Use of ultrasound to increase effectiveness of isokinetic exercise for knee osteoarthritis.
ABSTRACT To investigate the effects of ultrasound (US) in isokinetic muscle strengthening exercises on functional status of patients with knee osteoarthritis (OA).
Effectiveness of isokinetic muscle strengthening exercises for treatment of periarticular soft tissue disorders was compared with and without pulsed and continuous US.
Outpatient exercise program in a Taiwan medical university hospital.
One hundred twenty subjects with bilateral knee OA (Altman grade II).
Subjects were randomized sequentially into 1 of 4 groups. Group I received isokinetic muscular strengthening exercises, group II received isokinetic exercise and continuous US, group III received isokinetic exercise and pulsed US treatment, and group IV was the control group.
Therapeutic effects of isokinetic exercise were evaluated by changes in ambulation speed and the Lequesne index. In addition, changes in knee range of motion (ROM), visual analog scale for pain, and muscle peak torques during knee flexion and extension were compared. Compliance in each group was recorded.
Each treated group had increased muscle peak torques and significantly reduced pain and disability after treatment and at follow-up. However, only patients in groups II and III had significant improvement in ROM and ambulation speed after treatment. Fewer participants in group III discontinued treatment due to knee pain during exercise. Patients in group III also showed the greatest increase in walking speed and decrease in disability after treatment and at follow-up. Gains in muscular strength in 60 degrees /s angular velocity peak torques were also noted in groups II and III. However, group III showed the greatest muscular strength gains with 180 degrees /s angular velocity peak torques after treatment and follow-up.
US treatment could increase the effectiveness of isokinetic exercise for functional improvement of knee OA, and pulsed ultrasound has a greater effect than continuous US.
SourceAvailable from: Martin van der EschCochrane database of systematic reviews (Online) 01/2015; 1:CD004376. DOI:10.1002/14651858.CD004376.pub3 · 5.94 Impact Factor
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ABSTRACT: To analyse the effect of exercise-based rehabilitation programs for improving lower limb muscle strength in individuals with hip or knee osteoarthritis (OA). A systematic search utilizing seven databases identified randomized controlled trials (RCTs) evaluating lower limb strength outcomes of exercise-based interventions for participants with hip or knee OA. All studies were screened for eligibility and methodological quality. Quality of evidence was assessed using GRADE. Data were pooled and meta-analyses performed where appropriate. Forty RCTs were included and the majority (77%) involved resistance based exercise programs. For knee OA populations, there was high quality evidence for improved knee extension (SMD=0.47, 95% CI 0.29, 0.66) and flexion strength (SMD=0.74, 95% CI 0.56, 0.92) with low-intensity resistance program when compared to a control at short term follow-up. There was moderate quality evidence for a large effect favouring high-intensity resistance programs (SMD=0.76, 95% CI 0.47, 1.06) when compared to a control. This effect was sustained at intermediate term follow-up (SMD=0.80, 95%CI 0.44, 1.17). Few studies reported on outcomes at long term follow-up. Only one study reported on a population with hip OA. When compared to a control group, high-intensity resistance exercise demonstrated moderate quality of evidence for large and sustained improvements for knee muscle strength in knee OA patients. Further work is needed to compare different modes of exercise at a long term follow-up for knee OA patients and to address the dearth of literature evaluating exercise interventions in people with hip OA.Osteoarthritis and Cartilage 07/2014; 22(11). DOI:10.1016/j.joca.2014.07.005 · 4.66 Impact Factor
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ABSTRACT: The purpose of this study was to examine the effect of phonophoresis in the management of patients with knee osteoarthritis (OA). Subjects: Sixty male patients with knee OA were assigned randomly into two equal groups .Their ages were ranged from 40-50 years old. Methods: The patients were evaluated for the following parameters: Pain and knee joints kinematics, kinetics and spatiotemporal parameters by 3-D motion analysis Lab before and after three months of treatment program. patients in the control group received selected physical therapy program in the form of stretching exercises, strengthening exercises, transcutaneous electrical nerve stimulation (TENS), ultrasound whereas patients in the study group received the same selected physical therapy program in addition to phonophoresis therapy. The data were collected and analyzed using a paired and un-paired t-test to compare the difference between the results within each group pre test and post test and between the two groups. Results: this study revealed that there were significant differences (p<0.05) of all of the measured variables (pain score, cadence, stride length, knee flexion ROM at stance and swing phase, knee flexion and extension moment) between pre test and post test in the control and experimental groups for right and left knees. There were significant differences between post test of control and experimental groups for right and left knees except knee extension moment there was no significant differences. Conclusion: Phonophoresis has got clear effect when added to treatment program in reducing the pain and improving mechanics of knee joint in patients with osteoarthritis.