scholarly journals Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Cid André Fidelis de Paula Gomes ◽  
Fabiano Politti ◽  
Cheila de Souza Bacelar Pereira ◽  
Aron Charles Barbosa da Silva ◽  
Almir Vieira Dibai-Filho ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Exercise Program ◽  
Current Therapy ◽  
Controlled Clinical Trial ◽  
Clinical Effects ◽  
Pressure Pain ◽  
Knee Oa ◽  
Link Type

Abstract Background It is not yet clear which of the various electrophysical modalities used in clinical practice is the one that contributes most positively when added to an exercise program in patients with knee osteoarthritis (OA). The aim of the present study was to analyze the clinical effects of the inclusion of interferential current therapy (ICT), shortwave diathermy therapy (SDT) and photobiomodulation (PHOTO) into an exercise program in patients with knee OA. Methods This prospective, five-arm, randomised, placebo-controlled trial was carried out with blinded participants and examiners. We recruited 100 volunteers aged 40 to 80 years with knee OA. Participants were allocated into five groups: exercise, exercise + placebo, exercise + ICT, exercise + SDT, and exercise + PHOTO. The outcome measures included Western Ontario and McMaster Universities (WOMAC), numerical rating pain scale (NRPS), pressure pain threshold (PPT), self-perceived fatigue and sit-to-stand test (STST), which were evaluated before and after 24 treatment sessions at a frequency of three sessions per week. Results In all groups, there was a significant improvement (p < 0.05) in all variables over time, except pressure pain threshold. We observed significant differences (p < 0.05) between the groups for WOMAC function (exercise vs. exercise + placebo, mean difference [MD] = 5.55, 95% confidence interval [CI] = 3.63 to 7.46; exercise vs. exercise + ICT, MD = 3.40, 95% CI = 1.46 to 5.33; exercise vs. exercise + SDT, MD = 4.75, 95% CI = 1.85 to 7.64; exercise vs. exercise + PHOTO, MD = 5.45, 95% CI = 3.12 to 7.77) and WOMAC pain, with better scores achieved by the exercise group. However, these differences were not clinically relevant when considering the minimum clinically important difference. Conclusion The addition of ICT, SDT or PHOTO into an exercise program for individuals with knee OA is not superior to exercise performed in isolation in terms of clinical benefit. clinicaltrials.gov: NCT02636764, registered on March 29, 2014.

scholarly journals Serum Levels of Proinflammatory Cytokines in Painful Knee Osteoarthritis and Sensitization

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Marta Imamura ◽  
Fernando Ezquerro ◽  
Fábio Marcon Alfieri ◽  
Lucy Vilas Boas ◽  
Tania Regina Tozetto-Mendoza ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Functional Capacity ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Serum Levels ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
The World ◽  
Joint Disorder ◽  
Painful Knee

Osteoarthritis (OA) is the most common joint disorder in the world. Among the mechanisms involved in osteoarthritis, biomarkers (cytokines profile) may be related to pain and pain intensity, functional capacity, and pressure pain thresholds (PPT). Thus, the study of these relationships may offer useful information about pathophysiology and associated mechanisms involved in osteoarthritis. Therefore, the objective of this study was to investigate the seric concentration of pro (IL-6, IL-8, and TNF-α) and anti-inflammatory (IL-10) cytokines in patients with painful knee osteoarthritis and to correlate the levels of these biomarkers with the patients’ functional capacity and pressure pain threshold (PPT) values.

scholarly journals Genicular artery embolization as a novel treatment for mild to moderate knee osteoarthritis: protocol design of a randomized sham-controlled clinical trial

Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
T. A. van Zadelhoff ◽  
A. Moelker ◽  
S. M. A. Bierma-Zeinstra ◽  
P. K. Bos ◽  
G. P. Krestin ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Knee Osteoarthritis ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Scale Efficiency ◽  
Control Group ◽  
Artery Embolization ◽  
Sham Treatment ◽  
Pressure Pain ◽  
Genicular Artery

Abstract Introduction Knee osteoarthritis is a common disease with pain as the most prevalent symptom. Previous cohort studies have shown genicular artery embolization to reduce pain symptoms in patients with mild to moderate knee osteoarthritis. Patients resistant to conservative therapy but not eligible yet for surgical treatment due to young age or comorbidities may profit from an effective and sustained pain reduction treatment. This study is a randomized sham-controlled trial to evaluate the efficacy of genicular artery embolization in patients with knee osteoarthritis. Methods and analysis Fifty-eight patients with mild-to-moderate knee osteoarthritis will be recruited and randomly allocated to the treatment or control group in a 1:1 ratio. Participants in the treatment group will undergo genicular artery embolization. Patients in the control group will undergo sham treatment. Outcome measurements will be assessed at baseline and after 1, 4, 8, and 12 months with questionnaires, pressure pain threshold testing, and MR imaging. The MR imaging protocol is designed to (semi)quantitatively assess osteoarthritis in the knee joint. The primary outcome is the change from baseline of the Knee injury and Osteoarthritis Outcome Score (KOOS) pain subscale after 4 months. Secondary outcomes include change in osteoarthritis-related questionnaires, pressure pain threshold, and OA-related MRI features, particularly synovitis and bone marrow lesions. Ethics and dissemination This trial will determine the efficacy of genicular artery embolization compared to a sham treatment. This is of importance to assess before proceeding to larger-scale efficiency studies and, ultimately, implementing this treatment into day to day clinical practice. Trial registration ClinicalTrials.gov NCT03884049. Registered on 21 March 2019

Ultrasound-guided Dry Needling in Jumper’s Knee: A Case Report

2020 ◽  
Author(s):  
Álvaro Cuñado-González ◽  
Marta Ríos-León
Keyword(s):  
Knee Flexion ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Preliminary Evidence ◽  
Clinical Effects ◽  
Dry Needling ◽  
Ultrasound Guided ◽  
Jumper’S Knee ◽  
Pressure Pain ◽  
Volleyball Player

Abstract Background Jumper’s knee is a highly prevalent tendon condition in volleyball players population. Research on clinical effects of tendon dry needling in jumper’s knee is scarce. Therefore, the aim of this study was to present clinical effects of ultrasound-guided dry needling of quadricipital tendon in a patient with jumper’s knee. Methods A 23-years-old volleyball player, who experienced pain in quadricipital tendon for 5 months, was presented and treated by ultrasound-guided dry needling of quadricipital tendon with one session. Slightly limited knee flexion range of motion, high scores in Visual Analogue Scale (VAS) at rest and during Single-Leg decline Squat test (SLDS) related to high pain intensity, low scores in Victorian Institute of Sport Assessment (VISA-P) scale and Lower Extremity Functional Scale (LEFS) were found. Further examination revealed sensitization of the quadricipital tendon (low pressure pain threshold). Results We found important improvements in VISA-P, LEFS and VAS. Besides, pressure pain threshold and knee flexion during SLDS also showed improvements. Results which were obtained were better in all the variables studied and these recoveries were stable for 6 months. Conclusions Our findings showed improvements in pain and function in medium term and could provide preliminary evidence of beneficial effects of quadricipital tendon dry needling in patients with jumper’s knee. Future studies are needed to clarify our results and compare dry needling with conservative treatments.

Immediate Effects of Electroacupuncture and Manual Acupuncture on Pain, Mobility and Muscle Strength in Patients with Knee Osteoarthritis: A Randomised Controlled Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Ralph Plaster ◽  
Wellington Bueno Vieira ◽  
Flávia Alves Duarte Alencar ◽  
Eduardo Yoshio Nakano ◽  
Richard Eloin Liebano
Keyword(s):  
Muscle Strength ◽  
Knee Osteoarthritis ◽  
Pain Intensity ◽  
Isometric Contraction ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Manual Acupuncture ◽  
Single Session ◽  
Maximum Voluntary Isometric Contraction ◽  
Pressure Pain

Objective To compare the immediate effects of electroacupuncture and manual acupuncture on pain, mobility and muscle strength in patients with knee osteoarthritis. Methods Sixty patients with knee osteoarthritis, with a pain intensity of ≥2 on the pain Numerical Rating Scale, were included. The patients were randomised into two groups: manual acupuncture and electroacupuncture. Pain intensity, degree of dysfunction (Timed Up and Go (TUG) test), maximal voluntary isometric contraction and pressure pain threshold were assessed before and after a single session of manual acupuncture or electroacupuncture treatments. Results Both groups showed a significant reduction in pain intensity (p<0.001) and time to run the TUG test after the acupuncture treatment (p=0.005 for the manual acupuncture group and p=0.002 for the electroacupuncture group). There were no differences between the groups regarding pain intensity (p=0.25), TUG test (p=0.70), maximum voluntary isometric contraction (p=0.43) or pressure pain threshold (p=0.27). Conclusions This study found no difference between the immediate effects of a single session of manual acupuncture and electroacupuncture on pain, muscle strength and mobility in patients with knee osteoarthritis. Trial Registration Number RBR-9TCN2X.

scholarly journals Cutaneous temperature and pressure pain threshold in individuals with knee osteoarthritis

2020 ◽  
Vol 58 (5) ◽  
pp. 272-276
Author(s):  
Fábio Marcon Alfieri ◽  
Natália Cristina de Oliveira Vargas e Silva ◽  
Artur César Aquino dos Santos ◽  
Linamara Rizzo Battistella
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Pressure Pain ◽  
Cutaneous Temperature ◽  
Temperature And Pressure

The clinical effects of mobilization with passive ankle dorsiflexion using a passive ankle dorsiflexion apparatus on older patients with knee osteoarthritis: A randomized trial

2021 ◽  
pp. 1-8
Author(s):  
Kerry W.Y. Fung ◽  
Daniel H.K. Chow ◽  
W.C. Shae
Keyword(s):  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Repeated Measures ◽  
Ankle Dorsiflexion ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Osteoarthritis Of The Knee ◽  
Clinical Effects ◽  
Knee Oa ◽  
Double Blinded

BACKGROUND: Active exercise is the only proven effective intervention for knee osteoarthritis (OA). The addition of manual therapy has shown to improve outcome of exercises. Passive mobilization with submaximal bilateral passive ankle dorsiflexion was examined in a double-blinded randomized controlled clinical trial. A passive ankle dorsiflexion apparatus was used to standardize the frequency, range of motion, and duration parameters. OBJECTIVES: The purpose of the study was to determine whether a simple standardised mobilization technique could be incorporated as a safe and unsupervised conservative treatment for knee OA. METHODS: In total, 73 participants were randomly assigned to the experimental (n= 37) or control group (n= 36). All participants performed active exercises and received six sessions of 10-minute dorsiflexion intervention, either real or sham, for two weeks. Pre- and post-experimental assessments for the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), visual analog scale (VAS) for pain, and range of motion of the knee were conducted. RESULTS: Results were analyzed using two-way repeated measures analysis of variance and Independent-Samples Mann-Whitney U Test. The mean score of WOMAC for the experimental and control groups changed from 31.84 to 18.19 and 34.74 to 21.06, respectively, after the intervention. The VAS also showed significant improvements. Significant improvements were observed in WOMAC in both groups after the intervention; however, differences between the groups were not statistically significant. CONCLUSIONS: Exercise with either 30∘ or 5∘ of passive dorsiflexion yielded favorable clinical effects. Although submaximal bilateral ankle dorsiflexion was proven to be safe for elderly participants with osteoarthritis of the knee, whether it provided extra benefits to exercises alone was unclear. Further research is required to determine the effectiveness of dorsiflexion and optimal range of mobilization.

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