Diz osteoartritinde transkutanöz elektrik stimülasyonu ile ınterferansiyel akımın etkinliğinin karşılaştırılması
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2020
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info:eu-repo/semantics/openAccess
Özet
Osteoartrit (OA) en yaygın görülen dejeneratif eklem hastalığı olup özellikle yaşlı popülasyonu etkilemektedir. Diz OA tedavisinde interferansiyel akım (İFA) ve transkütanöz elektriksel sinir stimülasyonu (TENS) gibi elektroterapotik modaliteler kullanılmaktadır. Diz OA hastalarında TENS'in ağrı ve diz fonksiyonları üzerinde etkisi olduğu bildirilmiştir. TENS'in aksine, diz OA'da İFA'nın etkinliği hakkında yeterli düzeyde kanıta dayalı veri bulunmamaktadır. Bu çalışmanın amacı, diz OA tedavisinde İFA ve TENS'in etkinliğini karşılaştırmaktır. Gereç ve Yöntem 2010 "American College of Rheumatology" kriterlerine göre bilateral diz OA'sı olan 50 hasta ile randomize tek kör çalışma gerçekleştirildi. Hastalar iki tedavi grubuna randomize edildi: Hotpack, ultrason ve TENS (TENS grubu), hotpack, ultrason ve İFA (İFA grubu). Tüm hastalara izometrik kuadriseps güçlendirme egzersizleri önerildi. Tedavi haftada 5 defa uygulandı, 3 hafta boyunca devam etti. Hastalar tedavi öncesinde, tedaviden sonra ve üçüncü ayda eklem hareket açıklığı (EHA), ağrı için vizüel analog skala (VAS istirahat ve günlük yaşam aktiviteleri sırasındaki VAS), yaşam kalitesi için Nottingham Health Profile (NHP) ve Western Ontario and McMaster University Osteoarthritis Index (WOMAC) ile değerlendirildi. Bulgular TENS grubunun ortalama yaşı 57,8 ± 5,2 yıl, İFA grubunun 55,8 ± 7,5 yıldı. TENS grubunun %72'si, İFA grubunun %64'ü kadındı. Tedavi sonrasında her iki tedavi grubunda diz fleksiyonu, istirahat VAS, aktivite VAS ve WOMAC total skor ve NHP total skor açısından gelişme izlendi. NHP total skoru tedavi sonrasında (p=0,029) ve üçüncü ayda (p=0,009) İFA grubunda TENS grubuna kıyasla daha iyiydi. Ancak, tedavi sonrasında ve üçüncü ayda istirahat VAS, aktivite VAS, ROM, WOMAC skorları gruplar arasında farklılık tespit edilmedi. Sonuç Diz OA'da hem İFA hem de TENS etkin bulunmuştur. Ancak, diz OA hastalarında İFA yaşam kalitesi açısından TENS'ten üstün bulunmuştur.. Bu nedenle diz OA tedavisinde İFA iyi bir tercih olabilir.
Knee osteoarthritis (OA) is the main cause of pain, physical impairment and chronic disability especially in older people. Electrotherapeutic modalities such as interferential therapy (IFC) and transcutaneous electrical nerve stimulation (TENS) are used for the treatment of knee OA. TENS has been reported to relieve pain and improve function in patients with knee osteoarthritis. Unlike TENS, there is insufficient evidence-based data on the effectiveness of IFC in knee OA. This study aimed to compare the effectiveness of IFC and TENS on knee OA. Material and methods A randomized and single-blind study was performed on 50 patients diagnosed with bilateral knee OA according to 2010 "American College of Rheumatology" criteria. The patients were allocated to two treatment groups: Hotpack, ultrasound and TENS (TENS group), and hotpack, ultrasound, IFC (IFC group). Isometric quadriceps strengthening exercises were recommended to all patients.Treatments were performed 5 times a week for 3 weeks consecutively. Each patient was assessed before treatment, at the end of the treatments and at the third month using the following measurements: range of motion (ROM), visual analog scale for pain (pain at rest; VAS resting, pain on daily life activities; VAS activities), Nottingham Health Profile (NHP) for quality of life, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Results The average age of the TENS group was 57.8 ± 5.2 years, and the IFA group was 55.8 ± 7.5 years. 72% of the TENS group was female, 64% of the IFA group was female. After treatment, significant improvement was observed in knee flexion, resting VAS resting, VAS activities, WOMAC total score and NHP total score in both treatment groups. NHP total scores after treatment (p=0.029) and 3rd month after treatment (p=0.009) were better in the IFC group compared to TENS group. However, VAS resting, VAS activities, ROM and WOMAC scores did not differ between the two treatment groups after treatment and at the third month. Conclusion Both IFC and TENS are effective modalities for knee OA. However, IFC treatment for knee OA may be superior to TENS in terms of quality of life. Therefore, IFC may be a good option in the treatment of knee OA.
Knee osteoarthritis (OA) is the main cause of pain, physical impairment and chronic disability especially in older people. Electrotherapeutic modalities such as interferential therapy (IFC) and transcutaneous electrical nerve stimulation (TENS) are used for the treatment of knee OA. TENS has been reported to relieve pain and improve function in patients with knee osteoarthritis. Unlike TENS, there is insufficient evidence-based data on the effectiveness of IFC in knee OA. This study aimed to compare the effectiveness of IFC and TENS on knee OA. Material and methods A randomized and single-blind study was performed on 50 patients diagnosed with bilateral knee OA according to 2010 "American College of Rheumatology" criteria. The patients were allocated to two treatment groups: Hotpack, ultrasound and TENS (TENS group), and hotpack, ultrasound, IFC (IFC group). Isometric quadriceps strengthening exercises were recommended to all patients.Treatments were performed 5 times a week for 3 weeks consecutively. Each patient was assessed before treatment, at the end of the treatments and at the third month using the following measurements: range of motion (ROM), visual analog scale for pain (pain at rest; VAS resting, pain on daily life activities; VAS activities), Nottingham Health Profile (NHP) for quality of life, the Western Ontario and McMaster University Osteoarthritis Index (WOMAC). Results The average age of the TENS group was 57.8 ± 5.2 years, and the IFA group was 55.8 ± 7.5 years. 72% of the TENS group was female, 64% of the IFA group was female. After treatment, significant improvement was observed in knee flexion, resting VAS resting, VAS activities, WOMAC total score and NHP total score in both treatment groups. NHP total scores after treatment (p=0.029) and 3rd month after treatment (p=0.009) were better in the IFC group compared to TENS group. However, VAS resting, VAS activities, ROM and WOMAC scores did not differ between the two treatment groups after treatment and at the third month. Conclusion Both IFC and TENS are effective modalities for knee OA. However, IFC treatment for knee OA may be superior to TENS in terms of quality of life. Therefore, IFC may be a good option in the treatment of knee OA.
Açıklama
Anahtar Kelimeler
Diz osteoartriti, interferansiyel akım, Knee osteoarthritis, interferential current
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Künye
Yılmaz, Y. E. (2020). Diz osteoartritinde transkutanöz elektrik stimülasyonu ile ınterferansiyel akımın etkinliğinin karşılaştırılması. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, Konya.
