Acta, 532, 145-163. https://doi.org/10.1016/j.cca.2022.05.030 Oliveira, M. C., Vullings, J., & van de Loo, F. A. J. (2020). Osteoporosis and osteoarthritis are two sides of the same coin paid for obesity. Nutrition, 70, 110486. https://doi.org/10.1016/j.nut.2019.04.001 Ortega, E., Gálvez, I., Hinchado, M. D., Guerrero, J., Martín-Cordero, L., & Torres-Piles, S. (2017). Anti-inflammatory effect as a mechanism of effectiveness underlying the clinical benefits of pelotherapy in osteoarthritis patients: regulation of the altered inflammatory and stress feedback response. Int J Biometeorol, 61(10), 1777-1785. https://doi.org/10.1007/s00484-017-1361-x Osiri, M., Welch, V., Brosseau, L., Shea, B., McGowan, J., Tugwell, P., & Wells, G. (2000). Transcutaneous electrical nerve stimulation for knee osteoarthritis. Cochrane Database Syst Rev(4), CD002823. https://doi.org/10.1002/14651858.CD002823
66. Özkan, N. (2016). Osteoartritin Nöralterapi Yaklaşımı İle Değerlendirilmesi Ve Tedavisi. Bilimsel Tamamlayıcı Tıp Regülasyon ve Nöral Terapi Dergisi, 10(1), 17-21.
67. Palazzo, C., Nguyen, C., Lefevre-Colau, M. M., Rannou, F., & Poiraudeau, S. (2016). Risk factors and burden of osteoarthritis. Ann Phys Rehabil Med, 59(3), 134-138. https://doi.org/10.1016/j.rehab.2016.01.006
68. Penninx, B. W., Messier, S. P., Rejeski, W. J., Williamson, J. D., DiBari, M., Cavazzini, C., . . . Pahor, M. J. A. o. I. m. (2001). Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. 161(19), 2309-2316.
69. Pereira, D., Ramos, E., & Branco, J. (2015). Osteoarthritis. Acta Med Port, 28(1), 99-106. https://doi.org/10.20344/amp.5477
70. Pereira, D., Severo, M., Barros, H., Branco, J., Santos, R. A., & Ramos, E. (2013). The effect of depressive symptoms on the association between radiographic osteoarthritis and knee pain: a cross-sectional study. BMC Musculoskelet Disord, 14, 214. https://doi.org/10.1186/1471-2474-14-214 Perlman, A., Fogerite, S. G., Glass, O., Bechard, E., Ali, A., Njike, V. Y., . . . Katz, D. L. (2019). Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. J Gen Intern Med, 34(3), 379-386. https://doi.org/10.1007/s11606-018-4763-5
71. Pouli, N., Das Nair, R., Lincoln, N. B., & Walsh, D. (2014). The experience of living with knee osteoarthritis: exploring illness and treatment beliefs through thematic analysis. Disability and Rehabilitation, 36(7), 600-607. https://doi.org/10.3109/09638288.2013.805257
72. Pouli, N., Das Nair, R., Lincoln, N. B., & Walsh, D. (2014). The experience of living with knee osteoarthritis: exploring illness and treatment beliefs through thematic analysis. Disabil Rehabil, 36(7), 600-607. https://doi.org/10.3109/09638288.2013.805257
73. Prieto-Alhambra, D., Judge, A., Javaid, M. K., Cooper, C., Diez-Perez, A., & Arden, N. K. (2014). Incidence and risk factors for clinically diagnosed knee, hip and hand osteoarthritis: influences of age, gender and osteoarthritis affecting other joints. Ann Rheum Dis, 73(9), 1659-1664. https://doi.org/10.1136/annrheumdis-2013-203355
74. Protano, C., Fontana, M., De Giorgi, A., Marotta, D., Cocomello, N., Crucianelli, S., . . . Vitali, M. (2023). Balneotherapy for osteoarthritis: a systematic review. Rheumatol Int, 43(9), 1597-1610. https://doi.org/10.1007/s00296-023-05358-7
75. Raji, A. R., & Bowden, R. E. (1982). Effects of high peak pulsed electromagnetic fields on degeneration and regeneration of the common peroneal nerve in rate. Lancet, 2(8295), 444-445. https://doi.org/10.1016/s0140-6736(82)90476-7 Rannou, F., & Poiraudeau, S. (2010). Non-pharmacological approaches for the treatment of osteoarthritis. Best Pract Res Clin Rheumatol, 24(1), 93-106. https://doi.org/10.1016/j.berh.2009.08.013
76. Raposo, F., Ramos, M., & Lucia Cruz, A. (2021). Effects of exercise on knee osteoarthritis: A systematic review. Musculoskeletal Care, 19(4), 399-435. https://doi.org/10.1002/msc.1538
77. Rayegani, S. M., Raeissadat, S. A., Heidari, S., & Moradi-Joo, M. (2017). Safety and Effectiveness of Low-Level Laser Therapy in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. J Lasers Med Sci, 8(Suppl 1), S12-s19. https://doi.org/10.15171/jlms.2017.s3
78. Reichenbach, S., Juni, P., Hincapie, C. A., Schneider, C., Meli, D. N., Schurch, R., . . . da Costa, B. R. (2022). Effect of transcutaneous electrical nerve stimulation (TENS) on knee pain and physical function in patients with symptomatic knee osteoarthritis: the ETRELKA randomized clinical trial. Osteoarthritis Cartilage, 30(3), 426-435. https://doi.org/10.1016/j.joca.2021.10.015
79. Roddy, E., Zhang, W., & Doherty, M. J. A. o. t. r. d. (2005). Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. 64(4), 544-548.
80. Runhaar, J., Luijsterburg, P., Dekker, J., Bierma-Zeinstra, S. J. O., & cartilage. (2015). Identifying potential working mechanisms behind the positive effects of exercise therapy on pain and function in osteoarthritis; a systematic review. 23(7), 1071-1082.
81. Schrieber, L., Colley, M. J. B. p., & rheumatology, r. C. (2004). Patient education. 18(4), 465-476.
82. Sharma, L. J. C. o. i. r. (2002). Nonpharmacologic management of osteoarthritis. 14(5), 603-607.
83. Silveira, P. C., Silva, L. A., Fraga, D. B., Freitas, T. P., Streck, E. L., & Pinho, R. (2009). Evaluation of mitochondrial respiratory chain activity in muscle healing by low-level laser therapy. J Photochem Photobiol B, 95(2), 89-92. https://doi.org/10.1016/j.jphotobiol.2009.01.004
84. Sivaramakrishnan, A., Solomon, J. M., & Manikandan, N. (2018). Comparison of transcutaneous electrical nerve stimulation (TENS) and functional electrical stimulation (FES) for spasticity in spinal cord injury - A pilot randomized cross-over trial. J Spinal Cord Med, 41(4), 397-406. https://doi.org/10.1080/10790268.2017.1390930
85. Skou, S. T., Koes, B. W., Grønne, D. T., Young, J., & Roos, E. M. (2020). Comparison of three sets of clinical classification criteria for knee osteoarthritis: a cross-sectional study of 13,459 patients treated in primary care. Osteoarthritis Cartilage, 28(2), 167-172. https://doi.org/10.1016/j.joca.2019.09.003
86. Suzuki, Y., Iijima, H., Tashiro, Y., Kajiwara, Y., Zeidan, H., Shimoura, K., . . . Tatsumi, M. J. C. R. (2019). Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial. 38, 133-141.
87. Thacoor, A., & Sandiford, N. A. (2019). Cryotherapy following total knee arthroplasty: What is the evidence? J Orthop Surg (Hong Kong), 27(1), 2309499019832752. https://doi.org/10.1177/2309499019832752
88. Thomas, K., Muir, K., Doherty, M., Jones, A., O'reilly, S., & Bassey, E. J. B. (2002). Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial. 325(7367), 752.
89. Thomas, S., Browne, H., Mobasheri, A., & Rayman, M. P. (2018). What is the evidence for a role for diet and nutrition in osteoarthritis? Rheumatology (Oxford), 57(suppl_4), iv61-iv74. https://doi.org/10.1093/rheumatology/key011
90. Tieppo Francio, V., Dima, R. S., Towery, C., & Davani, S. (2017). Prolotherapy and Low Level Laser Therapy: A Synergistic Approach to Pain Management in Chronic Osteoarthritis. Anesth Pain Med, 7(5), e14470. https://doi.org/10.5812/aapm.14470
91. UK, N. C. G. C. (2014). Osteoarthritis: care and management in adults.
92. Umay, E., Tezelli, M. K., Dinç, A., Rükşen, S. J. J. o. P. M., & Science, R. (2012). Kaplıca Tedavisi Birlikteliği ile Diz Osteoartritli Hastalarda İzotonik ve İzokinetik Egzersiz Yöntemlerinin Karşılaştırılması. 15, 31-38.
93. van Doormaal, M. C. M., Meerhoff, G. A., Vliet Vlieland, T. P. M., & Peter, W. F. (2020). A clinical practice guideline for physical therapy in patients with hip or knee osteoarthritis. Musculoskeletal Care, 18(4), 575-595. https://doi.org/10.1002/msc.1492
94. Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain Manag, 4(3), 197-209. https://doi.org/10.2217/pmt.14.13
95. Varzaityte, L., Kubilius, R., Rapoliene, L., Bartuseviciute, R., Balcius, A., Ramanauskas, K., & Nedzelskiene, I. (2020). The effect of balneotherapy and peloid therapy on changes in the functional state of patients with knee joint osteoarthritis: a randomized, controlled, single-blind pilot study. Int J Biometeorol, 64(6), 955-964. https://doi.org/10.1007/s00484-019-01785-z
96. Verville, L., Hincapié, C. A., Southerst, D., Yu, H., Bussières, A., Gross, D. P., . . . Cancelliere, C. (2023). Systematic Review to Inform a World Health Organization (WHO) Clinical Practice Guideline: Benefits and Harms of Transcutaneous Electrical Nerve Stimulation (TENS) for Chronic Primary Low Back Pain in Adults. J Occup Rehabil, 33(4), 651-660. https://doi.org/10.1007/s10926-023-10121-7
97. Vincent, H. K., Heywood, K., Connelly, J., & Hurley, R. W. (2012). Obesity and weight loss in the treatment and prevention of osteoarthritis. PM R, 4(5 Suppl), S59-67. https://doi.org/10.1016/j.pmrj.2012.01.005
98. Wei, N., & Dai, Z. (2022). The Role of Nutrition in Osteoarthritis: A Literature Review. Clin Geriatr Med, 38(2), 303-322. https://doi.org/10.1016/j.cger.2021.11.006
99. Woolf, A. D., & Pfleger, B. (2003). Burden of major musculoskeletal conditions. Bull World Health Organ, 81(9), 646-656.
100. Wu, Z., Ding, X., Lei, G., Zeng, C., Wei, J., Li, J., . . . Xie, D. (2018). Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis. BMJ Open, 8(12), e022879. https://doi.org/10.1136/bmjopen-2018-022879
101. Yang, X., Guo, H., Ye, W., Yang, L., & He, C. (2021). Pulsed Electromagnetic Field Attenuates Osteoarthritis Progression in a Murine Destabilization-Induced Model through Inhibition of TNF-α and IL-6 Signaling. Cartilage, 13(2_suppl), 1665s-1675s. https://doi.org/10.1177/19476035211049561
102. Yin, B., Ni, J., Witherel, C. E., Yang, M., Burdick, J. A., Wen, C., & Wong, S. H. D. (2022). Harnessing Tissue-derived Extracellular Vesicles for Osteoarthritis Theranostics. Theranostics, 12(1), 207-231. https://doi.org/10.7150/thno.62708
103. Zeng, C., Li, H., Yang, T., Deng, Z. H., Yang, Y., Zhang, Y., & Lei, G. H. (2015). Electrical stimulation for pain relief in knee osteoarthritis: systematic review and network meta-analysis. Osteoarthritis Cartilage, 23(2), 189-202. https://doi.org/10.1016/j.joca.2014.11.014
104. Zhao, X., Shah, D., Gandhi, K., Wei, W., Dwibedi, N., Webster, L., & Sambamoorthi, U. (2019). Clinical, humanistic, and economic burden of osteoarthritis among noninstitutionalized adults in the United States. Osteoarthritis Cartilage, 27(11), 1618-1626. https://doi.org/10.1016/j.joca.2019.07.002
105. Zhu, S., Qu, W., & He, C. (2024). Evaluation and management of knee osteoarthritis. J Evid Based Med, 17(3), 675-687. https://doi.org/10.1111/jebm.12627