scholarly journals Effect of Quadriceps Strengthening Exercise on Reduction of Pain in Knee Osteoarthritis

2014 ◽  
Vol 41 (3) ◽  
pp. 19-22
Author(s):  
CM Walid ◽  
MH Islam ◽  
AZM M Rahman ◽  
MT Islam ◽  
MK Hassan ◽  
...  

Osleoarthritis is the leading cause of musculoskeletal pain and disability. Nonsteroidal anti-inflammatory drugs and physical modalities like Quadriceps muscle strengthening exercise can be used to treat such cases. This Randomized clinical trial study was done in the department of Physical Medicine and Rehabilitation, Sylhet M.A.G Osmani Medical College Hospital Sylhet, lo evaluate the role of quadriceps strengthening exercise in knee osteoarthritis during 1st April 2009 to 3lst October 2009. Sixty patients with knee osteoarthritis were selected according to inclusion and exclusion criteria. They were divided in, group A and group B randomly. Group- A was treated with NSAID (Aceclofenac 100 mg 12hrly) and group-B with NSAID and quadriceps strengthening exercise 10 repetition 3 times daily. Each patient was followed try every week for four weeks. The mean age was 61.067 ± 8.320 years and male female ratio was 1.4:1. Marked improvement was observed in both the groups assessed by pain score (p<0.001), physicians global assessment (p<0.001) and patients global assessment (p<0 001); and was continued throughout the treatment period of 4 weeks; with significantly marked in group A than group B beginning at 1st week of treatment [pain score (p<0.001), physicians global assessment (p<0.040) and patients global assessment (p<0.034)] and was continued at the 4th week of treatment [pain score (p<0.001), physicians global assessment (p<0.001) and patients global assessment (p<0.001)]. The overall difference between the groups from baseline to end point of treatment is significant with group A (exercise plus NSAIDs) experienced a faster pain relief than that of group B (Only NSAID) (p:<0.001). So from the present study, it may be concluded that quadriceps strengthening exercise is useful in reduction of pain in knee osteoarthritis and may be an adjuvant therapy in knee osteoarthritis. DOI: http://dx.doi.org/10.3329/bmj.v41i3.18953 Bangladesh Medical Journal 2012 Vol.41(3): 19-22

2018 ◽  
Vol 30 (2) ◽  
pp. 13-19
Author(s):  
Md Tariqul Islam Khan ◽  
Badrunnesa Ahmed ◽  
AKM Salek ◽  
Fazlul Karim

Background: Knee osteoarthritis (OA) is the common form of disability in comparatively elderly patient. Lateral wedge shoe insole is an easy, simple and cost effective approach which can be applied as an adjunct to pharmacotherapy to treat the patients with OA knee. The objective of the study is to evaluate the effectiveness of using lateral wedge shoe insole on pain and physical functioning in patients with OA knee.Method: A randomized prospective study was carried out in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January, 2012 to March, 2012. Patients with OA knee by American College of Rheumatology Criteria were selected. Two intervention groups were compared. In patients of Group-A (32 patients) were treated with aceclofenac100mg and, omeprazole20mg bid, and daily instructions of activities of daily living (ADLs), isometric quadriceps muscle strengthening exercise. Patients of Group-B were given lateral wedge shoe insole along with above treatment. The change between two weeks post intervention and baseline WOMAC (Western Ontario and McMaster Universities) subscale and scores were calculated. There were 4 visits and in each visit, patients were assessed for pain, stiffness and physical function by WOMAC index.Results: A total 65 patients with OA knee were included in this study. The mean age was 56.5± 10 years. Male to female ratio was 1.32:1. Comparison of mean pretreatment and 8th week post treatment WOMAC physical function subscale score in Group A (4.9 ± 1.2 vs. 2.4 ± 0.8) showed significant improvement and in Group B (4.3 ± 1.2 vs. 1.9 ± 0.5) which also shows significant improvement more than group A. The result was compared and student t-test was done to see the level of significance. Method was found significant after treatment (p <0.05).Interpretation: Effects of use of lateral wedge shoe insole in patients with knee OA is beneficial.TAJ 2017; 30(2): 13-19


2020 ◽  
Vol 27 (09) ◽  
pp. 1891-1894
Author(s):  
Asif Javeed ◽  
Muhammad Absar Alam ◽  
Atif Maqsood ◽  
Amna Azher ◽  
Muhammad Arif ◽  
...  

Objectives: To compare the efficacy of Duloxetine with Amitriptyline in Terms of Reduction in Frequency of Pain in The Management of Patients of Diabetic Neuropathy. Study Design: Randomized Control Trial. Setting: Medical OPD of ABWA Medical College Hospital Faisalabad. Period: Six Months from 01-01-2019 to 30-06-2019. Material & Methods: A total of 200 cases (100 in each group) between the age 20-65 years of any gender, ≥ 5 years history of diabetes, symptoms of peripheral neuropathy for at least six months, having HbA1c >7.5% were included. Two groups were formed Group A was given 60mg Duloxetine each day and Group B was given 75mg amitriptyline in a single dose. After 3 weeks, an additional three weeks supply of medication was dispensed and patient were scheduled to return at week 6 for the final evaluation that recorded by me in terms of reduction in pain score and also assessed for 50% reduction in pain score from base line that was labeled as reduced. Results: 62%(n=62) in Group-A and 35%(n=35) in Group-B were treated effectively, which shows a significant difference between the two groups. Conclusion: The duloxetine was more effective than amitriptyline in terms of reduction of pain in diabetic neuropathy.


2020 ◽  
Vol 32 (2) ◽  
pp. 126-129
Author(s):  
Jahangir Alam Mazumder ◽  
Md Golam Mustafa ◽  
AHM Delwar ◽  
Shazibur Rashid ◽  
Md Mostafizur Rahaman ◽  
...  

Introduction: After SMR/septoplasty with or without turbinate surgery, it needs to keep apart the septum and turbinates upto their complete healing otherwise there is a chance of adhesion (synechia) formation. To prevent this there are variousprocedures. To place an intranasal splint in one or both sides of the septum is one of them. Nowadays there raised thequestion of whether the splinting is necessary or not. There is no significant difference in result with or without anintranasal splint. Weighing against the co-morbidities the routine use of an intranasal splint can no longer be justified. Materials and Methods: This is a randomized control study of 200 patients of SMR/septoplasty, done for nasal septaldeviation causing symptoms in Cumilla Medical College Hospital in the period of January 2016 to December 2019. Theywere equally divided into two groups, group-A were operated placing an intranasal splint and group-B with no intranasalsplint. They were followed up for 6 weeks to detect any synechia and co-morbidities. Result: The age of our patients wasranged from 13-49 years with a mean age of 22.45 years. The male to female ratio is 1.78:1. Synechia was found in 4% ofthe splinted group and 6 of the nonsplinted groups. Co-morbidities were detected more in the splinted group than that ofnon-splinted. In INS group these were found as follows: pain in the nose, face and head (26%), faint during removal ofnasal splint (6%), nasal obstruction (38%), the anxiety of splint removal in the postoperative period (35%) and vestibulitisdue to persistent irritation by a splint (17%). Conclusion: There is little significant advantage of using intranasal splintroutinely in septal surgery to prevent synechia formation. Medicine Today 2020 Vol.32(2): 126-129


2014 ◽  
Vol 13 (2) ◽  
pp. 21-27
Author(s):  
Sunam Kumar Barua ◽  
Sohely Rahman ◽  
Prashanta Kumar Chakrabarti ◽  
Zahangir Alam

This prospective study was performed in the department of Physical Medicine, Dhaka Medical College Hospital (DMCH), Dhaka for a period of 6 months to see the effect of phonophoresis (Ultrasound therapy with Naproxen gel) on adhesive capsulitis. During this period 240 (4% of total patients) patients were diagnosed as adhesive capsulitis of shoulder in outpatient department, Physical Medicine, Dhaka Medical College Hospital. Sixty patients were selected for the study and divided them into two groups. In group A, patients were treated with phonophoresis and exercises in contrast with group B patients who were treated with same exercises without phonophoresis for same duration. Patients in both groups were followed up weekly for consecutive six weeks. The mean age of the patients in this study was 51.73 ± 10.01 year, with a range of 35 to 70 years. Out of sixty patients 31 (51.7%) were male and 29 (48.3%) were female. The male: female ratio was 1.07: 1. Among 60 patients, 27 (45%) were housewives, 20 (33.3%) service holders (official job), 4 (6.7%) businessmen, 1 (1.7%) teacher and 8 (13.3%) retired persons. In this study 53.3% patients had right shoulder involvement and rest of them (46.7%) had left sided involvement. Pain was improved just after initiation of treatment and it was completely alleviated in group A patients after 6th week, on the contrary although pain was increased after 1st week of treatment thereafter it was gradually decreased but it was not completely alleviated in group B patients at the end of the study. All sorts of range of motions (abduction, internal rotation on abduction, external rotation on abduction) of affected shoulder were improved more rapidly in group A compared to group B patients. Shoulder pain and disability index (SPADI) were significantly reduced in group A compared to group B patients.DOI: http://dx.doi.org/10.3329/cmoshmcj.v13i2.21057


1970 ◽  
Vol 12 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Abul Kalam Azad ◽  
Golam Nabi ◽  
MA Shakoor ◽  
MD Moyeenuzzaman

A total of 106 patients of osteoarthritis of knee were selected for the study. Out of 106 patients 26.41% were male and 73.58% were female. The female and male ratio is 2.78: 1. Mean age was 49.68 ± 9.16 years and house wives were maximum in number 75 (70.8%). They were divided into two groups, 52 patients in group–A, were treated with NSAID plus Exercise and another 54 patients in group-B, were treated with NSAID only. In both group patients were treated for six weeks duration. The improvement was assessed with WOMAC scoring system. Student’s‘t’ test was to see the level of significance. In present study, the patients groups those who received NSAID plus Exercise, improved more significantly (p= 0.001) than those who received NSAID only. So it can be concluded that quadriceps muscle strengthening exercise is effective in the patients with OA knee. Keyword: Osteoarthritis, Knee, Exercise. DOI: http://dx.doi.org/10.3329/jom.v12i2.8418 JOM 2011; 12(2): 120-124


2021 ◽  
Vol 15 (10) ◽  
pp. 2865-2868
Author(s):  
Muhammad Muddasser Khan Panezai ◽  
Shahzad Gul ◽  
Zia Ehsan Kakar ◽  
Uzma Rasheed ◽  
Shazia Zammurad ◽  
...  

Objective: To compare the efficacy of Duloxetine with NSAIDS versus NSAIDS alone for the treatment of knee pain secondary to osteoarthritis. Study Design: Randomized clinical trial study. Setting and Duration: Department of Rheumatology, PIMS Hospital, Islamabad, from April to August 2021. Methodology: One hundred and twenty eight patients with knee osteoarthritis were included in the study and were divided in two equal groups; one group was subjected to Duloxetine plus NSAIDs and other to just NSAIDs. The response was assessed at end of 3 months. Reduction in pain more than or equal to 50% from the baseline was considered as efficacy. Results: The mean VAS score was 3.56±1.15 in group A (Duloexetine plus NSAIDS) A while in group B (NSAID alone), 4.45±1.22 and significantly (p-value > 0.05). Similarly, the comparison of WOMAC score for pain showed that the mean WOMAC score was significantly (P-value > 0.05) less 5.68±1.56 in group A in contrast to 6.39 ± 1.69 in group B. Comparison of efficacy between two groups showed that the rate of efficacy was significantly (P-value >0.05) higher in group A 48.4% as compared to 31.3% in group B. Conclusion: Addition of Duloxetine to NSAIDs resulted in more reduction of pain in terms of VAS and WOMAC score with acceptable adverse effects. Keywords: Chronic pain, Duloxetine, Knee pain, NSAIDs, Osteoarthritis


2018 ◽  
Vol 27 (1) ◽  
pp. 62-67
Author(s):  
Moinuddin Hossain Khan ◽  
Sohely Rahman ◽  
Md Shahadat Hossain ◽  
Muhammad Mahbub Hossain ◽  
Maksuda Khatun ◽  
...  

Context: Osteoarthritis is primarily a disease of cartilage as it is characterized by the degradation of hyaline cartilage in the joints. It is believed to be a dynamic disease that reflects the balance between destruction and repair. Clinically, there is pain, swelling of joints and limitation of motion. Pathological disease is characterized by focal erosive lesions, cartilage destruction, subchondral sclerosis, cyst formation and large osteophyte at the margin of the joints. The objectives of management of osteoarthritis (OA) of the knee are to relieve pain, maintain or improve mobility, and minimize disability. Treatment options include non -pharmacologic intervention, drug therapy, and surgery. Different modalities of physical therapy have been shown to help improve clinical symptoms and function of knee OA with fewer adverse effects. Transcutaneous electrical nerve stimulation (TENS) is among these non invasive therapies which have been used to treat a variety of painful acute and chronic conditions including osteoarthritis. Material and Methods: This randomized clinical trial was conducted on 60 (sixty) patients attending in Physical Medicine and Rehabilitation department of Dhaka Medical College Hospital, who were suffering from knee osteoarthritis. The patients were randomly divided into two groups, Group-A and Group-B. The patients were evaluated clinically and data was collected from both groups in a pre designed data collection sheet for visual analogue scale (VAS) on Pain, 50 feet walking time in seconds and tenderness index in every two weeks interval from the first visit for up to 6 weeks. All the data were analyzed by SPSS version 16.1. Result : The present study showed pain, tenderness and walking time were significantly improved in Group A who were treated with TENS, NSAID & ADL instructions than in Group B who were treated with NSAID & ADL instructions after 6 weeks( P<0.05). Conclusion: The results of this study suggest that application of TENS along with NSAIDs and ADL instructions is more effective in reduction of pain and improving functional performances in patients with knee osteoarthritis than the drug only treatment. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 62-67


2013 ◽  
Vol 24 (1) ◽  
pp. 31-35
Author(s):  
Muhammad Kamrul Hassan ◽  
M Habibur Rahman ◽  
Fauzia Sobhan ◽  
Farzana Khan Shoma ◽  
Chowdhury Mohammad Walid

This prospective type of experimental study was carried out to determine the improvement of symptoms by ultrasound therapy in management of de'Quervain's disease. It was done in the department of physical medicine and rehabilitation in Dhaka medical college hospital during the period of 30th January 2008 to 30th July 2008.The diagnosis of de'Quervain's disease confirmed by history and clinical examination(Finkelstein test). 50 patients were selected and randomly divided into two groups. Group-A patients were treated with thumb splint,NSAIDS and ADL. Group-B patients were treated with thumb splint, NSAIDS, ADL and ultrasound therapy. Each patients was assessed by pain score, visual analogue scale(VAS), grading of tenderness and swelling. Mean age was 41.02 years. Female and male ratio was 7.5:1. Most patients occupation was housewife 40(80%) and had a precipitating factor as wringing of cloths 31(62%). History of recurrence was found in 7(14%). Most of the patients developed pain gradually 72%(36). Post treatment VAS score improved significantly in group B(p<0.05), in groupB 96%(24) and in group A 52%(13) patients had VAS score 0 to 4. Post treatment significantly (p<0.01) higher number of patients were in swelling score. So in group B(84%) compared to group A (44%), After treatment pain score showed significant improvement (p<0.01) in group B patients (72%) compared to group A(24%). In group A, 16%(4) and in group B 32%(8) patient were completely cured(No pain,no tenderness and no swelling). DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14112 Medicine TODAY Vol.24(1) 2012 pp.31-35


2020 ◽  
Vol 21 (2) ◽  
pp. 105-110
Author(s):  
Md Shawkat Alam ◽  
Sudip Das Gupta ◽  
Hadi Zia Uddin Ahmed ◽  
Md Saruar Alam ◽  
Sharif Muhammod Wasimuddin

Objective: To compare the clean intermittent self-catheterization (CISC) with continuous indwelling catheterization (CIDC) in relieving acute urinary retention (AUR) due to benign enlargement of prostate (BEP). Materials and Methods :A total 60 patients attending in urology department of Dhaka Medical college hospital were included according to inclusion criteria ,Patients were randomized by lottery into two groups namely group –A and group –B for CISC and IDC drainage respectively . Thus total 60 patients 30 in each group completed study. Results : Most men can safely be managed as out-patients after AUR due to BPH. The degree of mucosal congestion and inflammation within the bladder was found to be lower in those using CISC and the bladder capacity in these patients was also found higher.Patients with an IDC had a high incidence of UTIs then that of patients with CISC. During the period of catheterization the incidence of UTI was 43.3% in group B in comparison to 40% in group A; before TURP 36% in group B in comparison to 10% incidence in group A.According to patient’s opinion CISC is better than IDC in the management of AUR. Experiencing bladder spasm, reporting blood in urine, management difficulties, incidence and severity of pain were less in CISC group, and the method of CISC was well accepted by patients as well as their family members. Conclusion: From the current study it may be suggested that CISC is better technique for management of AUR patient due to BPH than IDC. It can also be very helpful when surgery must be delayed or avoided due to any reasons in this group of patients. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.105-110


2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana

Abstract Introduction Management of complicated diverticulitis has shifted towards a conservative approach over time. This study evaluates the feasibility and long-term outcomes of conservative management. Method We retrospectively evaluated a consecutive series of patients managed with perforated colonic diverticulitis from 2013-2017. Results Seventy-three (73) patients were included with a male to female ratio of 1:2. Thirty-one (31) underwent Hartmann’s procedure (Group A) and 42 patients were managed with antibiotics +/- radiological drainage (Group B). Mean follow-up was 64.9 months (range 3-7 years). CT Grade 3 and 4 disease was observed in 64.5% and 40.4% of Group A and Group B patients, respectively. During follow-up, 9 (21.4%) Group B patients required Hartmann’s. Group A had longer median length of stay compared to Group B (25.1 vs 9.2 days). Post-operative complications occurred in 80.6% with 40% being Clavien-Dindo grade III or higher in group A. Stoma reversal was performed in 8 patients (25.8%). Conclusions In carefully selected cases, complicated diverticulitis including CT grade 3 and 4 disease, can be managed conservatively with acceptable recurrence rates (16.7% at 30 days, 4.8% at 90 days, 19.0% at 5 years). Surgical intervention on the other hand, carries high post-operative complication rates and low stoma reversal rates.


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