The Effects of Microcurrent Treatment and Ultrasound Treatment on the Pain Relief and Functional Recovery after Total Knee Replacement

미세전류치료와 초음파치료가 슬관절전치환술 후 통증경감과 기능회복에 미치는 영향

  • Cho, Woon-Su (Department of Physical Therapy, Nambu University) ;
  • Kim, Yong-Nam (Department of Physical Therapy, Nambu University) ;
  • Kim, Yong-Seong (Department of Physical Therapy, Nambu University) ;
  • Hwang, Tae-Yeon (Department of Physical Therapy, Chunnam Techno College) ;
  • Jin, Hee-Kyung (Department of Physical Therapy, Graduate School, Seonam University)
  • 조운수 (남부대학교 물리치료학과) ;
  • 김용남 (남부대학교 물리치료학과) ;
  • 김용성 (남부대학교 물리치료학과) ;
  • 황태연 (전남과학대학 물리치료학과) ;
  • 진희경 (서남대학교 대학원 물리치료학과)
  • Received : 2012.03.12
  • Accepted : 2012.04.12
  • Published : 2012.04.25

Abstract

Purpose: The purpose of this study was to investigate pain relief and functional recovery after total knee replacement. Methods: The treatment was performed by dividing individuals into a control group ($n_1=5$), ultrasound treatment group ($n_2=5$), and micro-current treatment group ($n_3=5$). The control group applied the hot pack for 15 minutes, Transcutaneous Electrical Nerve Stimulation (TENS) for 15 minutes, and Continuous Passive Movement (CPM) for 40 minutes. The ultrasound therapy group applied the frequency of 1 MHz, intensity of 1.0 $W/cm^2$ for five minutes following the same treatment as the control group. The micro-current therapy group applied the intensity of 25 ${\mu}A$, and pulsation frequency 5 pps for 15 minutes following the same treatment as the control group. After treatment, Visual Analogue Scale (VAS), Korean Western Ontario and McMaster Universities Arthritis Index (K-WOMAC), Berg Balance Scale (BBS), Range of Movement (ROM) and wound length was measured. Results: VAS showed significant effect in the control group and micro-current therapy group during the treatment period. According to the treatment of K-WOMACK, BBS, ROM, and Healing wounds showed main effects between groups. Conclusion: According to the results of this study, data showed improvement of pain relief, wound healing effects, and range of motion recovery. Thus, these selected treatments were effective after total knee replacement. In other words, electrical treatment continues to influence pain relief and functional recovery after total knee replacement.

Keywords

References

  1. Kim JH, Song YW, Lee JC et al. The study of risk factors for symptomatic knee osteoarthritis in Korea. J Rheumatol. 2008;15(2):123-30.
  2. Goodfellow J, O'Connor J, Murray DW. The oxford meniscal unicompartmental knee. J Knee Surg. 2002;15(4):240-6.
  3. Latarjet J, Choinere M. Pain in burn patients. Burns. 1995;21(5):344-8. https://doi.org/10.1016/0305-4179(95)00003-8
  4. Johnson S, Jones P, Newman JH. The survivorship and results of total knee replacements converted from unicompartmental knee replacements. Knee. 2007;14(2):154-7. https://doi.org/10.1016/j.knee.2006.11.012
  5. Kim SH. Electrical modalities and pain control. J Collection of Kaya. 2007;16:119-31.
  6. Philadelphia Panel. Philadelphia panel evidence-based clinical practice guidelines on selected rehabilitation interventions for knee pain. Phys Ther. 2001;81(10):1675-700.
  7. Curtis D, Fallows S, Morris M et al. The efficacy of frequency specific microcurrent therapy on delayed onset muscle soreness. J Bodyw Mov Ther. 2010;14(3):272-9. https://doi.org/10.1016/j.jbmt.2010.01.009
  8. Doan N, Reher P, Meghji S et al. In vitro effects of therapeutic ultrasound on cell proliferation, protein synthesis, and cytokine production by human fibroblasts, osteoblasts, and monocytes. J Oral Maxillofac Surg. 1999;57(4):409-19. https://doi.org/10.1016/S0278-2391(99)90281-1
  9. Antov Y, Barbul A, Mantsur H et al. Electroendocytosis: Exposure of cells to pulsed low electric fields enhances adsorption and uptake of macromolecules. Biophys J. 2005;88(3):2206-23. https://doi.org/10.1529/biophysj.104.051268
  10. Maenpaa H, Jaakkola R, Sandstrom M et al. Does microcurrent stimulation increase the range of movement of ankle dorsiflexion in children with cerebral palsy. Disabil Rehabil. 2004;26(11):669-77. https://doi.org/10.1080/09638280410001684046
  11. Park RJ. The effects of transcutaneous electrical nerve stimulation, and microampere electrical nerve stimulation on sympathetic tone in healthy subjects. J Kor Soc Phys Ther. 1997;9(1):51-7.
  12. Warden SJ, McMeeken JM. Ultrasound usage and dosage in sports physiotherapy. Ultrasound Med Biol. 2002;28(8):1075-80. https://doi.org/10.1016/S0301-5629(02)00552-5
  13. Huang MH, Ding HJ, Chai CY et al. Effects of sonication on articular cartilage in experimental osteoarthritis. J Rheumatol. 1997;24(10):1978-84.
  14. Million R, Hall W, Nilsen KH et al. Assessment of the progress of the back-pain patient 1981 volvo award in clinical science. Spine (Phila Pa 1976). 1982;7(3):204-12. https://doi.org/10.1097/00007632-198205000-00004
  15. Videbech M, Carlsson PS, Jensen NC et al. Measuring of preoperative anxiety by three self-reporting scales: state trait anxiety inventory, symptoms checkList 92 and visual analogue scale. Ugeskr Laeger. 2003;165(6):569-74.
  16. Roos EM, Roos HP, Lohmander LS. Womac osteoarthritis index-additional dimensions for use in subjects with post-traumatic osteoarthritis of the knee. western ontario and macMaster universities. Osteoarthritis Cartilage. 1999;7(2):216-21. https://doi.org/10.1053/joca.1998.0153
  17. Ko JK. Comparision of the results of t-womac and k-womac application on korean knee disease. Inje University. Dissertation of Master's Degree. 2007.
  18. Berg KO, Maki BE, Williams JI et al. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992;73(11):1073-80.
  19. Stevenson TJ. Detecting change in patients with stroke using the berg balance scale. Aust J Physiother. 2001;47(1):29-38.
  20. Rockstroh G, Schleicher W, Krummenauer F. Effectiveness of microcurrent therapy as a consti- tuent of post-hospital rehabilitative treatment in patients after total knee alloarthroplasty - a randomized clinical trial. Rehabilitation (Stuttg). 2010;49(3):173-9. https://doi.org/10.1055/s-0029-1246152
  21. Son JH, LEE YG, Lee DO. Analysis of patients' satisfactory level after total knee replacement arthroplasty. J Kor Knee Soc. 2004;16(2):105-10.
  22. Cho WS, Ahn HS, Kim MY et al. Pain after total knee arthroplasty. J Kor Orth Ass. 2006;41(1):129-33.
  23. Flandry F, Hunt JP, Terry GC et al. Analysis of subjective knee complaints using visual analog scales. Am J Sports Med. 1991;19(2):112-18. https://doi.org/10.1177/036354659101900204
  24. Song B, Zhao M, Forrester JV et al. Electrical cues regulate the orientation and frequency of cell division and the rate of wound healing in vivo. Proc Natl Acad Sci USA. 2002;99(21):13577-82. https://doi.org/10.1073/pnas.202235299
  25. Wi HN. Change of the functional status of knee joint and fatique after total knee arthroplasty. Chonnam National University. Dissertation of Master's Degree. 2011.
  26. Han JH. Effectiveness of 8 weeks of application of aqua complexed exercise on lower limbs muscular strength, pain relief and balance after total knee arthroplasty. Korea University. Dissertetion of master's Degree. 2010.
  27. Jin HK, Park JS, Kim JM. The effect of microcurrent stimulation intensity on osteoarthritis in rat. J Kor Acad Univ Tr Phys Ther. 2011;18(1):83-92.
  28. Oh HJ. The effects of microcurrent stimulation on recovery of function and pain in chronic low back pain. Daegu University. Dissertation of Master's Degree. 2007.
  29. Broughton G 2nd, Janis JE, Attinger CE. Wound healing: An overview. Plast Reconstr Surg. 2006;117(7 Suppl):1e-S-32e-S.
  30. Petrofsky J, Schwab E, Lo T et al. Effects of electrical stimulation on skin blood flow in controls and in and around stage III and IV wounds in hairy and non hairy skin. Med Sci Monit. 2005;11(7):CR309-16.
  31. Nunez PL, Wingeier BM, Silberstein RB. Spatial-temporal structures of human alpha rhythms: theory, microcurrent sources, multiscale measurements, and global binding of local networks. Hum Brain Mapp. 2001;13(3):125-64. https://doi.org/10.1002/hbm.1030
  32. Watson T. The role of electrotherapy in contemporary physiotherapy practice. Man Ther. 2000;5(3):132-41. https://doi.org/10.1054/math.2000.0363
  33. Sena K, Leven RM, Mazhar K et al. Early gene response to low-intensity pulsed ultrasound in rat osteoblastic cells. Ultrasound Med Biol. 2005;31(5):703-8. https://doi.org/10.1016/j.ultrasmedbio.2005.01.013
  34. Reher P, Doan N, Bradnock B et al. Effect of ultrasound on the production of IL-8, basic FGF and VEGF. Cytokine. 1999;11(6):416-23. https://doi.org/10.1006/cyto.1998.0444
  35. Lehmann JF, Warren CG, Scham SM. Therapeutic heat and cold. Clin Orthop Relat Res. 1974;(99):207-45.
  36. Munting E. Ultrasonic therapy for painful shoulders. Physiotherapy. 1978;64(6):180-1.
  37. Harle J, Salih V, Mayia F et al. Effects of ultrasound on the growth and function of bone and periodontal ligament cells in vitro. Ultrasound Med Biol. 2001;27(4):579-86. https://doi.org/10.1016/S0301-5629(00)00326-4
  38. Kim YS, Oh TY, Kim SB. An immunohistochemical study of effects of therapesutic ultrasound on the expression of vegf and substance-p in muscle contusion injury. J Kor Soc Phys Ther. 2003;15(1):9-25.
  39. Young SR, Dyson M. Effect of therapeutic ultrasound on the healing of full-thickness excised skin lesions. Ultrasonics. 1990;28(3):175-80. https://doi.org/10.1016/0041-624X(90)90082-Y
  40. Karnes JL, Burton HW. Continuous therapeutic ultrasound accelerates repair of contraction-induced skeletal muscle damage in rats. Arch Phys Med Rehabil. 2002;83(1):1-4. https://doi.org/10.1053/apmr.2002.26254