The Efficacy of Ultrasound, Pulsed Shortwave Diathermy and Bicycle Exercises in Knee Osteoarthritis

Abstract

Objective: The purpose of this study is to investigate if the bicycle exercises being addition to different physical therapy combinations have effects on pain, functional capacity and quality of life in the patients with knee osteoarthritis (OA). Materials and Methods: 80 patients with knee OA were randomly divided into four groups and applied hot pack (HP) + transkutanoz elektrikil neurol stimulastion (TENS) + ultrasound (US) to the first group, HP + TENS + Pulsed shortwave diathermy (PSWD) to the second group, HP + TENS + US + bicycle exercises to the third group and HP + TENS + Pulsed SWD + bicycle exercises to the fourth group. These therapy programs were applied for 3 weeks. Patients were evaluated with pain, the duration of 50 steps walking, and range of motion. Results: Statistically significant improvement was observed all groups at the end of the therapy. The patients in groups who were subjected to bicycle exercises (Groups 3 and 4) were siginficantly better in terms of the decrease in pain and the duration of 50 steps walking than the other groups. Conclusion: Physical therapy combinations involving bicycle exercises were found out to be more efficient than single physical therapy combinations. Key words: Knee Osteoarthritis, Bicycle Exercises, Ultrasound, Pulsed Shortwave Diathermy

Keywords

• Knee Osteoarthritis, Bicycle Exercises, Ultrasound, Pulsed Shortwave Diathermy

Diz Osteoartritinde Ultrason, Kesikli Kısa Dalga Diatermi ve Bisiklet Egzersizlerinin Etkinliği

Öz

Amaç: Bu çalışmanın amacı; diz osteoartriti (OA) olan hastalarda farklı fizik tedavi kombinasyonlarına ilave edilen bisiklet egzersizlerinin; ağrı, fonksiyonel durum ve yaşam kalitesine katkısının olup olmadığını araştırmaktır. Gereç ve Yöntem: 80 diz OA'li hasta rastgele yöntemle dört gruba ayrılarak; 1. gruba sıcak paket + transkutanöz elektriksel sinir stimülasyonu (TENS) + ultrason, 2. gruba sıcak paket + TENS + kesikli kısa dalga diatermi (KDD), 3. gruba sıcak paket + TENS + ultrason + bisiklet egzersizi, 4. gruba ise sıcak paket + TENS + kesikli KDD + bisiklet egzersizi uygulandı. Tedavi programı 3 hafta süreyle uygulandı. Hastalar; ağrı, 50 adım yürüme süresi ve eklem hareket açıklığı ile değerlendirildiler. Bulgular: Tedavi bitiminde grupların hepsinde istatistiksel olarak anlamlı düzelme görüldü. Bisiklet egzersizlerinin uygulandığı 3. ve 4. grupta ağrı ve 50 adım yürüme süresi istatistiksel olarak anlamlı düzeyde diğer gruplardan daha iyiydi. Sonuç: Bisiklet egzersizleri ile birlikte uygulanan fizik tedavi kombinasyonlarının tek başına uygulanan fizik tedavi kombinasyonlarından daha etkili olduğu sonucuna varıldı. Anahtar kelimeler: Diz Osteoartriti, Bisiklet Egzersizi, Ultrason, Kesikli Kısa Dalga Diatermi

Anahtar Kelimeler

• Diz Osteoartriti, Bisiklet Egzersizi, Ultrason, Kesikli Kısa Dalga Diatermi

Kaynakça

1. Ozgonenel L, Aytekin E, Durmusoglu G. A double-blind trial of clinical effects of therapeutic ultrasound in knee osteoarthritis. Ultrasound Med Biol 2009; 35: 44-9.
2. Laufer Y, Zilberman R, Porat R, Nahir AM. Effect of pulsed short-wave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial. Clin Rehabil 2005; 19: 255-63.
3. Lange AK, Vanwanseele B, Foroughi N, Baker MK, Shnier R, Smith RM, et al. Resistive Exercise for Arthritic Cartilage Health (REACH): a randomized double-blind, sham-exercise controlled trial. BMC Geriatr 2009; 9: 1.
4. Petrella RJ. Is exercise effective treatment for osteoarthritis of the knee? Br J Sports Med 2000; 34: 326-31.
5. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, et al. Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 1986; 29: 1039-49.
6. Bellamy N, Bachmeier C, Brooks PM, Browne CD, Cohen ML, March L, Conaghan PG, Day RO, Campbell J. Osteoarthritis antirheumatic drug trials: Effects of a standardized instructional videotape on the reliability of observer-dependent dependent outcome measures. Inflammopharmacology 1997; 5: 285-95.
7. Lequesne MG, Mery C, Samson M, Gerard P. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests. Scand J Rheumatol Suppl 1987; 65: 85-9.
8. Bergner M, Bobbitt RA, Carter WB, Gilson BS. The Sickness Impact Profile: development and final revision of a health status measure. Med Care 1981; 19: 787-805.

9. Petersson IF, Boegard T, Saxne T, Silman AJ, Svensson B. Radiographic osteoarthritis of the knee classified by the Ahlback and Kellgren & Lawrence systems for the tibiofemoral joint in people aged 35-54 years with chronic knee pain. Ann Rheum Dis 1997; 56: 493-6.
10. Kalyon TA. Ultrasonlar. In: Tuna N, ed. Elektroterapi. İstanbul: Nobel Tıp Kitabevi; 1999: 129-38.
11. Ketenci A. Yüksek frekanslı akımlar. In: Tuna N, ed. Elektroterapi. İstanbul: Nobel Tıp Kitabevi; 1999: 93-117.
12. Welch V, Brosseau L, Peterson J, Shea B, Tugwell P, Wells G. Therapeutic ultrasound for osteoarthritis of the knee. Cochrane Database Syst Rev 2001: CD003132.
13. Falconer J, Hayes KW, Chang RW. Effect of ultrasound on mobility in osteoarthritis of the knee. A randomized clinical trial. Arthritis Care Res 1992; 5: 29-35.
14. Kalpakçıoğlu B, Çakmak B, Bahadır C. Comparison of Ultrasound and Short Wave Diathermy Therapy in Knee Osteoarthritis. Turk J Phys Med Rehab 2006: 52; 168-73.
15. Özgürsoy P. Osteoartritte Tedavi İlkeleri. Romatizma 2006; 21: 67-72.
16. Callaghan MJ, Whittaker PE, Grimes S, Smith L. An evaluation of radioleucoscintigraphy: a randomised, double blind, controlled trial. Joint Bone Spine 2005; 72: 150-5. knee
17. osteoarthritis using
18. Karaburun S, Akşit R, Cüreklibatur F. Sürekli kısa dalga diatermi ile kesikli kısa dalga diatermi uygulamasının gonartroz üzerine etkileri. Türk Fiz Tıp Rehab Derg 1986; 5: 88-9.
19. Jan MH, Chai HM, Wang CL, Lin YF, Tsai LY. Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study. Phys Ther 2006; 86: 236-44.
20. Tüzün EH, Otman S, Kirdi N. Comparison of different methods of pulsed shortwave diathermy in knee osteoarthritis. The Pain Clinic 2003;15: 421-7.
21. Mangione KK, McCully K, Gloviak A, Lefebvre I, Hofmann M, Craik R. The effects of high-intensity and low-intensity cycle ergometry in older adults with knee osteoarthritis. J Gerontol A Biol Sci Med Sci 1999; 54: M184-90.
22. Hazneci B, Göktepe S, Alaca R, Balaban B, Kalyon T. Diz osteartrozlarında fizik tedavi modaliteleri ile kombine edilmiş ev egzersiz programının ağrı ve fonksiyonel değerlendirme üzerine etkisi. Türk Fiz Tıp Rehab Derg 2000; 3: 30-4.