A Comparative Study of the Effects of Lateral Wedge Insole Shoe Modification on the Patients with Knee Osteoarthritis

2018 ◽  
Vol 30 (2) ◽  
pp. 13-19
Author(s):  
Md Tariqul Islam Khan ◽  
Badrunnesa Ahmed ◽  
AKM Salek ◽  
Fazlul Karim
Keyword(s):  
Knee Osteoarthritis ◽  
Physical Function ◽  
Cost Effective ◽  
Subscale Score ◽  
Quadriceps Muscle ◽  
Post Intervention ◽  
Female Ratio ◽  
Knee Oa ◽  
Group A ◽  
Group B

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

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 ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Pain Score ◽  
Global Assessment ◽  
Quadriceps Muscle ◽  
College Hospital ◽  
Female Ratio ◽  
Strengthening Exercise ◽  
Reduction Of Pain ◽  
Group A ◽  
Group B

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

scholarly journals Effect of Intra-articular Ketorolac Versus Corticosteroid Injection for Knee Osteoarthritis: A Retrospective Comparative Study

2020 ◽  
Vol 8 (4) ◽  
pp. 232596712091112
Author(s):  
Jianda Xu ◽  
Yuxing Qu ◽  
Huan Li ◽  
Aixiang Zhu ◽  
Tao Jiang ◽  
...  
Keyword(s):  
Pain Relief ◽  
Knee Osteoarthritis ◽  
Sodium Hyaluronate ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Group A ◽  
Successful Outcomes ◽  
Group B ◽  
Corticosteroid Injections

Background: Intra-articular corticosteroid injections have been widely used and are considered a mainstay in the nonoperative treatment of symptomatic knee osteoarthritis (OA). However, their increased use can have negative implications, including chondral toxicity and a high risk of infections. As a result, nonsteroidal anti-inflammatory drugs have been considered as an alternative. Purpose: To determine the pain relief and safety of ketorolac versus a corticosteroid to supplement an intra-articular sodium hyaluronate injection for the treatment of symptomatic knee OA. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 84 patients with unilateral symptomatic knee OA receiving 5 weekly injections were enrolled in this retrospective study. Group A (n = 42) received 3 weekly intra-articular corticosteroid injections (0.5% lidocaine, 25 mg of triamcinolone acetonide, and 25 mg of sodium hyaluronate, followed by 2 weekly injections of 0.5% lidocaine and 25 mg of sodium hyaluronate), while group B (n = 42) received 5 weekly ketorolac injections (0.5% lidocaine, 10 mg of ketorolac, and 25 mg of sodium hyaluronate). The following parameters were used to evaluate pain relief and safety: visual analog scale (VAS) for pain, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and side effects before the injection and at 1, 2, and 5 weeks after treatment commencement as well as 3 months after the last injection. Results: Patients from both groups had a significant improvement in VAS and WOMAC scores from the first injection to final follow-up at 3 months. In the first week, the VAS score was lower in group A ( P = .041), but no significant between-group differences were found for either the VAS or the WOMAC score at the other time points. Of the 42 patients in group A, 34 (81.0%) and 25 (59.5%) achieved successful outcomes at 5 weeks after treatment commencement and 3 months after the last injection, respectively. In group B, 32 (76.2%) and 24 (57.1%) patients achieved successful outcomes at 5 weeks after treatment commencement and 3 months after the last injection, respectively. At final follow-up, no significant difference was found in the successful treatment rate between the groups ( P = .825). Conclusion: The current study demonstrated that intra-articular ketorolac and corticosteroid injections produce the same pain relief and functional improvement.

scholarly journals Comparison Of Diacerein-Ginger With Diacerein Alone In Treating Knee Osteoarthritis

2019 ◽  
Vol 09 (04) ◽  
pp. 308-311
Author(s):  
Mehtab Munir ◽  
Shahid Mustafa Memon ◽  
Sajid Abbas Jaffri ◽  
Khalid Mustafa Memon
Keyword(s):  
Knee Osteoarthritis ◽  
P Value ◽  
Womac Pain ◽  
Test Results ◽  
Knee Oa ◽  
Significant Difference ◽  
Group A ◽  
Insignificant Difference ◽  
Group B ◽  
Pain At Rest

Objective: To compare clinical efficacy of diacerein-ginger with diacerein alone in treating knee osteoarthritis. Duration and place of study: It was a randomized clinical trial conducted from 21st September 2018 to 31stMarch 2019, in medical OPD of a private hospital in Karachi. Methodology: 60 diagnosed patients of knee osteoarthritis were included in this study. Male and female patients 50 years of age, fulfilling the inclusion criteria and after written informed consent experienced a wash-out period of 72 hours. These patients were systematically randomized into 2 groups each having 30 members. Group A received capsule Diacerein 50mg + capsule Ginger 550 mg twice daily and group B received capsule Diacerein 50mg twice daily, for 12 weeks. Parameters checked at 0, 6 and 12 weeks were: Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, pain at rest and movement (Visual Analogue Scale). Comparison of the two groups was done by independent t-test. Results: Among 60 patients; 20 (33.33 %) were males and 40 (66.66%) were females. 4 patients in group A and 4 in B, dropped out during the study. Comparison of group A with group B in WOMAC and pain (at rest and movement) scores showed insignificant difference at day 0 before prescription of the drugs. However comparison showed highly significant difference (P-value < 0.001) between the two groups in WOMAC, pain at rest and movement scores at the end of 6th and 12th weeks of intervention. Conclusion: Diacerein-Ginger is clinically more efficacious for management of knee OA than Diacerein alone

scholarly journals THE EFFECTS OF MUSCLE ENERGY TECHNIQUE AND STATIC STRETCHING OF GASTROCNEMIUS ON PAIN AND DISABILITY IN KNEE OSTEOARTHRITIS

2018 ◽  
Vol 7 (2) ◽  
pp. 32-37
Author(s):  
Amna Aamir Khan ◽  
Jaza Rizvi
Keyword(s):  
Knee Osteoarthritis ◽  
Static Stretching ◽  
Knee Oa ◽  
Muscle Energy Technique ◽  
Koos Score ◽  
Group A ◽  
Muscle Energy ◽  
Degenerative Disorder ◽  
Group B ◽  
Gastrocnemius Muscles

BACKGROUND AND AIMS Knee Osteoarthritis (OA) is a degenerative disorder and a leading cause of disability associated with pain, restricted ROM and difficulty in performing Activities of Daily Living (ADLs). The aim of this study was to compare the effectiveness of Muscle Energy Technique (MET) and static stretching on gastrocnemius muscles among the patients suffering with knee OA. METHODOLOGY A 2-arm Randomized Control Trial was conducted at Ziauddin Hospital among 120 patients suffering with grade-II OA. Initial screening was conducted on the basis of Knee OOS. Group A received the MET whereas Group B received Static Stretching Technique both group received the treatment for three days/week for 4 weeks. RESULTS In initial evaluation, our results revealed that group A shows the KOOS score 0.43±0.10 that improved significantly after four weeks of treatment to 0.49±0.14. Our results revealed that at 95% CI, the KOOS score of patients significantly improved in both the groups p<0.05

A Randomised Placebo-Controlled Trial to Assess the Efficacy of Osteoarthritic nosode in the Treatment of Knee Osteoarthritis

2021 ◽  
Vol 34 (03) ◽  
pp. 199-205
Author(s):  
Reteka Sexena ◽  
Tarkeshwar Jain
Keyword(s):  
Knee Osteoarthritis ◽  
Daily Living ◽  
Controlled Trial ◽  
Research Centre ◽  
Functional Domains ◽  
Functional Domain ◽  
Knee Oa ◽  
Group A ◽  
Group B

Abstract Background Knee osteoarthritis (OA) is the most common musculoskeletal disease that affects the ability for sitting on the chair, standing, walking and climbing stairs and various other daily living activities of an affected individual. Objective The primary objective of the study was to assess the efficacy of Osteoarthritic nosode in the treatment of knee OA on the symptomatic and functional domains in comparison to control group with knee-specific exercises as co-intervention in both the groups. Materials and Methods It was a single blind randomised controlled trial study conducted at the out/inpatient department of Dr Madan Pratap Khunteta Homoeopathic Medical College, Hospital & Research Centre and Dr Girendra Pal Homoeopathic Hospital, Homoeopathy University, Saipura, Sanganer, Jaipur for a period of 1 year where cases were registered for first 9 months so that minimum of 3 months follow-up can be obtained during the course of the study. Total 50 patients who were radiographically diagnosed to be suffering from knee OA excluding Grade 4 of knee OA were allocated equally and randomly into two treatment groups. The patients in Group A received placebo and physiotherapy and patients in Group B received Osteoarthritic nosode and physiotherapy. The changes in patients' symptomatic and functional domain were evaluated by Knee Outcome Survey-Activity of Daily Living Scale (KOS- ADLS) questionnaire score assessed at the baseline and after 3 months (six follow-ups at 15 days interval) of treatment. Results Out of 50 patients enrolled, 45 patients completed the trial. Those patients who had completed 3 months of follow-up, that is, 6 follow-ups at 15 days interval, were included in the study. The results showed that the patients with knee OA in Group B had significant improvement in both symptomatic and functional domains after treatment when compared with their initial status and when compared with Group A. Group A (placebo and physiotherapy) showed non-significant to no improvement in 72% of cases and 16% were aggravated when assessed on the symptomatic and functional domains. Group B (OA nosode and physiotherapy) showed mild to marked improvement in 80% of cases, whereas 12% showed non-significant to no improvement when assessed on the symptomatic and functional domains. Conclusion Osteoarthritic nosode with physiotherapy is significantly effective than placebo with physiotherapy in the management of cases of knee OA.

scholarly journals Clinical effects of two different doses of duloxetine compared to conventional analgesic therapy in patients with osteoarthritis knee

2021 ◽  
Vol 12 (10) ◽  
pp. 97-104
Author(s):  
Arpita Choudhury ◽  
Dipasri Bhattacharya ◽  
Rajasree Biswas ◽  
Swati Saroha ◽  
Nitisha Chakraborty ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Physical Function ◽  
Womac Score ◽  
Functional Improvement ◽  
Clinical Effects ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Group A ◽  
Group B ◽  
Different Doses

Background: Pain is the leading symptom of knee osteoarthritis (OA) leading to significant morbidity and decreased quality of life. Duloxetine, a selective serotonin norepinephrine reuptake inhibitor, has been demonstrated to have a centrally acting analgesic effect. Aims and Objectives: To evaluate the efficacy and safety of two different doses of duloxetine and compare with conventional pharmacotherapy in treatment of chronic pain due to osteoarthritis of knee. Materials and Methods: 90 patients with symptomatic knee OA were randomly divided into 3 groups to receive duloxetine 40 mg & 3g paracetamol/day (Group A), duloxetine 20 mg & 3g paracetamol/day (Group B) and paracetamol 3gm/day (Group C). Patients were followed up for 6 months to assess pain relief and functional improvement. Visual Analogue Scale (VAS) for assessing pain intensity and Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire physical function subscale for assessing physical function were used. Results: Reduction in VAS score from baseline was significantly high in groups A and B as compared to C at 1 month, 3 months and 6 months. Reduction in WOMAC score from baseline were also significantly high in groups A and B as compared to C at 1 month, 3 month and 6 months. Adverse effects in Group A were significantly high as compared to group B and C. Patients discontinuing due to adverse effects were significantly high in group A. Conclusion: Lower dose of duloxetine is associated with significant pain reduction and improved function with lesser adverse effects in patients with pain due to knee OA.

scholarly journals Reliability and validity of 3 different Chinese versions of the Oxford knee score (OKS)

Arthroplasty ◽  
2020 ◽  
Vol 2 (1) ◽  
Author(s):  
James Reeves Mbori Ngwayi ◽  
Jie Tan ◽  
Ning Liang ◽  
Daniel Edward Porter
Keyword(s):  
Hong Kong ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Bodily Pain ◽  
Oxford Knee Score ◽  
Smart Devices ◽  
Knee Score ◽  
Sf 36 ◽  
Group A ◽  
Group B

Abstract Background Different Chinese versions of the Oxford Knee Score (OKS) are available for knee arthritis assessment. These include the Malaysian, Hong Kong and Singaporean Chinese versions with slight variations in wordings and use of Cantonese in the Hong Kong Version. This study evaluated the validity and reliability of the different Chinese OKS versions in Mainland China. Methods One hundred ninety four China mainland-based patients participated in the study, each being diagnosed with knee osteoarthritis. The patients were randomly assigned into 3 groups: Group A completed the Malaysian OKS; Group B completed the Singaporean OKS; Group C completed the Hong Kong OKS. Participants also completed the 36-item Short Form Survey (SF 36). The electronic versions of the questionnaires completed by the patients were sent to smart devices via a social media platform. Results Interclass coefficients for test-retest reliability of the groups were 0.917 in group A, 0.921 in group B, 0.824 in group C. Cronbach alpha results for internal consistency of the 3 groups were: 0.912 in group A, 0.896 in group B, 0.846 in group C. Spearson correlation results with individual SF-36 domains were as follows: Group A showed strong negative correlations with bodily pain and physical function domains; group B exhibited moderate negative correlations with the bodily pain and physical function domains; group C revealed strong negative correlations with the bodily pain and physical function domains and weak negative correlations with vitality domain. Conclusions Different Chinese versions of the OKS showed good reliability and convergent validity in mainland samples of patients with knee osteoarthritis, supporting their use in research and other related studies.

scholarly journals A COMPARATIVE STUDY ON EFFICACY OF COLLAGEN PEPTIDE ACECLOFENAC AND PARACETAMOL VERSUS ACECLOFENAC AND PARACETAMOL ALONE FOR THE TREATMENT OF KNEE OSTEOARTHRITIS.

2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Mareena Raju ◽  
Blessy K Johnson ◽  
Ambarish Sharma ◽  
Bharathi D R
Keyword(s):  
Visual Analogue Scale ◽  
Knee Osteoarthritis ◽  
Analogue Scale ◽  
Symptomatic Relief ◽  
Keywords Knee ◽  
Knee Oa ◽  
Collagen Peptide ◽  
Group A ◽  
Group B

Background: The existing treatment for Osteoarthrits (OA)  is symptomatic by NSAIDS are effective for reducing pain associated with OA, they do not reverse the disease. This makes way for the emergence of nutraceuticals like collagen peptide which are chondroprotective in nature. Objectives: To assess the prevalence of knee OA, efficacy of combination of collagen peptide, aceclofenac and paracetamol against aceclofenac and paracetamol alone in the treatment of osteoarthritis, the medication adherence and drug related problems in OA. Methods: A prospective observational study was carried out in the outpatients of Department of Orthopaedics, BMCH & RC and Ambarish’s Clinic, Chitradurga. A total of 154 patients suffering from OA were identified. 60 subjects of Grade I knee OA were selected for the study from 112 cases of knee OA. The subjects were divided in two groups; Group A comprised of 30 subjects who were treated with collagen peptide, aceclofenac and paracetamol (Acetaminophen) for a period of two months, with a follow up of one month and the therapy was assessed by Visual Analogue Scale(VAS). Whereas Group B of 30 subjects who were treated with aceclofenac and paracetamol for  two months with a follow up of one month and assessed by VAS. Results:  The prevalence of knee osteoarthritis was found to be 72.72%.Among them Grade I was 77.67%. From this 60 patients were selected for further study of which 90% were females and 10% males. At the end Group A showed better results than Group B. Acetaminophen and Aceclofenac related gastrointestinal disturbances were found in both the groups. Majority of the patients also had good medication adherences. Conclusion: The study identifies and supports the use of collagen peptide to provide symptomatic relief and can be used as adjunct therapy for OA management. Keywords: Knee osteoarthritis, nutraceuticals, collagen peptide, Visual Analogue Scale.

scholarly journals To Compare the Effects of UST and TENS with PNF Stretching To Increase the Mobility and Reduce Pain in OA - A Randomised Control Trial

2021 ◽  
Vol 9 (8) ◽  
pp. 1320-1326
Author(s):  
Dr Nidhi Agarwal
Keyword(s):  
Range Of Motion ◽  
Joint Stiffness ◽  
Quadriceps Muscle ◽  
Randomised Control Trial ◽  
Knee Oa ◽  
Keywords Osteoarthritis ◽  
Osteoarthritis Patient ◽  
Osteoarthritis Knee ◽  
Group A ◽  
Group B

Abstract: Osteoarthritis is a chronic disorder which is degenerative in nature having a multifactorial etiology characterized by subchondral sclerosis, loss of the articular cartilage, hypertrophy of the marginal bone along with morphological and biochemical changes in the joint capsules and synovium. Knee osteoarthritis is the most common form of osteoarthritis. Knee OA is characterized by quadriceps muscle weakness, hamstring weakness, possible joint stiffness, effusion, loss of proprioception loss of range of motion and knee pain. Transcutaneous electrical nerve stimulation is the most widely used physical modalities for the management osteoarthritis knee. The benefits of TENS for relive chronic pain are well documented. The UST for the treatment of OA will lead to improvement of life by decreasing the swelling and reducing the pain at the knee joint. PNF relieves pain improves the ROM, restores proprioception as confirmed by clinical research. The aim of study to find out the effect of UST and TENS with PNF stretching to increase the mobility and reduce pain in OA Patients. Study duration is 6-week, source of data is Goldi masala factory, Kanpur. Sample size is 60 and method of data collection is random. Subjects were divided into two equal group, for group A we give PNF with ultrasound and for group B we give PNF with TENS for six consecutive weeks. After analysis of collected data result was null hypothesis is rejected and alternate hypothesis is accepted. In this way both technique is statistically significant. So, we concluded that both the technique i.e., PNF with UST and PNF with TENS is effective in treating the osteoarthritis patient with relieving pain and increasing range of motion. But statistically PNF with TENS is more significant over PNF with UST. Keywords: Osteoarthritis, proprioceptive neuromuscular facilitation, ultrasound therapy, transcutaneous electrical nerve stimulator, pain, range of motion, VAS scale, goniometer.

scholarly journals 439 Conservative Versus Surgical Management of Complicated Diverticulitis - A Retrospective Study of Long-Term Outcomes

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
E Durity ◽  
G Elliott ◽  
T Gana
Keyword(s):  
Complicated Diverticulitis ◽  
Complication Rates ◽  
Long Term Outcomes ◽  
Female Ratio ◽  
Stoma Reversal ◽  
Group A ◽  
Grade 3 ◽  
Group B

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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