ABSTRACT
Background and aim: Osteoarthritis (OA) is characterized by pain and inflammation. Electroacupuncture (EA) and swimming (SW) are non-pharmacological interventions recommended for treating OA. The study evaluated the benefits of electroacupuncture (EA) and swimming (SW) association when compared with isolated protocols in an OA rodent model. Experimental. Procedures: An ankle monoarthritis model was induced in rats by applying Complete Freund's Adjuvant (CFA). After seven days of induced OA, the groups were submitted to EA (ST36 and the GB 30 Acupoint), SW, or the EA + SW protocol. The nociceptive behavior was measured by the Von Frey test, the Cold Stimulation test, and the Paw Flick Immersion test. Inflammatory activity was evaluated by measuring TNF levels, myeloperoxidase, NAGase, immunological parameters and the histology from the subcutaneous tissue. Results: Compared to CFA group, EA decreased the nociceptive scores in the cold stimulation test (p < 0.05), and it also increased the latency time in thermal cold (p < 0.01) and heat hyperalgesia (p < 0.001). Also, EA reduced NAGase (p < 0.01). SW reduced the edema (p < 0.05) and did not increase the inflammatory infiltrates or congestion, neither in the histological measurements nor by analyzing the levels of TNF. The association of EA + SW decreased the neutrophils and the monocytes, MPO (p < 0.05), and the glutamate levels in the cerebrospinal fluid (CSF, p < 0.001). Conclusion: There were statistical differences between combination therapy and monotherapy as seen by the inflammatory parameters, which could be associate to the delay of the chronification osteoarthritis retardation. However, EA + SW did not show benefits when compared to isolated protocols in nociceptive behavior.
ABSTRACT
Introdução: A osteoartrose (OA) é um distúrbio articular caracterizado patologicamente por perda localizada de cartilagem, remodelação de osso adjacente, formação de osteófitos e inflamação associada. Manifesta-se como um desarranjo molecular seguido de alterações anatômicas e fisiológicas, caracterizadas por degradação da cartilagem, remodelação óssea, formação de osteófitos, inflamação das articulações e perda da função articular normal. Objetivo: Realizar uma revisão da literatura, avaliando a influência da fisioterapia no tratamento dos indivíduos com OA de joelho, quanto ao seu impacto na qualidade de vida, identificando os diferentes tratamentos para OA de joelho. Métodos: Foi realizado uma revisão da literatura nas bases de dados Pubmed, Pedro, Scielo e Biblioteca Cochrane, com ensaios clínicos com data de publicação de 2014 a 2018 com as palavras-chave: osteoartrose de joelho, fisioterapia e qualidade de vida. Foram escolhidos estudos com participantes com diagnóstico de OA de joelho, com idade ï¾ 50 anos, de ambos os gêneros, que relatassem informações sobre o tratamento e a qualidade de vida dos pacientes. Resultados: Foram encontrados 224 artigos e selecionados 12 artigos para análise. Conclusão: Os estudos demonstraram a eficiência do uso de exercícios e da educação na melhora dos sintomas decorrentes da osteoartrose, como dor, melhora da função física e qualidade de vida. (AU)
Introduction: Osteoarthrosis (OA) is a pathological disorder characterized by localized loss of cartilage, remodeling of adjacent bone, formation of osteophytes and associated inflammation. It manifests as molecular derangement followed by anatomical and physiological alterations, characterized by cartilage degradation, bone remodeling, formation of osteophytes, inflammation of the joints and loss of normal joint function. Objective: To review the literature evaluating the influence of physical therapy on the treatment of individuals with knee OA and its impact on quality of life, identifying the different treatments for knee OA. Methods: A literature review study was carried out in the Pubmed, Pedro, Scielo and Cochrane Library databases, with clinical trials with publication date from 2014 to 2018 with the keywords: osteoarthritis of knee, physical therapy and quality of life. Patients with a diagnosis of knee OA, ï¾50 years, of both genders, who reported information on treatment and quality of life, were chosen. Results: We selected 12 articles on 224 for analysis. Conclusion: Studies demonstrated the efficacy of exercise and education in improving the symptoms of osteoarthritis, such as pain, improvement of physical function and quality of life. (AU)
