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Objective:To compare the application effect among Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scale, Medical Outcomes Study 36-item Short Form (SF-36) scale and "Assessment for Therapeutic Efficacy on Kashin-Beck Disease" (WS/T 79-2011) standard in the evaluation of therapeutic effect of patients with Kashin-Beck disease, which could provide basis for the treatment evaluation of patients with Kashin-Beck disease.Methods:A total of 213 patients with Kashin-Beck disease in Gansu Province were investigated. WOMAC scale, SF-36 scale and standard of WS/T 79-2011 were used to analyze the quality of life of patients before and after treatment. The reliability, construct validity, content validity, discriminant validity of WOMAC and SF-36 scales were compared. Correlation between WOMAC, SF-36 scales and standard of WS/T 79-2011 were evaluated.Results:Both WOMAC and SF-36 scales had good construct validity and content validity (construct validity showed WOMAC and SF-36 scales contained 1 and 2 common factors, respectively; content validity showed WOMAC and SF-36 scales contained 3 and 8 common factors, respectively). The reliability and discriminant validity of WOMAC scale were better than those of SF-36 seale (reliability showed WOMAC reliability coefficient ≥0.934, the reliability coefficient of SF-36 scale was ranged from 0.386 to 0.999. Discriminant validity showed there were differences in 3 dimensions of the WOMAC scale before and after treatment, while there were differences in 6 out of 8 dimensions of the SF-36 scale). The correlation coefficients between WOMAC scale and standard of WS/T 79-2011 ranged from 0.175 to 0.437, the correlation coefficients between SF-36 scale and standard of WS/T 79-2011 ranged from - 0.434 to - 0.099 ( P < 0.05). Conclusion:The reliability, discriminant validity and correlation with the standard of WS/T 79-2011 of WOMAC scale are better than those of SF-36 scale in efficacy evaluation of patients with Kashin-Beck disease.
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Background: Osteoarthritis (OA) is the most common type of rheumatic disease and a leading cause of disability. Current treatments aim at alleviating these symptoms by several different methods: non-pharmacological and pharmacological treatments and invasive interventions. Among the regenerative methods, hyaluronic acid (HA) is popular now-a-days where differences exist in concentration, molecular weight, dosage, expected duration of effects and added formulations. Based on HA molecular weight, these products are classified in two groups (high and low). Due to cost effectiveness, low molecular weight HA is commonly used. To find out the outcome of single intra-articular injection of high-molecular- weight HA in patients with knee osteoarthritis.Material & Methods:This was a randomized clinical trial conducted among purposively selected 55 patients suffering from Knee OA attending at the Physical Medicine and Rehabilitation outpatient department, DMCH during July 2020 to June 2021. Patients were randomly allocated into two groups; group A received single dose of high molecular weight HA and designed exercise program and group B received same exercise program only. Pre-treatment and 3 weekly post treatment assessment were done up to 12 weeks in each group. In each follow up visit, pain, and functional status were measured in Visual Analog Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively and compared between group A and group B where was considered as significant (p value <0.050.Results:The mean age of the participants in group A and group B were 56.8 (±9.8) and 53.3 (±7.4) years respectively where majority of the patients in both groups were female patients with overweight. In group A, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with high-molecular-weight HA (P<0.001). In group B, VAS and WOMAC significantly decreased from base line to each follow up till 12th weeks after treatment with conservative management (P<0.001). After 6 weeks of intervention, the mean VAS scores of the patients became 4.9 ±1.1 and 6.0±1.0 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the VAS score was significantly decreased in group A (2.8±1.3) than group B (4.9±1.7) (P<0.001). After 3 weeks of intervention, the mean WOMAC scores of the patients became 71.2±6.6 and 75.0 ±4.9 in group A and group B respectively which showed significant statistical difference (P<0.001). At the end of 12 weeks, the WOMAC score was significantly decreased in group A (61.9±6.6) than group B (68.1±4.6) (P<0.001). Conclusion:Single intra-articular injection of high-molecular-weight Hyaluronic Acid is effective in patients with knee osteoarthritis in reducing pain and improving functional impairment. Long term and large scale research studies are needed to establish the effectiveness and safety of this procedure in patients with knee osteoarthritis.
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Background & objectives: Osteoarthritis (OA) is the most common form of arthritis that increases with age affecting the population from the middle age to the elderly. The present study was undertaken to find whether neuromuscular stimulation of vastus medialis oblique (VMO) in combination with Maitland’s mobilization and exercises was more effective as compared to Maitland’s mobilization with exercises alone in patients with knee OA. Methods: Sixty patients with knee OA were purposively selected and randomly distributed to two groups that received an intervention for eight weeks. Group A patients received Maitland’s mobilization in combination with exercises and group B patients received the same intervention as group A in combination with neuromuscular stimulation of VMO muscle. After eight weeks, outcome measures, i.e. Numeric Pain Rating Scale (NPRS) and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) index, were reassessed. Results: Both groups showed significant (P<0.05) within-group improvement in the knee pain levels and stiffness as reflected by NPRS and WOMAC index. Interpretation & conclusions: Patients of both the groups (A and B) were found to be improving significantly in pain and disability, group A patients receiving Maitland’s mobilization in combination with exercises were found to get more relief in pain and disability.
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@#Introduction: Osteoarthritis (OA) is estimated to be the fourth leading cause of disability in the general population. It probably is the most common disease of joints in adults throughout the world. Knee OA accounts for more than 80% of the disease’s total burden and as per an estimate in US population, it affects at least 19% of adults aged 45 years and older. This was a randomised study aimed to evaluate the efficacy of platelet rich plasma (PRP) as a treatment modality for osteoarthritis knee in comparison to arthroscopic management. Materials and methods: This study was conducted from 2018 to 2020 at a tertiary care teaching hospital, under reference number ELMC&H/RCELL2019/39. A total of 70 patients of osteoarthritis knee with grade 2-3 according to the Kellgren-Lawrence classification were selected using computer generated random number among them 35 patients were subjected to arthroscopy (Group II) and 35 were administered platelet rich plasma injection (Group I) and evaluated at 3, 6 and 9 months of follow-up. Both the groups were assessed and scored with the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and Visual Analog Pain Scale (VAS) to compare pre-treatment and post-treatment values. As all the patients in the sample was followed-up, resulting into no loss of subjects. Result: Overall, percentage reduction in VAS score at 3 months, 6 months, and 9 months was 24.45±9.09, 18.45±11.60 and 8.29±14.19%, respectively in Group I and 18.96±5.85, 7.33±8.60 and 3.20±7.39%, respectively in Group II. A statistically significant difference between two groups was observed at 3- and 6-months’ time intervals only (p<0.05). Overall, percentage reduction in WOMAC score at 3 months, 6 months and 9 months was 24.03±11.41, 17.45±9.24, and 9.49±9.80%, respectively in Group I and 11.27±5.73, 5.70±4.78, and -0.13±5.06%, respectively in Group II. At all the three-time intervals, the difference between two groups was significant statistically (p<0.001). Conclusion: This study suggested that both PRP as well as arthroscopy provide a reduction in WOMAC and VAS scores for pain among cases of knee osteoarthritis. Most effective reduction is observed at three months follow-up which thereafter tends to diminish. Of the two modalities, PRP seemed to have an edge over arthroscopic debridement, however, this efficacy was more pronounced for KellgrenLawrence Grade 2 as compared to Grade 3.
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Objective: This study was conducted with the aim to evaluate the efficacy and safety of Vitamin B complex as an add-on therapy to diclofenac in patients with primary osteoarthritis (OA) of the knee. Materials and Methods: In this prospective, open-labeled, randomized, and comparative clinical study, a total of 130 patients of age >40 years with primary OA of knee attending orthopedics OPD were randomly allocated into two groups of 65 each, i.e., Group D and Group B. In Group D, patients received tablet diclofenac 75 mg and in Group B, patients received tablet Vitamin B complex along with diclofenac once daily for 4 weeks, respectively. Clinical assessment was done at baseline and at the end of 4 weeks and 8 weeks by the visual analog scale (VAS), WOMAC index, and Lequesne index. Results: During the intergroup comparison, it was found that Vitamin B complex as an add-on therapy to diclofenac produced statistically significant reduction in mean VAS pain score (P < 0.05). However, the difference in mean WOMAC index and Lequesne index was not statistically different at 4 and 8 weeks between the two groups (P > 0.05). Mild side effects were seen at 4 weeks, but no side effects persisted up to 8 weeks in both the groups. Conclusion: The present study suggested that Vitamin B complex as an add-on therapy was found to cause a significant reduction in pain score. It could be a promising drug in patients with OA to improve the analgesic effect, when combined can reduce the dose of diclofenac, thereby minimizing the side effects.
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Objective:To investigate the safety and efficacy of transcatheter genicular artery embolization (GAE) for moderate to severe knee osteoarthritis (KOA).Methods:This prospective study included 13 patients (17 knees) with KOA who were treated with GAE from October 2020 to March 2021. The Kellgren-Lawrence (K-L) grade was 2-3 for 11 knees, and 4 for 6 knees. The Western Ontario and McMaster Universities osteoarthritis index (WOMAC) and the Whole-Organ Magnetic Resonance Imaging Score (WORMS) assessments were performed for all the subjects before operation. The success rate, clinical efficacy and complications were recorded after operation. Clinical outcomes were evaluated at 1 day, 1week and 1, 3, 6 months after the operation.Results:The success rate of GAE in 17 cases was 100%, and the success rate of target artery superselection was 98.4%(63/64). The baseline WOMAC pain score was 11(10, 13) and total score was 44(38, 58) for 17 knees. Post-operation follow-up WOMAC pain score were 4(3, 7), 2(1, 5), 2(1, 6) and 4(2, 6) at 1 day, 1 week, 1 month, and 3 months. Post-operation follow-up WOMAC total score were 22 (15, 34),20 (12, 24),17 (12, 26) and 20 (12, 31) at 1 day, 1 week, 1 month, and 3 months. There were 16 knees with 6 month follow-up assessment, with the WOMAC pain score of 2.5(2, 5), and the total score of 15(12, 26). Significant difference was found in the WOMAC pain score between baseline and the 1 day, 1 week, 1, 3 and 6 months follow up ( Z=-3.631, -3.623, -3.622, -3.622, -3.532, all P<0.001); also, the total score was statistically significant different between the baseline and the 1 day, 1 week, 1, 3 and 6 months follow up ( Z=-3.639, -3.634, -3.646, -3.527, -3.532, all P<0.001). At 3 months follow-up, there was 1 knee recognized clinical failure. Post-operative adverse reaction in this group included skin ecchymosis in femoral artery puncture area ( n=3), knee joint stiffness and pain within 1 week ( n=4),and clanging joints during postoperative activities ( n=6). Conclusion:GAE is a feasible and safe procedure with obvious short-term curative effect, which can alleviate pain symptoms and improve restricted movement in patients with KOA.
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OBJECTIVE@#To compare the clinical effect of fire needling and filiform needling for mild to moderate knee osteoarthritis (KOA) and observe the influence on related serum inflammatory sytokines.@*METHODS@#A total of 60 patients with mild to moderate KOA were randomly divided into an observation group (30 cases, 4 cases dropped off) and a control group (30 cases, 4 cases dropped off). Both groups were given basic health management, and the acupoints of the two groups were Liangqiu (ST 34), Xuehai (SP 10), Neixiyan (EX-LE 4), Dubi (ST 35), Yanglingquan (GB 34) and @*RESULTS@#At each time point of treatment and follow-up, the pain, stiffness, difficulty of daily activities scores and WOMAC total scores of the two groups were lower than those before treatment (@*CONCLUSION@#Fire needling can improve the pain, stiffness and joint dysfunction of patients with mild to moderate KOA, and increase serum MMP-3 and IL-1α levels. Its short and long term clinical effects are better than filiform needling.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Cytokines , Osteoarthritis, Knee/therapy , Treatment OutcomeABSTRACT
BACKGROUND: The original structure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been contested in several languages. OBJECTIVE: To assess the structural validity of the Brazilian version of WOMAC among patients with knee osteoarthritis. DESIGN AND SETTING: Structural validity study conducted at physiotherapy clinics and primary healthcare units. METHODS: The study included males and females aged 40 to 80 years who were all native Brazilian Portuguese speakers, with knee pain in the previous six months and a diagnosis of knee osteoarthritis. We used exploratory factor analysis (EFA) followed by confirmatory factor analysis (CFA) with implementation of a polychoric matrix and the robust diagonally weighted least squares (RDWLS) extraction method. The adequacy of the model was assessed using the following fit indices: root mean square error of approximation (RMSEA), comparative fit index (CFI), Tucker-Lewis index (TLI), standardized root mean square residual (SRMR) and chi-square/degree of freedom (DF). RESULTS: 203 patients with knee osteoarthritis were included. The model proposed in this study with two factors, i.e. "pain" (items 1, 2, 3 and 4) and "physical function" (items 10, 11, 16, 17, 18, 19, 21 and 22), showed adequate fit indices in CFA: chi-square/DF = 1.30; CFI = 0.976; TLI = 0.970; RMSEA = 0.039; and SRMR = 0.070. The factorial loads ranged from 0.68 to 0.76 for the "pain" domain and 0.44 to 0.62 for the "physical function" domain. CONCLUSION: The Brazilian version of WOMAC with two domains, i.e. "pain" (four items) and "physical function" (eight items), presents the best structure.
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surveys and Questionnaires , Osteoarthritis, Knee/diagnosis , Language , Brazil , Reproducibility of ResultsABSTRACT
Background: Knee osteoarthritis causes pain, functional limitation, and disability in the elderly. Whole-body vibration has gained a lot of attention in recent years. It is currently used in alleviating pain and improve physical function along with strength and balance. Methods: 34 individuals aged between 50-70 years fulfilling the inclusion criteria were selected and randomized into two groups. Baseline assessment was done using the VAS scale, WOMAC scale, Berg Balance Scale, and 30seconds chair stand test. Group A received whole-body vibration, and knee strengthening exercises, and group B received only strengthening exercises. The treatment was given thrice in a week for four weeks. The assessment was done by the end of the 2nd and 4th weeks. Results: Whole body vibration had shown greater improvement of VAS on rest (p<0.05) compared to VAS on activity. Also, the WOMAC score was statistically improved between and within the group with p<0.05. Conclusion: Whole body vibration, along with strengthening exercises, showed superior effects in reducing pain, stiffness, physical function, balance, and lower limb strength in osteoarthritis knee patients.
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Background: Osteoarthritis (OA) is estimated to be the fourth leading cause of disability in most of the countries. It is the most frequent joint disease with a prevalence of 22% to 39% in India. The objectives of the study were to assess the effect of OA of knee on activities of daily living using Western Ontario and McMasters University Osteoarthritis (WOMAC) index and treatment seeking behaviour of patient with OA of knee.Methods: Convenience sampling was used to find out patients of OA from 15th April to 1st June 2016 with cross-section type of study design. Data was collected and analyzed using MS Excel 2000.Results: In this study 16% of participants in underweight category and 79% participants in overweight category reported moderate to very severe pain on visual analogue score (VAS). Treatment seeking behaviour was quite poor in lower socio-economic class (SEC) as compared to upper SEC. 20.34% participants had extreme pain while walking. 9.74% participants experienced extreme level of morning stiffness while 18.72% had extreme difficulty while ascending stairs. 14.87% experienced extreme difficulty during getting standing position from sitting position.Conclusions: Moderate to severe pain on VAS was more common in overweight group compared to underweight group. Treatment seeking behaviour was quite poor in lower SEC as compared to upper SEC. 20.34% participants had extreme pain while walking. 14.87% experienced extreme difficulty during getting standing position from sitting position.
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PURPOSE: This study aimed to evaluate the validity of the Western Ontario and McMaster Universities Arthritis Index Short Form (WOMAC-SF) for the assessment of musculoskeletal disorders. We evaluated whether WOMAC-SF correlated with the World Health Organization Disability Assessment Schedule 12 (WHODAS-12) and Kaigo-Yobo questionnaires for assessing health-outcomes in Korea.MATERIALS AND METHODS: This cross-sectional study used data from the Namgaram-2 cohort. WOMAC, WOMAC-SF, WHODAS-12, and Kaigo-Yobo questionnaires were administered to patients with musculoskeletal disorders, including radiology-confirmed knee osteoarthritis (RKOA), sarcopenia, and osteoporosis. The relationships among WOMAC-SF, WHODAS-12, and Kaigo-Yobo scores were analyzed by stepwise multiple regression analysis.RESULTS: WOMAC-SF was associated with the WOMAC questionnaire. The results of confirmatory factor analysis for the hypothesized model with two latent factors, pain and function, provided satisfactory fit indices. WOMAC-SF pain and function were associated with RKOA. Kaigo-Yobo was associated with WOMAC-SF pain (B=0.140, p=0.001) and WOMAC-SF function (B=0.042, p=0.004). WHODAS-12 was associated with WOMAC-SF pain (B=0.679, p=0.003) and WOMAC-SF function (B=0.804, p<0.001).CONCLUSION: WOMAC-SF was validated for the evaluation of low extremity musculoskeletal disorders and health-related quality of life in a community-based population. Furthermore, we confirmed that WOMAC-SF were reflective of disability and frailty, which affect health outcomes.
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Humans , Appointments and Schedules , Arthritis , Cohort Studies , Cross-Sectional Studies , Extremities , Korea , Ontario , Osteoarthritis, Knee , Osteoporosis , Quality of Life , Sarcopenia , World Health OrganizationABSTRACT
BACKGROUND: Backward walking is mainly considered to improve the symptoms of patients with knee osteoarthritis, which is used for rehabilitation and adjuvant treatment of knee osteoarthritis, but there is no evidence for evidence-based medicine. OBJECTIVE: To systematically review and quantify the evidence for the effect of backward walking on knee osteoarthritis in order to clarify the effect of backward walking on knee osteoarthritis. METHODS: PubMed, CINAHL, EMBASE, CNKI, CBM, WanFang and VIP were searched for relevant literature. After randomized controlled trials were screened, a meta-analysis was used to evaluate the effectiveness of backward walking on knee osteoarthritis. A total of 7 articles involving 231 patients were included in the result analysis. RESULTS AND CONCLUSION: Meta-analysis found that: compared with conventional treatment alone, the combination of conventional treatment with backward walking was better in pain relief [mean difference (MD)=-1.05, 95% confidence interval (CI) (-1.46,-0.63), P= 0.000 1], improving knee joint function [standardized mean difference (SMD)=-0.98, 95% CI (-1.33,-0.64), P < 0.000 01], enhancing quadriceps strength [SMD=1.07, 95% CI (0.52, 1.63), P=0.000 2] and improving timed up to go performance [MD=-0.41, 95% CI (-0.67, 0.16), P=0.001]. However, there was no significant difference in the WOMAC score after backward and forward walking [SMD=-0.43, 95% CI (-0.94,-0.08), P=0.10]. Meta-analysis results indicate that the combination of backward walking with conventional treatment has better clinical efficacy than conventional treatment alone for knee osteoarthritis patients. However, on the basis of conventional treatment, backward walking has comparable effects on WOMAC scores as compared with forward walking, which needs further large-sample high-quality randomized controlled trials to be verified.
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Objective: To evaluate the clinical efficacy of Biqi Capsule in treating knee osteoarthritis through randomized controlled trial, and investigate its effect on radiography. Methods: One hundred eligible patients were randomly assigned at a 1:1 ratio to receive Biqi Capsule (intervention group) and Calcitriol Capsule (control group). The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and VAS for pain were assessed at week 12 and 24. MRI Osteoarthritis Knee Score (MOAKS) was assessed at week 24. The safety index and adverse event were also tested before and after the trial. Results: A total of 100 participants were enrolled in this trial, of which 16 patients were lost to follow-up, and 84 patients were included into analysis for per-protocol set. The intervention group could better improve the WOMAC than the control group after 24-week treatment (P 0.05). However, in the sub-group analysis, the intervention group had an improvement on the MOAKS score in the patients who did not take the non-steroid anti-inflammatory drugs (NSAIDs) (P 0.05). Conclusion: Biqi Capsule had a better treatment effects on the improvement of joint stiffness and function of patients with knee osteoarthritis. It also had a better effect in the patients who did not take NSAIDs on the radiographic evaluation.
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Objective • To investigate the safety and efficacy of focused low-intensity pulsed ultrasound (FLIPUS) therapy on the patients with knee osteoarthritis (KOA). Methods • A total of 100 subjects with KOA from August 2018 to August 2019 in the Department of Rehabilitation Medicine at the Second Affiliated Hospital of Chongqing Medical University were sequentially randomized into group A and group B. Among them, FLIPUS was adopted to treat the 50 patients in group A, and the diclofenac sodium was adopted to treat the other 50 patients in group B. Visual analogue scale (VAS), Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne index (LI) were used to evaluate knee joint pain, the structure and function of the affected knee joint, and the severity of the affected knee joint at baseline, on day 3, day 6 and day 10 after treatment respectively. The knee range of motion (KROM) and maximum walking speed (MWS) were used to evaluate the knee joint movement and walking function at baseline and on day 10 after treatment respectively. Results • There were on significant differences between two groups with respect to KOA evaluation indexes (P>0.05). Compared with those in group B, patients in group A showed significant improvements in VAS and WOMAC scores on day 6 and day 10 after treatment (P=0.021, P=0.000; P=0.005, P=0.001). Meanwhile, patients in group A had higher LI scores than those in group B on day 10 after treatment (P=0.000). In addition, patients in group A showed significant improvements in MWS (P=0.006) and non-significant improvements in KROM (P=0.064) on day 10 after treatment. Conclusion • FLIPUS is a safe and effective treatment modality for relieving pain and improving the functions of patients with KOA.
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Abstract Background: Intra-articular injections of platelet-rich plasma to treat symptoms of knee osteoarthritis have been successfully used in young patients. However in most of these studies the control and test knees were present in different patients thus incorporating a large amount of bias in the results. Therefore, the present study was designed in which patients with bilateral osteoarthritis knee were included and platelet-rich plasma was administered in one knee and normal saline in another knee of same patient. Methods: 20 patients aged 30-65 years with bilateral osteoarthritis knees (ASA class I and II) of either gender were included in the study. Patients were randomized to receive platelet-rich plasma and normal saline in one of the two knees. The primary outcome was VAS and WOMAC score at 6 months after procedure. The secondary outcome included changes in joint stiffness, physical function, any adverse effects noted during the course of study. Results: The baseline VAS score in platelet-rich plasma knee was 8.4 ± 0.88 which improved significantly to 4.85 ± 2.48 (p < 0.001) at 6 months as compared to normal saline knee (p = 0.017). The WOMAC pain score also improved from baseline (14.5 ± 1.3) to over 6 month 7.00 ± 4.24 (p < 0.001) in platelet-rich plasma knee while in the normal saline knee, no significant change occurred from baseline to six months (10.2 ± 1.2 to 10.05 ± 1.23). There was also significant decrease in stiffness and improvement of physical activity in the platelet-rich plasma knee as compared to normal saline knee. Conclusion: The present study showed significant decrease in pain and stiffness and improvement of physical functions of knee joint with intra-articular platelet-rich plasma injection as compared to normal saline.
Resumo Justificativa e objetivos: Injeções intra-articulares de plasma rico em plaquetas têm sido usadas com sucesso para tratar os sintomas da osteoartrite de joelho em pacientes jovens. Porém, na maioria desses estudos, os joelhos de controle e teste estavam presentes em diferentes pacientes, o que incorporou uma grande quantidade de viés aos resultados. Portanto, o projeto do presente estudo incluiu pacientes com osteoartrite em ambos os joelhos, com a administração de plasma rico em plaquetas em um dos joelhos e de solução salina normal no outro joelho do mesmo paciente. Métodos: 20 pacientes, de ambos os sexos, com idades entre 30-65 anos e portadores de osteoartrite bilateral de joelho (classificação ASA I e II) foram incluídos no estudo. Os pacientes foram randomizados para receber plasma rico em plaquetas e solução salina normal em um dos dois joelhos. O desfecho primário foram os escores VAS e WOMAC seis meses após o procedimento. O desfecho secundário incluiu alterações na rigidez articular, função física e qualquere feito adverso observado durante o curso do estudo. Resultados: O escore VAS basal para o joelho que recebeu plasma rico em plaquetas foi 8,4 ± 0,88 e melhorou significativamente para 4,85 ± 2,48 (p < 0,001) após seis meses, comparado ao joelho que recebeu solução salina normal (p = 0,017). A intensidade da dor avaliada com o WOMAC também melhorou de 14,5 ± 1,3 na fase basal para 7,00 ± 4,24 após seis meses (p < 0,001) nos joelhos que receberam plasma rico em plaquetas, enquanto nenhuma mudança significativa ocorreu nos joelhos que receberam solução salina normal entre a fase basal e após seis meses (10,2 ± 1,2 a 10,05 ± 1,23). Além disso, houve uma diminuição significativa da rigidez e melhora da atividade física nos joelhos que receberam plasma rico em plaquetas, comparados aos joelhos que receberam salina normal. Conclusão: O presente estudo identificou uma diminuição significativa da dor e da rigidez e uma melhora das funções físicas da articulação do joelho com a injeção intra-articular de plasma rico em plaquetas, comparada à solução salina normal.
Subject(s)
Humans , Male , Female , Adult , Aged , Arthralgia , Arthralgia/etiology , Osteoarthritis, Knee/complications , Platelet-Rich Plasma , Pain Management/methods , Knee Joint , Double-Blind Method , Treatment Outcome , Injections, Intra-Articular , Middle AgedABSTRACT
Introduction: Osteoarthritis is the most common form of arthritis. Osteoarthritis is a joint failure, which occurs due to pathological change in all structure joint. Aim: The aim of the study was to compare the efficacy and tolerability of Rosehip Extract and ibuprofen along with individual effect of both drugs. Materials and Methods: This was an open, randomized, prospective study to compare ROSE HIP Extract and IBUPROFEN for treatment of Osteoarthritis in 100 patients. In this study two comparative groups (50 each) were taken. First group was prescribed 400 mg TDS Ibuprofen and the other group was given Rose hip extract in the form of 275 mg capsule BD. The pain assessment was done through Womac scale and visual analogue scale. The data was collected for efficacy and tolerability for both drugs at 14 days and 3 months. Result: In ibuprofen group, the mean score of pain intensity on womac scale on visit 1 was 39.2 ± 9.58 which was decreased to 11.62 ± 4.97 in the last visit. On VAS scale on visit 1 was 7.26 ± 1.426 and was decreased to 3.36 ± 1.467 at visit 3. In rosehip group. The mean score of pain intensity on WOMAC scale on visit 1 was 38.44 ± 8.45, 30.88 ± 8.068 which was decreased to 26.68 ± 8.474. The mean score of pain intensity at on VAS scale on visit 1 was 7.02 ± 1.06, 5.84 ± 1 and was decreased to 4.6 ± 1.16 at the end of study. Conclusion: Ibuprofen is a better choice than rosehip because it had shown better improvement. Both rosehip and ibuprofen were well tolerated.
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Background: Osteoarthritis (OA) is the most common joint disease causing disability. Current physical therapy management for knee OA is aiming to increase range of motion and improve functional ability. The purpose of this study is to find out the effectiveness of fibular glide with conventional treatment for improving range of motion and functional ability in the subjects with knee OA. Methods: Twenty four subjects with osteoarthritis of knee were selected for the study and randomly divided in to two groups of 12 subjects each. Group A received tibio femoral glide and Group B received tibio fibular glide, ROM was measured by Goniometry and functional ability was measured by WOMAC scale. Results: The patients those who received fibular glide and tibio femoral glide their functional ability was improved was measured by WOMAC and ROM improved significantly (p<0.05) so both the groups are equally effective. Conclusion: This study showed that tibio fibular glide and tibio femoral glide are E effective in improving functional ability and ROM in patients with knee osteoarthritis
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Background: Osteoarthritis (OA) is a joint failure and OA is the most frequent chronic joint disease causing pain and disability. Where all the structures of joints have undergone pathological changes and they are hyaline articular cartilage loss which may be focal or non-uniform, initially it will be focal then spread all over non-uniformly. Non-Steroidal Anti Inflammatory Drugs (NSAID) are the mainstay of medical management of OA. Increased in reports suggests that GIT adverse effect with old NSAID’s and cardiovascular effects with selective cyclooxygenase-2 (COX2) inhibitors had precipitated to chase for better NSAID’s with minimal adverse effects. The current study compares the clinical effectiveness and safety of newer NSAID’s, etoricoxib, lornoxicam, to diclofenac which has been standard therapy in patients of OA of the knee joint.Methods: The current study is randomized, prospective, open-label, parallel group study conducted in 120 patients with OA of the knee joint diagnosed using American College of Rheumatology criteria. After getting the informed consent, they were randomized in three groups of 40 patients each who received tablet etoricoxib 120mg BID, tablet Lornoxicam 16mg BID, tablet diclofenac 50mg TID respectively. The duration of the study is 12 weeks. Data are calculated, tabulated and analyzed using analysis of variance (ANOVA) test, and level of significance was determined by its P value.Results: After 12weeks of treatment, the severity of pain and functional indices using visual analog scale and Western Ontario and McMaster Universities Osteoarthritis score were significantly better (P <0.05) in etoricoxib group as compared to lornoxicam or diclofenac group along with a lesser rate of adverse effects.Conclusions: It is concluded that etoricoxib is more effective and tolerated NSAID than lornoxicam and diclofenac in the treatment of knee joint OA.
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Objective To investigate the effect of acupuncture and moxibustion plus Zushima on serum vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (b FGF) in patients with knee osteoarthritis.Method Two hundred and thirty-six patients with knee osteoarthritis were allocated, using a random number table, to two groups, 118 cases each. The control group was treated with Celecoxib and the observation group, with acupuncture and moxibustion plus Zushima. The therapeutic effects, and pre-treatment and post-treatment VAS scores and WOMAC scores and serum VEGF and bFGF levels were compared between the two groups of patients. The adverse reaction incidences were compared between the two groups of patients. Result The total efficacy rate was 87.3％ in the control group and 94.9％ in the observation group and was significantly higher in the observation group than in the control group (P<0.05). There were no statistically significant pre-treatment differences in the VAS score and WOMAC score between the two groups (P>0.05). The VAS score and WOMAC score decreased significantly in both groups after treatment (P<0.05). After treatment, there was no statistically significant difference in the VAS score between the two groups (P>0.05) but the WOMAC score was significantly lower in the observation group than in the control group (P<0.05). There were no statistically significant pre-treatment differences in VEGF and bFGF between the two groups (P>0.05). After treatment, VEGF and bFGF decreased significantly in both groups (P<0.05) and were significantly lower in the observation group than in the control group (P<0.05). The adverse reaction incidence was3.4％ in the control group and 1.7％ in the observation group with no statistically significant difference between the two groups (P> 0.05). Conclusion Acupuncture and moxibustion plus Zushima can reduce inflammatory reactions, inhibit synovial angiogenesis, and effectively relive the pain, and improve articular functions in the treatment of knee osteoarthritis.
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PURPOSE: To identify the effect of knee joint traction therapy on pain, physical function, and depression in patients with degenerative arthritis.METHODS: In total, 30 patients with degenerative arthritis were randomly assigned to one of two groups: the experimental group, who underwent knee joint traction therapy, and the control group, who underwent general physical therapy (15 patients per group). Pain was measured using the visual analogue scale (VAS), physical function was measured using the Western ontario and McMaster universities osteoarthritis (WOMAC) index, and depression was measured using the Beck depression inventory (BDI). The VAS, WOMAC score, and BDI score were recorded before and after the 4-week treatment.RESULTS: As a result of comparison within groups, the experimental and control group showed significant difference for VAS, WOMAC and BDI after the experiment (p<0.05). In comparison between the two groups, the experimental group in which knee joint traction was applied showed more significant change in VAS, WOMAC and BDI than the control group (p<0.05).CONCLUSION: This study showed that knee joint traction therapy was effective in improving pain, physical function, and depression in patients with degenerative arthritis.