scholarly journals Multimodal Impact of Acupuncture, Exercise Therapy, And Concurrent Functional Electrical Stimulation On Osteoarthritis of the Knee: a Case Report

2019 ◽  
Vol 44 (2) ◽  
pp. 135-145
Author(s):  
Azadeh Hakakzadeh ◽  
Ardalan Shariat ◽  
Vahide Moradi ◽  
Lee Ingle ◽  
Roshanak Honarpishe ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Knee Osteoarthritis ◽  
Knee Pain ◽  
Exercise Therapy ◽  
Functional Electrical Stimulation ◽  
Treadmill Walking ◽  
Office Worker ◽  
Medicine Physician ◽  
Patient Reported

Knee osteoarthritis (OA) causes functional limitation in weight-bearing actlVltles including walking. To investigate the multimodal impact of acupuncture, exercise therapy, and concurrent functional electrical stimulation (FES) on knee osteoarthritis. We designed a multidisciplinary treatment package including acupuncture; home based exercise therapy, and concurrent functional electrical stimulation during treadmill walking. Outcomes measurements included the numerical rating scale (NRS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), and the Tampa Scale of Kinesiophobia (TSK). Measurements were completed at baseline and following the treatment phase which consisted of six individual sessions. A 48-year-old male, office worker presented with a history of chronic right knee. During the previous year, he was diagnosed with knee osteoarthritis after clinical physical examination by a sports medicine physician. Following our novel training intervention, the patient reported a reduction in pain intensity from 8 to 2 on the NRS, improved in all KOOS subscale scores, and improved in the TSK scale (reduction from 15 to 11). In addition, the patient reported that he was able to return to work and undertake normal activities of daily living with reduced knee pain. This case report showed that our novel multimodal intervention including six sessions of acupuncture, exercise therapy, and treadmill walking with functional electrical stimulation (FES) had a positive impact on knee pain and function in a middle-aged male with knee osteoarthritis.

scholarly journals Program Evaluation of GLA:D® Australia: Physiotherapist Training Outcomes and Effectiveness of Implementation for People With Knee Osteoarthritis

2021 ◽  
Author(s):  
Christian Barton ◽  
Joanne Kemp ◽  
Ewa Roos ◽  
Soren Skou ◽  
Karen Dundules ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Exercise Therapy ◽  
Effect Size ◽  
Scale Up ◽  
Qualitative Evaluation ◽  
Effective Implementation ◽  
Small Effect Size ◽  
Patient Reported

Abstract BackgroundThe Good Life with osteoArthritis from Denmark (GLA:D®) program incorporates guideline-based patient education and exercise-therapy for osteoarthritis to implement guidelines into practice. We evaluated the implementation of GLA:D® for knee osteoarthritis within Australian physiotherapy practice using the RE-AIM QuEST (Reach, Effectiveness, Adoption, Implementation, Maintenance Qualitative Evaluation for Systematic Translation) framework.MethodsAustralian physiotherapists were trained and supported to deliver GLA:D® (2017-2019) and completed surveys before and after training to assess practices, beliefs about capabilities and confidence, and barriers and enablers to implementation. Patients participating in GLA:D® completed online baseline, 3-month (immediately post-treatment) and 12-month patient reported outcomes. Effective implementation was defined as within-subject moderate effect size (ES, ≥0.50) for average pain (100mm visual analogue scale) and knee osteoarthritis outcome score quality of life scores (KOOS-QoL), and small effect size (≥0.20) for health-related quality of life (EQ-5D-5L).ResultsReach: 1,064 physiotherapists (73% private) and 1,945 (79% private) from all states and territories consented to participation. Key barriers included out-of-pocket cost to patients, and program suitability for culturally and linguistically diverse communities. Effectiveness: Following training, more physiotherapists discussed treatment goals and the importance of weight management, and prescribed supervised, neuromuscular exercise. Patient outcomes at 3- and 12 months (n = 1,044 [54%] and 927 [48%]) reflected effective implementation, including reduced pain intensity (ES, 95%CI = 0.72, 0.62-0.84; and 0.65, 0.54-0.77), improved KOOS-QoL scores (0.79, 0.69-0.90; and 0.93, 0.81-1.04), and improved EQ-5D-5L scores (0.43, 0.31-0.54; and 0.46, 0.35-0.58). Seventy-three percent of participants reported minimal important changes for at least one of pain severity (≥ 15 mm), KOOS-QoL (≥ 15 points) or EQ-5D-5L (≥ 0.07 points). Adoption: GLA:D® was implemented at 297 sites (264 private, 33 public). Implementation: Most patients completed at least one education (90%), and 10 exercise-therapy (78%) sessions. Adequate staffing to support program delivery was a key enabler. Maintenance: Ninety-nine percent of sites (293/297) continued to offer the program in July 2020.ConclusionsTraining was associated with practice changes and widespread implementation of GLA:D® in Australia. Effective implementation, and clinically meaningful improvements in pain and quality of life for most participant, supports further work to scale up GLA:D® in Australia.

scholarly journals Feasibility of home-based functional electrical stimulation cycling: case report

Spinal Cord ◽  
2011 ◽  
Vol 50 (2) ◽  
pp. 170-171 ◽  
Author(s):  
D R Dolbow ◽  
A S Gorgey ◽  
D X Cifu ◽  
J R Moore ◽  
D R Gater
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Home Based

scholarly journals Spinal Cord Stimulation for the Treatment of Chronic Knee Pain Following Total Knee Replacement

2010 ◽  
Vol 3;13 (3;5) ◽  
pp. 251-256
Author(s):  
Thomas T. Simopoulos
Keyword(s):  
Spinal Cord ◽  
Case Report ◽  
Total Knee Replacement ◽  
Knee Pain ◽  
Knee Replacement ◽  
Spinal Cord Stimulation ◽  
Management Options ◽  
Chronic Knee Pain ◽  
Patient Reported ◽  
Total Knee

Background: Chronic pain after total knee replacement is common but remains poorly understood. Management options for patients with this condition are traditionally limited to pharmacological approaches. Objective: This article presents a case of using spinal cord stimulation in the management of chronic knee pain following total knee replacement. Design: Case report Setting: Pain management clinic Methods: A 68-year old patient presented with a 3-year history of persistent knee pain following total knee replacement. After failing to respond to medications and nerve blocks, a trial of spinal cord stimulation and subsequent permanent implantation of a spinal cord stimulator (SCS) were performed. The Oxford knee score (OKS) was used to assess her pain and functionality before and after SCS implantation. Results: The patient reported improvement in her pain and function. Her baseline OKS was 39 and fell to 26 one year post implantation of an SCS representing a reduction of pain and disability from severe to moderate. Limitations: A case report. Conclusion: Spinal cord stimulation might be an option in the management of refractory knee pain following total knee replacement. Key Words: total knee replacement, knee pain, spinal cord stimulation

scholarly journals 12-Month Cohort Study to Investigate Changes in Patient-Reported Outcomes Pain after Intra-articular Injection of Micro-Fragmented Adipose Tissue for Knee Osteoarthritis

2021 ◽  
Vol 3 (1) ◽  
pp. e19-e28
Author(s):  
Nathan Hogaboom ◽  
Ella D'Amico ◽  
Ken Mautner ◽  
Christopher Rogers ◽  
Gerard Malanga
Keyword(s):  
Quality Of Life ◽  
Adipose Tissue ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Knee Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptomatic Knee ◽  
Patient Reported

BackgroundTo evaluate changes in pain, function, and quality of life after treatment with injected micro-fragmented adipose tissue (MFAT) for knee osteoarthritis in a large cohort of individuals treated at multiple centers. MethodsOne hundred ten individuals were recruited from three private outpatient clinics. Participants had to be diagnosed with symptomatic knee OA (defined by persistent knee pain associated with clinical symptoms of OA and/ or classic imaging findings) and who had not received prior knee surgery or treatment with platelet-rich plasma, cortisone, or hyaluronic acid within the previous 6 weeks. Data from 120 knees were included in the analysis. Outcome measures included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, activities of daily living [ADL], sports and recreation, quality of life [QOL]) and an 11-point Numerical Rating Scale (NRS) for average knee pain over the past week. Outcomes were collected at baseline and 3, 6, and 12 months. ResultsSignificant increases and decreases in KOOS subscale and NRS scores were observed, respectively, in the cohort as a whole (p< .05). Lower BMI was associated with more significant improvements in pain, sports/recreation, and ADL KOOS subscale scores (p< .05). Greater age was associated with more significant improvements in symptoms and QOL subscale scores (p< .05). ConclusionsA single injection of MFAT improved pain, function, and QOL outcome measures up to 12 months in this cohort for more than half of the participants. Greater BMI and lower age negatively influenced outcomes. It is not known whether improvements continue after this timeframe or why many participants reported little-to-no improvement.

Functional electrical stimulation as a promising intervention for polymyositis-related weakness: a case report

2021 ◽  
Vol 28 (5) ◽  
pp. 1-8
Author(s):  
Marie Vazquez Morgan ◽  
Suzanne Tinsley ◽  
Rachael Henderson
Keyword(s):  
Electrical Stimulation ◽  
Case Report ◽  
Functional Electrical Stimulation ◽  
Berg Balance Scale ◽  
Functional Mobility ◽  
Walk Test ◽  
Timed Up And Go ◽  
Balance Confidence ◽  
Minute Walk ◽  
Confidence Scale

Background/aims Polymyositis is an inflammatory myopathy characterised by chronic and progressive muscle weakness. This case report discusses a 61-year-old African-American man with polymyositis. Even though pharmacological and physical therapy interventions had previously been prescribed, they had not been beneficial. This case report examined the effects of a functional electric stimulation-assisted exercise programme. Methods The patient was treated in an outpatient clinic two times a week and performed exercises three times a week on alternating days for 36 weeks. In the clinic, he received functional electrical stimulation-assisted strengthening to quadriceps, hamstrings and gluteus maximus while performing activities such as sit to stand, squats, bridging and cycling. For endurance training, he ambulated on the clinic track with a neuroprosthetic to assist with dorsiflexion in the swing phase of gait. At home, he performed lower extremity and core strengthening exercises. Measures to evaluate the intervention included the Manual Muscle Test, functional mobility (Timed Up and Go Test), balance (Berg Balance Scale, Activities of Balance Confidence Scale), endurance (Six-Minute Walk Test with a modified Borg scale) and gait speed (10-Metre Walk Test). Results After 36 weeks of treatment, the patient had made gains in strength in all muscle groups in his bilateral lower extremities except hip extensors. Timed Up and Go time decreased by 14.01 seconds. The patient changed from a medium fall risk to low fall risk on the Berg Balance Scale and his confidence increased by 46.2% on the Activities of Balance Confidence Scale. Furthermore, he gained endurance as exhibited by his increased distance of 289 feet on the Six-Minute Walk Test and his modified Borg score decreased from 4 out of 10 to 2 out of 10. The patient made subjective and objective gains in gait speed, increasing from 0.18 metres per second at his initial examination to 0.50 metres per second. Conclusions This case study demonstrates that functional electrical stimulation-assisted exercise, conducted in an outpatient setting, can improve strength and functional mobility in an individual with polymyositis without detrimental effects.

Effect of functional electrical stimulation on the proprioception, motor function of the paretic upper limb, and patient quality of life: A case report

2016 ◽  
Vol 29 (4) ◽  
pp. 507-514 ◽  
Author(s):  
Carlos Bustamante ◽  
Francisco Brevis ◽  
Sebastián Canales ◽  
Sebastián Millón ◽  
Rodrigo Pascual
Keyword(s):  
Quality Of Life ◽  
Electrical Stimulation ◽  
Case Report ◽  
Motor Function ◽  
Upper Limb ◽  
Functional Electrical Stimulation

Effects of an Exercise Therapy Targeting Knee Kinetics on Pain, Function, and Gait Kinetics in Patients With Knee Osteoarthritis: A Randomized Clinical Trial

2020 ◽  
pp. 1-19
Author(s):  
Hamid Reza Bokaeian ◽  
Fateme Esfandiarpour ◽  
Shahla Zahednejad ◽  
Hossein Kouhzad Mohammadi ◽  
Farzam Farahmand
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Exercise Therapy ◽  
Treadmill Walking ◽  
Knee Adduction Moment ◽  
Medial Knee ◽  
Treatment Groups ◽  
Knee Kinetics ◽  
Before And After ◽  
And Function

In this study, the effects of an exercise therapy comprising yoga exercises and medial-thrust gait (YogaMT) on lower-extremity kinetics, pain, and function in patients with medial knee osteoarthritis were investigated. Fifty-nine patients were randomly allocated to three treatment groups: (a) the YogaMT group practiced yoga exercises and medial thrust gait, (b) the knee-strengthening group performed quadriceps- and hamstring-strengthening exercises, and (c) the treadmill walking group practiced normal treadmill walking in 12 supervised sessions. The adduction and flexion moments of the hip, knee, and ankle; pain intensity; and 2-min walking test were assessed before and after treatment and at 1-month follow-up. The YogaMT group experienced a significant reduction in knee adduction moment. All groups showed significant improvement in pain and function. The YogaMT may reduce medial knee load in patients with knee osteoarthritis in the short term. A larger clinical trial is required to investigate the long-term outcomes of this intervention.

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