Yıl: 2008 Cilt: 54 Sayı: 2 Sayfa Aralığı: 54 - 58 Metin Dili: İngilizce İndeks Tarihi: 29-07-2022

The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis

Öz:
Objective: Pain is the the main symptom of knee osteoarthritis. Pain causes immobilisation, limitation in the range of motion (ROM) and periarticular muscle spasm through reflex inhibition. Consequently, patients develop weakness and atrophy in the quadriceps muscle. In this study, the effect of isometric exercises and electrical stimulation was compared on patients with knee osteoarthritis.Materials and Methods: Thirty-eight patients were separated into two groups randomly. In the first group; the combination of paracetamol + infrared + electrical stimulation (20 times, once a day) treatment was applied. In the second group; the combination of paracetamol + infrared + active resistive isometric exercises (20 times, once a day) treatment was applied. The evaluations performed include pre and post-treatment pain, active ROM, thigh circumference measurements, activity time and WOMAC and Lequesne indices. Cross-sections of rectus femoris muscle were measured quantitatively by computerized tomography before and after the treatment. Clinical and radiological findings were evaluated for both groups. Results: Statistically a significant improvement was observed in all of the parameters for both of the groups (p<0.05). The improvement in ROM was found larger in the exercise group in comparative group analysis (p<0.05). The diameter of the rectus femoris muscle increased in both of the groups (p<0.05). The increase in the diameter of the rectus femoris was higher in the electrical stimulation group (p<0.05).Conclusion: The treatment of electrical stimulation was found to be as efficient as the exercise treatment in cases such as knee osteoarthritis, quadriceps muscle weakness and atrophy prevention. Electrical stimulation treatment could be used alone or in combination with exercise treatment in clinical setting. And, isometric exercises could be undertaken as a home program.
Anahtar Kelime: Pain Measurement Exercise Therapy Osteoarthritis, Knee Electric Stimulation Therapy

Konular: Rehabilitasyon

Diz osteoartriti tedavisinde egzersiz ve elektriksel stimülasyonun etkilerinin karşılaştırılması

Öz:
Amaç: Diz osteoartritinin ana semptomu ağrıdır. Ağrı, refleks yolla, eklem çevresi kas spazmı, eklem hareket kısıtlığı ve immobilizasyona sebep olur. Sonuçta, kuadriseps kasında zayıflık ve atrofi gelişir. Bu çalışmada, diz osteoartritli hastalarda, izometrik egzersizler ve elektriksel stimülasyon karşılaştırıldı.Gereç ve Yöntem: Yirmisekiz hasta randomize tek kör olarak iki gruba ayrıldı. Birinci grupta; parasetamol + infraruj + elektrik stimülasyonu (günde bir kez, 20 seans) uygulandı. İkinci grupta; parasetamol + infraruj + aktif rezistif izometrik egzersizler (günde bir kez, 20 seans) uygulandı. Tedavi öncesi ve sonrası ağrı, aktif eklem hareket açıklığı, uyluk çevresi ölçümleri, aktivite zamanı, WOMAC ve Lequesne indeksleri değerlendirildi. Rektus femoris kasının çapı, tedavi öncesi ve sonrası kantitatif olarak bilgisayarlı tomografi ile ölçüldü. Klinik ve radyolojik bulgular, her iki grupta değerlendirildi.Bulgular: Her iki grupta, parametrelerin tümünde istatistiksel olarak anlamlı düzelme gözlendi (p<0.05). Egzersiz grubunda, eklem hareket açıklığı diğer gruptan daha fazla bulundu (p<0.05). Rektus femoris kasının çapı, grupların her ikisinde de arttı (p<0.05). Bu artış, elektriksel stimülasyon grubunda daha yüksekti (p<0.05).Sonuç: Elektriksel stimülasyon, diz osteoartritinde, kuadriseps kas zayıflığını ve atrofisini önlemede, egzersiz kadar etkin bulundu. Elektriksel stimülasyon, klinik uygulamada, tek başına veya kombinasyonla kullanılabilir. İzometrik egzersizler ev programı olarak devam ettirilebilir.
Anahtar Kelime: Osteoartrit, diz Elektrik uyarı tedavisi Ağrı ölçümü Egzersiz tedavisi

Konular: Rehabilitasyon
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Altman RD, Lozada CJ. Clinical features. In: Rheumatology. 3rd Ed. Vol. 2. Eds: Hochberg, Silman AJ, Smolen JS, Weinblatt ME, Weismann MH: Mosby, 2003, pp. 1793-800.
  • 2. ACR subcommittee: Recommendations for the medical management of osteoarthritis of the hip and knee. 2000 update, Arthritis Rheum 2000;43: 1905-15.
  • 3. Dennison E, Cooper C. Osteoarthritis: Epidemiology and classification. In: Rheumatology. 3rd Ed. Vol. 2. Eds: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weismann MH: Mosby, 2003, pp. 1781-91.
  • 4. Nuki G. Role of mechanical factors in the etiology, pathogenesis and progression of osteoarthritis. Reginster YJ, Pelletier PJ, Pelletier JM, Henrotin Y, Eds. Osteoarthritis. Springer Verlag, Berlin Heidelberg 1999, pp. 101-14.
  • 5. Manek NJ, Hart D, Spector TD, MacGregor AJ. The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis Rheum 2003;48:1024-9.
  • 6. Focht BC, Ewing V, Gauvin L, Rejeski WJ. The unique and transient impact of acute exercise on pain perception in older, overweight, or obese adults with knee osteoarthritis. Ann Behav Med 2002;24:201-10.
  • 7. Jadelis K, Miller ME, Ettinger WH Jr, Messier SP. Strength, balance, and the modifying effects of obesity and knee pain: results from the Observational Arthritis Study in Seniors (oasis). J Am Geriatr Soc 2001;49:884-91.
  • 8. Wolheim FA. Pathogenesis of osteoarthritis. In: Rheumatology. 3rd Ed. Vol. 2. Eds: Hochberg MC, Silman AJ, Smolen JS, Weinblatt ME, Weismann MH: Mosby, 2003, pp. 1801-15.
  • 9. Moskowitz RW. Clinical and laboratory findings in osteoarthritis. In: Artritis and allied conditions. McCarty DJ, Koopman WJ, Eds. Lea Febiger, Philadelphia, 1993, pp. 1735-60.
  • 10. Şahin Ü, Karamehmetoğlu ŞS, Akgün K, Kayserilioğlu A, ve ark.: Comparison of neuromuscular electrical stimulation and isometric exercise in muscle strenghtening. Turk J Phys Med Rehab 1997;21:4:161-7.
  • 11. Hart DJ, Spector TD. Radiographic criteria for epidemiologic studies of osteoartritis. J Rheumatol 1995;22:46-8.
  • 12. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, et al. The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum 1991;34:505-14.
  • 13. Kellgren JH, Lawrence JS. Radiological Assessment of Osteoarthritis. Ann Rheum Dis 1957;16:494-501.
  • 14. Lequesne MG: The algofunctional indices for hip and knee osteoarthritis. The Journal of Rheumatology, 1997:24:779-81.
  • 15. Barr S, Bellamy N, Buchanan WW, Chalmers A, et al. A comparative study of signal versus aggregate methods of outcome measurement based on the WOMAC Osteoarthritis Index, Western Ontario and Mc Master Universities Osteoarthritis Index. J Rheumatol 1994;21:2106-12.
  • 16. Brandt KD. The importance of non-pharmacologic approaches in management of osteoarthritis. Am J Med 1998;105:39-44.
  • 17. Dieppe P. Management of osteoarthritis of the hip and knee joints. Curr Opin Rheumatol 1993;5:487-93.
  • 18. Hainaut K, Duchateau J. Neuromuscular electrical stimulation and voluntary exercise. Sports Med 1992;14:100-13.
  • 19. Ferrari de Castro MC, Cliquet A. Artificial sensorimotor integration in spinal cord injured subjects through neuromuscular and electrotactile stimulation. Artificial Organs 2000;24:710-7.
  • 20. Quittan M, Sochor A, Wiesinger GF, Sturm B, et al. Strength improvement of knee extensor muscles in patients with chronic hearth failure by neuromuscular electrical stimulation. Artificial Organs 1999;23:432-5.
  • 21. Neder JA, Sword D, Ward SA, Mackay E, Cochrane LM, Clark CJ. Home based neuromuscular electrical stimulation as a new rehabilitative strategy for severely disabled patients with chronic obstructive pulmonary disease (COPD). Thorax 2002;57:333-7.
  • 22. W Man IO, Lepar GS, Morrissey MC, Cywinski JK. Effect of Neuromuscular Electrical Stimulation on Foot/Ankle Volume during Standing. Med Sci Sports Exerc 2003;35:630-4.
  • 23. Lieber RL, Kelly MJ. Factors influencing quadriceps femoris muscle torque using transcutaneous neuromuscular electrical stimulation. Physical Ther 1991;71:715-21.
  • 24. Hazneci B, Göktepe AS, Alaca R, Balaban B, Kalyon TA. Effects of on exercise program combined with physical therapy on pain and functional parameters in patients with gonarthrosis. Turk J Phys Med Rehab 2000;3:30-4.
  • 25. Van Baar ME, Assendelft WJJ, Dekker J, Oostendorp RAB, et al. Effectiveness of exercise therapy in patients with osteoarthritis of the hip and knee, a systematic review of randomized clinical trials Arthritis Rheum 1999:42:361-9.
  • 26. Laughman RK, Youdas JW, Garrett TR, Chao EYS. Strength changes in the normal quadriceps femoris muscle as a result of electrical stimulation. Physical Ther 1983;63:494-9.
  • 27. Fisher NM, Pendergast DR, Gresham GE, Calkins E. Muscle rehabilitation ; its effect on muscular and functional performance of patients with knee osteoarthritis. ARC Phys Med Rehab, 1991;72:367-74
  • 28. O’Relly SC, Muir KR, Doherty M. Effectiveness of home exercise on pain and disability from osteoarthritis of knee: a randomized controlled trial. Ann Rheum Dis , 1999;58:15-9.
  • 29. Rogind H, Bibow NB, Jensen B, Moller HJ, Moller HF, Henning B. The effects of a physical training program on patients with osteoarthritis of the knees. Arch Phys Med Rehabil, 1998; 79:1421-27.
  • 30. Talbot LA, Gaines JM, Ling SM, Metter EJ. A home-based protocol of electrical muscle stimulation for quadriceps muscle strength in older adults with osteoarthritis of the knee. J Rheumatol 2003;30:1571-8.
  • 31. Mohr T, Carlson B, Sulentic C, Landry R. Comparison of isometric exercise and high volt galvanic stimulation on questionnairesi femoris muscle strength. Physical Ther 1985;65: 606-9.
  • 32. Hepgüler S, Şahin Y, Barış M, Akşit R. Relationship between clinical findings and various quality of life questionnaires in patients with osteoarthritis of the knee. Turk J Phys Med Rehab 1998;4:49-54.
APA KOCAMAN O, KOYUNCU H, dinç a, TOROS H, KARAMEHMETOĞLU Ş (2008). The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. , 54 - 58.
Chicago KOCAMAN OMER,KOYUNCU Halil,dinç ahmet,TOROS Halime,KARAMEHMETOĞLU Şafak S. The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. (2008): 54 - 58.
MLA KOCAMAN OMER,KOYUNCU Halil,dinç ahmet,TOROS Halime,KARAMEHMETOĞLU Şafak S. The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. , 2008, ss.54 - 58.
AMA KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. . 2008; 54 - 58.
Vancouver KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. . 2008; 54 - 58.
IEEE KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş "The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis." , ss.54 - 58, 2008.
ISNAD KOCAMAN, OMER vd. "The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis". (2008), 54-58.
APA KOCAMAN O, KOYUNCU H, dinç a, TOROS H, KARAMEHMETOĞLU Ş (2008). The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 54(2), 54 - 58.
Chicago KOCAMAN OMER,KOYUNCU Halil,dinç ahmet,TOROS Halime,KARAMEHMETOĞLU Şafak S. The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 54, no.2 (2008): 54 - 58.
MLA KOCAMAN OMER,KOYUNCU Halil,dinç ahmet,TOROS Halime,KARAMEHMETOĞLU Şafak S. The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, vol.54, no.2, 2008, ss.54 - 58.
AMA KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2008; 54(2): 54 - 58.
Vancouver KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi. 2008; 54(2): 54 - 58.
IEEE KOCAMAN O,KOYUNCU H,dinç a,TOROS H,KARAMEHMETOĞLU Ş "The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 54, ss.54 - 58, 2008.
ISNAD KOCAMAN, OMER vd. "The comparison of the effects of electrical stimulation and exercise in the treatment of knee osteoarthritis". Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 54/2 (2008), 54-58.