A comparative study to find the effectiveness of weight bearing exercises on stable platform versus wobble board, to improve balance and functional outcome of individuals with knee osteoarthritis

Introduction and Aim: Knee osteoarthritis is a common degenerative disease, with its prevalence increasing with age and with multifactorial aetiology. It is a common cause of disability worldwide. Aim of the study is to compare the effect of weight bearing exercises on wobble board and stable platform in improving balance and functional outcome by the pre and post analysis. Materials and Methods: Experimental study was conducted in Saveetha hospital, Chennai. Forty subjects including both males and females diagnosed with osteoarthritis knee within the age of 40 to 70 years were recruited and divided into two groups with 20 subjects in each group (Group A- 20 subjects, Group B- 20 subjects). Group A was given weight bearing exercises on wobble board along with interferential therapy, in 4 sets with 6 repetitions in each set and a rest interval of one minute between each set, 15 minutes per session, 3 days/week for 4 weeks and Group B was given weight bearing exercises on stable platform along with interferential therapy in 4 sets with 6 repetitions in each set and a rest interval of one minute between each set, 15 minutes per session, 3 days/week for 4 weeks. Results: At the end of the study, data was analysed and there was improvement in balance and functional outcome. Conclusion: This study concluded that patients with knee osteoarthritis had improvement in balance and functional outcome through weight bearing exercises given on wobble board along with interferential therapy compared to the patients who were given weight-bearing exercises on stable platform along with interferential therapy. Keywords: Osteoarthritis; wobble board; stable platform; interferential therapy.

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Effect of Teriparatide in Fracture Healing in Lower Limbs- An Interventional Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47761.14673 ◽

2021 ◽

Author(s):

Sanjeev Kumar ◽

Girish Sahni ◽

Harjit K Singh Chawla ◽

Daljinder Singh

Keyword(s):

Functional Outcome ◽

Adverse Reactions ◽

Weight Bearing ◽

Test Group ◽

Control Group ◽

Dash Score ◽

Early Weight Bearing ◽

Group A ◽

Group B ◽

Radiological Union

Introduction: Many of the trauma patients presenting to the orthopaedic departments suffer from lower limb fractures. This often leads to prolonged period of morbidity and absence from work. Fracture healing can be delayed in elderly patients, postmenopausal women and in communited fractures. Teriparatide (TPH) given subcutaneously for 6 to 9 months, in such cases, may promote clinical and radiological union of bone. Aim: To know the effect of TPH in improving clinical and radiological union and also to evaluate early weight bearing, improvement in pain and functional outcome. Materials and Methods: In this prospective interventional study, a total of 125 patients were initially enrolled for the study and then after meeting inclusion criteria total 104 patients were selected for the study. They were allocated into two groups by randomisation by 1:1 method-group A was test group of 52 cases in which subcutaneous injection TPH 20 mcg daily (for six months) was given along with standard dosage of calcium and vitamin D; while in 52 cases in group B (control group) only calcium and vitamin D were given. Injection TPH was started within 10 days of fracture and given for six months. No placebo injection was given in control group. Time to weight bearing, time to clinical and radiological union and pain by Visual Analogue Score (VAS) were noted at regular follow-up at one month, three months, six months and 12 months and were compared in both the groups. Functional outcome by Disabilities of the Arm, Shoulder and Hand (DASH) score was noted as an additional tool, as DASH score questionnaire shows many activities of daily living that require mobility and stability of lower limb too. Adverse reactions were noted and compared within test and control groups. The collected data were analysed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 22.0 software and Mann-Whitney U test was used to calculate p-value. Results: Average time period for full weight bearing with or without support for test group A was 11±2.7 weeks and 16±1.8 weeks in control group B (p-0.001). Average time to clinical union in test group was 12±1.9 weeks and in control group 16±2.2 weeks (p-0.001). Average time to radiological union was 13±1.4 weeks in test group while 22±2.2 weeks in control group (p-0.001). Pain score by VAS and functional outcome by DASH were improved in test group (p-0.001). There was no difference in adverse reactions in both the groups (p>0.05). Conclusion: Regular intake of TPH 20 mcg subcutaneous daily for six months can reduce time to clinical and radiological fracture union, promote early weight bearing and provide better pain control. Hence, better functional outcome and prefracture ambulatory status can be achieved with no significant adverse events.

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

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.37507 ◽

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.

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Non-locking buttress plate in distal tibial metaphyseal fractures

Medical Journal of Pokhara Academy of Health Sciences ◽

10.3126/mjpahs.v1i2.23401 ◽

2018 ◽

Vol 1 (2) ◽

pp. 87-91

Author(s):

Norman Lamichhane ◽

Bhogendra Bahadur KC ◽

Chandra Bahadur Mishra ◽

Sabita Dhakal

Keyword(s):

Soft Tissue ◽

Weight Bearing ◽

Delayed Union ◽

Full Weight Bearing ◽

Distal Fibula ◽

Fibula Fracture ◽

Group A ◽

The Mean ◽

Group B ◽

Metaphyseal Fractures

Background: Treatment of distal tibial metaphyseal fractures is often challenging and no single technique has been unanimously advocated. Open reduction and internal fixation with plates and screws allows better restoration of anatomical alignment but with more soft tissue complication. Simultaneous fixation of the fibula is not universally carried out. This study aims at evaluation of the outcome of plating technique and the effect of fixation of fibula fracture in treatment of distal tibial metaphyseal fractures. Material and methods: Thirty-one cases (14 cases in Group A with concomitant distal fibula fracture and 17 cases in Group B without distal fibula fracture) were analyzed retrospectively for the mean duration of full weight bearing, mean union time and complications, and compared. Results: The mean time for full weight bearing and radiological union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively. 16.1% of cases had post-operative complications including one case of deep infection and malalignment of 6 degree varus (following delayed union) was seen in one case of Group A. Range of motion (ROM) at ankle was not problem in any of the cases except the one delayed union which had 5 degrees of dorsiflexion and 15 degrees of plantiflexion. Conclusion: Open reduction and internal fixation with plate and screws in distal tibial metaphyseal fracture is more economic means of treatment modality with comparable incidence of post-union malalignment and union time,though more soft tissue complications compared to other modalities. Fixation of fibula fracture aids in reducing the incidence of malalignment.

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COMPARISON OF IMMEDIATE EFFECT ON APPLICATION OF REMOTE SELFMYOFASCIAL RELEASE ON POSTERIOR CHAIN FLEXIBILITY IN ASYMPTOMATIC YOUNG INDIVIDUALS

10.36106/ijsr/0115384 ◽

2021 ◽

pp. 26-27

Author(s):

Rishika Balani ◽

Tanvi Patole

Keyword(s):

Weight Bearing ◽

Plantar Fascia ◽

Knee Extension ◽

Post Intervention ◽

Chain Flexibility ◽

Myofascial Release ◽

Outcomes Measures ◽

Group A ◽

Group B ◽

Plantar Fascia Release

Aim of study: The aim of the study was to compare the immediate effect on application of remote self- myofascial release on posterior chain exibility in asymptomatic young individuals. Material and Method: 44 subjects were assigned into two groups, Group (A) Plantar fascia release and Group (B) Suboccipital release. Outcomes measures used were Sit and reach test (SRT), Active knee extension test (AKE) and Weight bearing lunge test. Result: There was a signicant difference in SRT and AKE on left side between group A and B. Within the same group there was a signicant improvement in outcome measures post intervention. Conclusion: There was an immediate increase in exibility of the hamstrings, gastrocnemius-soleus muscles and lumbar spine ROM through remote self- myofascial release.

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Effect of Weight-Bearing in Conservative and Operative Management of Fractures of the Base of the Fifth Metatarsal Bone

BioMed Research International ◽

10.1155/2017/1397252 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Jae-Yong Park ◽

Hyong-Nyun Kim ◽

Yoon-Suk Hyun ◽

Jun-Sik Park ◽

Hwan-Jin Kwon ◽

...

Keyword(s):

Bone Resorption ◽

Weight Bearing ◽

Operative Management ◽

Foot And Ankle ◽

Early Weight Bearing ◽

Group A ◽

Vas Scores ◽

American Orthopaedic ◽

Group B ◽

Underlying Diseases

Background. There is no established principle regarding weight-bearing in conservative and operative management of fifth metatarsal base fractures. Methods. We reviewed 86 patients with acute fifth metatarsal base fractures. Conservatively treated late or early weight-bearing patients were assigned to Group A or C, respectively. Operatively treated late or early weight-bearing patients were assigned to Group B or D, respectively. Results were evaluated by clinical union, bone resorption, and the American Orthopaedic Foot and Ankle Society (AOFAS) and Visual Analogue Scale (VAS) scores. Results. All 4 groups had bone union at a mean of 6.9 weeks (range, 5.1–15.0). There were no differences between the groups in the AOFAS and VAS scores. In the early weight-bearing groups, there were fewer cases of bone resorption, and the bone unions periods were earlier. Conclusions. Early weight-bearing may help this patient population. Moreover, conservative treatment could be an option in patients with underlying diseases.

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TO COMPARE THE EFFECT OF FORWARD CYCLING VERSUS BACKWARD CYCLING ON PAIN FUNCTION AND RANGE OF MOTION IN SUBJECTS WITH KNEE OSTEOARTHRITIS – AN EXPERIMENTAL STUDY.

10.36106/ijsr/5824281 ◽

2020 ◽

pp. 1-4

Author(s):

Himakshi Bhattacharya ◽

Bhavna Gadhavi

Keyword(s):

Knee Osteoarthritis ◽

Range Of Motion ◽

Null Hypothesis ◽

Conventional Treatment ◽

Alternative Hypothesis ◽

Final Conclusion ◽

Primary Level ◽

Group A ◽

The Subject ◽

Group B

Background: Osteoarthritis is a chronic degenerative disease. The major symptom of Knee Osteoarthritis Are Pain Decreased Range of Motion and Functional impairment. The purpose of the study is to evaluate the effect of backward cycling and forward cycling in subject with Knee Osteoarthritis. The traditional protocol for treating knee osteoarthritis shows inability to treat the pain, function and range of motion at primary level of treatment. This can eradicate the drawback of generalized protocol. Method: The subject assessed thoroughly would be divided in three group. Group A would be given Conventional Treatment and Forward Cycling. Group B would be given Conventional Treatment and Backward Cycling. Group C would be given only Conventional Treatment. Treatment Duration for all three groups would be for 4 weeks. Then improvement would be evaluated in pain, Function and ROM by taking Post data. Then Pre-and Post data would be compared for final Conclusion. Conclusion: According to the present study the alternative hypothesis is accepted and null hypothesis is rejected. Which suggest that backward cycling proves to manage the symptoms efficiently than forward cycling and single handed conventional protocols.

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Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203723 ◽

2020 ◽

Vol 6 (5) ◽

pp. 1012

Author(s):

Lokesh Kumar Yogi ◽

Gagandeep Mahi ◽

C. R. Thorat ◽

Moti Janardhan Naik

Keyword(s):

Functional Outcome ◽

Large Scale ◽

Plate Fixation ◽

Tension Band ◽

Tension Band Wiring ◽

Clinical Event ◽

Dash Score ◽

Group A ◽

Group B ◽

Olecranon Fractures

Background: Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.Methods: A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.Results: Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.Conclusions: The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.

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A study to assess functional outcome of cemented and uncemented total hip replacement in a tertiary care center

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193679 ◽

2019 ◽

Vol 5 (5) ◽

pp. 828

Author(s):

Kunal Ajitkumar Shah ◽

Mohan Madhav Desai

Keyword(s):

Functional Outcome ◽

Total Hip Replacement ◽

Hip Replacement ◽

Cost Effective ◽

Harris Hip Score ◽

Total Hip ◽

Vas Score ◽

Group A ◽

The Difference ◽

Group B

Background: Total hip replacement (THR) is the most successful and cost effective treatment with aim of pain relief and functional rehabilitation for hip disorders. As the implant designs of THR have evolved over time, the functional outcome and survivorship has improved. Even after so many advancements, it remains unclear that which implants are better, uncemented or cemented. Hence, we took up this study to analyze which of the uncemented or cemented THR have better functional outcome.Methods: This was a longitudinal study conducted during 2014 to 2018. Hundred cases were randomized into groups of 50 each. All patients with age between 55-80 years in whom THR was indicated were included in the study. Uncemented THR was done in Group A and cemented THR was done in Group B. Patients were followed up at 12 weeks, 6 months, 12 months, and 3 years. At follow-up, functional examination in terms of visual analogue scale (VAS) score and Harris hip score (HHS) was done.Results: The mean age of patients in Group A (uncemented) and Group B (cemented) was 62.5 years and 60 years respectively. We found that the difference of VAS score and HHS between Group A and B was statistically significant at 12 weeks and 6 months. The difference of VAS and HHS scores between Group A and B at 12 months and 3 years was not significant.Conclusions: We conclude that cemented THR has better functional outcome at short term. They are cost effective option at age ≥55-60 years.

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Evaluation of β-Tricalcium Phosphate Biomaterial in Femur Fracture Repair in Dogs

Indian Journal of Animal Research ◽

10.18805/ijar.b-4418 ◽

2021 ◽

Author(s):

D.K. Dwivedi ◽

R.B. Kushwaha ◽

M.S. Bhadwal ◽

A.K. Gupta ◽

J.S. Soodan ◽

...

Keyword(s):

Fracture Healing ◽

Tricalcium Phosphate ◽

Femur Fracture ◽

Leukocyte Count ◽

Weight Bearing ◽

Fracture Repair ◽

Total Leukocyte Count ◽

Intramedullary Pinning ◽

Group A ◽

Group B

Background: Fracture repair is one of most common procedure carried out by veterinary clinicians. Fracture healing most of the time associated with delayed union, non-union and mal-uinon. Therefore, the objective of this study was to evaluate the clinical, haemato-biochemical and radiological outcome in patients after implantation of β-tricalcium phosphate as a bone graft substitute to promote the fracture healing.Methods: Eight clinical cases brought to the clinics with femur fracture were divided into two groups viz. A and B, with four animals in each group. Femur fractures were stabilized with intramedullary pinning and β-TCP biomaterial and intramedullary pinning and β-TCP plus autologous bone marrow aspirate (BMA) composite in group A and B respectively. The efficacy of fixation was studied on the basis of clinical evaluation, haemato-biochemical and radiographical parameters on day 0 and on 7th, 15th, 30th, 45th and 60th post-operative day. Result: Excellent weight bearing was noticed in group B. The overall functional outcome in group B was better in comparison to group A animals. Haematological parameters viz. haemoglobin, packed cell volume, total leukocyte count and differential leukocyte count did not differ significantly within and between the groups. The biochemical parameters viz. serum calcium increased significantly (P less than 0.05) on 7th and 15th post-operative day. A significant reduction in serum alkaline phosphatase level observed on successive post-operative days in both groups. Radiographs of fractures treated in both the groups showed good reduction and fracture fixation, early signs of fracture healing in group B than group A animals. The size of callus formation was more in group A than group B. No any graft related complications observed during the study period. The β-tricalcium phosphate facilitated fracture healing and early ambulation of affected limb.

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

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120911126 ◽

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.

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