Localized hyperthermia induced by microwave diathermy in osteoarthritis of the knee: a randomized placebo-controlled double-blind clinical trial (original) (raw)
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European journal of physical and rehabilitation medicine, 2012
Deep heating therapy (DHT) has shown to improve pain and function in patients with knee osteoarthritis (OA) in the short term. Benefits of superficial heating therapy (SHT) are controversial. Long-term effects of both heating modalities have not yet been investigated. To compare the effects of DHT and SHT in patients with symptomatic knee OA, and to determine the long-term effects of heat therapy. Double-blind randomized clinical trial. Outpatient clinic of Geriatrics and Physiatrics, University Hospital. Fifty-four patients with radiologically established diagnosis of moderate knee OA (Kellgren-Lawrence grade II or III) and pain lasting for at least three weeks. DHT: local microwave diathermy (three 30-min sessions a week for four weeks); SHT: application of hot packs (three 30-min sessions a week for four weeks). Western Ontario and McMaster Universities (WOMAC) index for the assessment of joint pain, stiffness and physical function limitations. British Medical Research Council (B...
The effects of heat on osteoarthritis of the knee
The Pain Clinic, 2006
The aim of our study was to evaluate the effects of the manual physical therapy methods conducted by superficial and deep heat treatments of primary bilateral knee osteoarthritis. A randomized, controlled trial was carried out. Eighty patients (160 knees) were included in the analysis. The patients were separated into two groups. Group I (n: 80 knees) performed daily physical therapy programs (ultrasounds, hot packs and exercises) in a period of fifteen days. Group II (n: 80 knees) performed only daily exercise programs in this period. Pain was evaluated by visual analogue scale (VAS) and WOMAC pain scale. Stiffness and functional capacity were measured by WOMAC osteoarthritis index at baseline, at the third and sixteenth weeks. At the third and sixteenth weeks, significant improvement in VAS, WOMAC were observed in both groups, when compared to baseline measures (Group I: p < 0.01, Group II: p < 0.05). At the sixteenth week, more significant improvement was observed in Group 1 than in Group II (p < 0.05).
International Journal of Nursing Practice, 2019
Aim: This study aimed to determine the effect of application of superficial local heat and a home exercise program on pain and function levels to patients with bilateral knee osteoarthritis. Methods: This study was conducted in Turkey between January 2014 and February 2015. The sample group of the study consisted of 62 patients with osteoarthritis; 15 assigned to heat application, 15 to exercise, 15 to exercise after heat application, and 17 for the control group. While the patients in the control group received routine treatment only, the patients in the intervention group were treated with heat application, exercise, or exercise after heat application, suggested for 5 days a week for 4 weeks in addition to routine treatment. Results: In this study, all of the intervention groups had decreases in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index pain, stiffness, and function scores when compared with the control group. It was found that this decrease in Visual Analogue Scale Pain and Western Ontario and McMaster Universities Osteoarthritis Index scores was mostly in the exercise group, but this condition was not statistically significant. Conclusions: As a result, it is recommended that nurses train patients with osteoarthritis on heat application and home exercises and encourage them to apply these practices.
Treatment of articular effusions with local deep microwave hyperthermia
Clinical Rheumatology, 1989
Local deep microwave hyperthermia (LDMWH) may be considered as a therapeutic tool for joint diseases because it has the advantage of heating the target organ e.g. synovium, while sparing the adjacent tissues, as demonstrated in animals. The effect of this new microwave device has been evaluated on seven rheumatoid arthritis patients with knee effusion. The hyperthermia apparatus consists of a 915 MHz power source with a cooling system to the skin. LDMWH was operated for one hour, twice a week for two weeks. Intra-articular knee temperature reached the level of 40.6 + 1.1 ~ within 15 minutes, raised to 41.2 + O. 7~ after 30 minutes and to 41.3 + 0.9~ at one hour. The skin temperature over the heated knee joints remained at 24.3 + 1.1 ~ during treatment. All patients noted a sensation of warmth in the treated knee. Aspiration of synovial fluid was performed before and immediately after each treatment. Walking time was improved (p = 0.04) and significant decrease in pain (p = 0.01) was noted following treatment. Synovial fluid leukocyte count and prostaglandin E 2 level, knee circumference and range of motion did not change. Severity of pain, walking time, knee circumference and range of motion remained stable in the six weeks following the last hyperthermia application. No adverse reaction could be observed. These results suggest LDMWH to be safe and successful as an adjuvant treatment of chronic inflammatory joint effusions.
The effectiveness of shortwave diathermy in osteoarthritic knee : a randomized controlled trial
Background: Shortwave diathermy (SWD) has been prescribed for years without definitely scientific proof of its effect. Design and methodology of the previous studies were still questionable. Objective: To compare the effectiveness of SWD for pain relief in knee osteoarthritis. Study design: A double blind randomized placebo-controlled trial. Materials and Methods: One-hundred and thirty-two patients with knee pain were randomized to control group (n=66) receiving sham SWD, or treatment group (n=66) receiving SWD, 15-20 min/session, 3 sessions / week, for 3 consecutive weeks. Outcome measured: WOMAC score (total score, pain, stiffness, and function dimensions), gait speed, global assessment and patient's satisfaction. Results: There was no statistically significant difference between the treatment and control groups in all dimensions of WOMAC score, patient gait speed, global assessment and incidence of adverse events. Subgroup analysis based on baseline WOMAC score also demonstrated the same results. Only the patient's satisfaction score was significantly different (p=0.015); with higher percentage of very satisfied subjects in treatment group. The SWD compliance and amount of NSAID used were also higher in the treatment group. (p = 0.002, 0.021 respectively). But the percentage of subjects with good exercise compliance was higher in the control group. However, the two groups were non-comparable in the following parameters; duration of disease, SWD compliance, exercise compliance and amount of NSAID used. After statistical adjustment using multiple linear regressions analysis, a trivial improvement (approximately 9% difference) of WOMAC score in the treatment group over the control group was revealed. The adverse events of SWD were not serious and not different between 2 groups (approximately 6%). Conclusion: There was no evidence to confirm the effectiveness of SWD for OA knee patients using this treatment protocol. However, other SWD treatment protocol should be re-evaluated to confirm the effectiveness.
Homeostasis
Knee osteoarthritis (OA) is the most common knee pain complaint. Non pharmacological therapy, including microwave diathermy therapy (MWD) and infra red therapy (IR) is one of the treatment options. Both work in tissue repair, increase metabolic processes, and reduces inflammation in knee OA by electromagnetic radiation hyperthermia. The purpose of this literature review was to analyze comparison of the effectiveness of MWD and IR in reducing pain intensity in knee OA patients. The data were collected by analyzing literature from several databases, namely PubMed-NCBI, ProQuest, Science Direct, and Google Scholar. The criteria for inclusion of articles are articles in English and Indonesian in research published in 2011-2021. In this literature review, 8 articles were used. According to the findings of the review, MWD and IR were both effective in reducing pain in knee OA patients. Three of the five MWD articles showed that reducing pain intensity of knee OA was more effective. Two of the three IR articles showed that reducing pain intensity of knee OA was more effective. It may be concluded that IR therapy is better than MWD therapy in reducing pain knee OA based on the average score of pain parameters using VAS before and after therapy.
Superficial Heat and Cold Applications in the Treatment of Knee Osteoarthritis
Osteoarthritis - Progress in Basic Research and Treatment, 2015
Heat and cold applications for the purpose of treatment are applied to a part or whole of the body and cause local or systemic effects [1]. In general, the physiological effects of heat are vasodilatation, increased capillary permeability, acceleration of cell metabolism, muscle relaxation, acceleration of inflammation, pain reduction by relaxing muscles, sedative effect, and reducing the viscosity of the synovial fluid to decrease joint stiffness. The physiological effects of cold are generally the opposite of warm effects. The effects of cold are vasoconstriction, a slowdown in cell metabolism, local anesthesia, decrease in blood flow, reduction of the arrival of oxygen and metabolites to the area and the reduction of residuum removal (Table 1) [1-4]. When applying heat to a local and large area of the body, low blood pressure can be seen due to the excessive peripheral vasodilation. This reduction in blood pressure can cause
Effect of Thermotherapy on Clinical Outcomes among Patients with Osteoarthritis
Deleted Journal, 2023
Background: The most common and crippling type of arthritis is osteoarthritis (OA), which is characterized as a degenerative disorder targeting synovial joints. Patients with osteoarthritis frequently lament a dull aching pain that worsens with movements. When physical agents as heat therapy are used properly, they can combat unpleasant conditions. Aim: This study was carried out to determine the effect of thermotherapy on Clinical Outcomes among Patients with Osteoarthritis. Design: A quasi-experimental research design (pre-post study/control) was used to achieve the study's aim. Setting: The study was conducted in the orthopedic outpatient department of the shebin EL
Ibadan Biomedical Communications Group, 2004
This study was designed to compare the effects of shortwave diathermy (SWD) and ice on pain, range of motion and function in osteoarthritis (OA) of the knee. Subjects were fourteen patients (4 males and 10 females) aged 40-70years diagnosed as having OA of the knee. Subjects were assigned into either the SWD or ice treatment groups, as they became available. All subjects received routine adjunct therapeutic exercises, were excluded from analgesic drugs and were treated thrice weekly during the four-week duration of the study. Subjects were assessed at the beginning and end of the study for pain, range of motion (ROM) and function using visual analog scale, universal goniometer and functional index questionnaire respectively. Data were subjected to descriptive statistics of means and standard deviation and inferential statistics of independent and paired t-tests. Results showed that while the subjects in the SWD group had significantly greater ROM and function than the ice group at the beginning of the study, both groups were not statistically significantly different on all dependent variables at the end of the study. Paired t-test also indicated that the ice group improved significantly on all three dependent variables while the SWD group improved significantly in pain and ROM only. The improv ements in pain, ROM and function effected by SWD and ice were however not significantly different. It was concluded that SWD and ice are equally effective on OA of the knee and that ice can be substituted for SWD in the treatment of OA of the knee.