DOI QR코드

DOI QR Code

Potential Benefits of a Selective Region High-frequency Diathermy with Therapeutic Exercises on Older Persons with Degenerative Knee Osteoarthritis: A Case Report

  • Ha, Sin Ho (Department of Physical Therapy, Graduate School of Kyungnam University) ;
  • Lee, Dong Geon (Department of Physical Therapy, Sinsegye Nursing Care Facility) ;
  • Hong, Soung Kyun (Department of Physical Therapy, Woosuk University) ;
  • Lee, Gyu Chang (Department of Physical Therapy, Kyungnam University)
  • Received : 2021.07.15
  • Accepted : 2021.10.15
  • Published : 2021.12.31

Abstract

Objective: The purpose of this case study was to investigate selective region high-frequency diathermy at trigger points with therapeutic exercises on pain, function, balance and gait in older patients with degenerative knee osteoarthritis (DKO). Design: A case report. Methods: The patient who participated in this study was a 71-year-old woman, who had been diagnosed with moderate osteoarthritis with grade II Kellgren & Lawrence grading scale. The intervention consisted of selective region high-frequency diathermy at trigger points, with hip and knee stretching and strengthening exercises. The participant was given assessments before and after every intervention session using the Visual Analogue Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), the Timed Up and Go test (TUG) and the 10 Meter Walk Test (10MWT). The participant performed the intervention 18 times for a total of 30 minutes each. Results: As a result of this study, the patient VAS decreased to 3 points, and the WOMAC decreased to 53 points. In addition, the TUG decreased to 3.25 s and the 10MWT decreased to 1.14 s. Conclusions: The results of this study suggest that selective region high-frequency diathermy at trigger points with therapeutic exercises may be an effective intervention to decrease pain, improve knee function, balance and gait in patients with DKO. The selective region high-frequency diathermy with therapeutic exercises may be feasible and provide potential benefits for rehabilitation of DKO.

Keywords

References

  1. Imagama S, Ando K, Kobayashi K, Seki T, Hamada T, Machino M, et al. Impact of comorbidity rates of lumbar spondylosis, knee osteoarthritis, and osteoporosis on physical QOL and risk factors for poor physical QOL in middle-aged and elderly people. Mod Rheumatol. 2020;30:402-9. https://doi.org/10.1080/14397595.2019.1601839
  2. Brooks PM. Impact of osteoarthritis on individuals and society: how much disability? Social consequences and health economic implications. Curr Opin Rheumatol. 2002;14:573-7. https://doi.org/10.1097/00002281-200209000-00017
  3. Scott D, Kowalczyk A. Osteoarthritis of the knee. BMJ Clin Evid. 2007;2007:1121.
  4. Davies CM, Guilak F, Weinberg JB, Fermor B. Reactive nitrogen and oxygen species in interleukin-1-mediated DNA damage associated with osteoarthritis. Osteoarthritis Cartilage. 2008;16:624-30. https://doi.org/10.1016/j.joca.2007.09.012
  5. Ersoz M, Ergun S. Relationship between knee range of motion and Kellgren-Lawrence radiographic scores in knee osteoarthritis. Am J Phys Med Rehabil. 2003;82:110-5. https://doi.org/10.1097/00002060-200302000-00005
  6. Holla JF, Steultjens MP, van der Leeden M, Roorda LD, Bierma-Zeinstra SM, den Broeder AA, et al. Determinants of range of joint motion in patients with early symptomatic osteoarthritis of the hip and/or knee: an exploratory study in the CHECK cohort. Osteoarthritis Cartilage. 2011;19:411-9. https://doi.org/10.1016/j.joca.2011.01.013
  7. Ozdemir F, Tukenmez O, Kokino S, Turan FN. How do marginal osteophytes, joint space narrowing and range of motion affect each other in patients with knee osteoarthritis. Rheumatol Int. 2006;26:516-22. https://doi.org/10.1007/s00296-005-0016-0
  8. Simons DG, Mense S. Understanding and measurement of muscle tone as related to clinical muscle pain. Pain. 1998;75:1-17. https://doi.org/10.1016/S0304-3959(97)00102-4
  9. Zhang W, Nuki G, Moskowitz RW, Abramson S, Altman RD, Arden NK, et al. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage. 2010;18:476-99. https://doi.org/10.1016/j.joca.2010.01.013
  10. Vicenzino B, Paungmali A, Buratowski S, Wright A. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Man Ther. 2001;6:205-12. https://doi.org/10.1054/math.2001.0411
  11. Ganzit GP. New methods in the treatment of jointmuscular pathologies in athletes: The "TECAR" therapy. Medicina Dello Sport. 2000;53:361-7.
  12. Bennell K, Hinman R. Exercise as a treatment for osteoarthritis. Curr Opin Rheumatol. 2005;17:634-40. https://doi.org/10.1097/01.bor.0000171214.49876.38
  13. Cetin N, Aytar A, Atalay A, Akman MN. Comparing hot pack, short-wave diathermy, ultrasound, and TENS on isokinetic strength, pain, and functional status of women with osteoarthritic knees: a single-blind, randomized, controlled trial. Am J Phys Med Rehabil. 2008;87:443-51. https://doi.org/10.1097/PHM.0b013e318174e467
  14. Giombini A, Di Cesare A, Di Cesare M, Ripani M, Maffulli N. Localized hyperthermia induced by microwave diathermy in osteoarthritis of the knee: a randomized placebo-controlled double-blind clinical trial. Knee Surg Sports Traumatol Arthrosc. 2011;19:980-7. https://doi.org/10.1007/s00167-010-1350-7
  15. Ozen S, Doganci EB, Ozyuvali A, Yalcin AP. Effectiveness of continuous versus pulsed short-wave diathermy in the management of knee osteoarthritis: A randomized pilot study. Caspian J Intern Med. 2019;10:431-8.
  16. Kim H, Suzuki T, Saito K, Kim M, Kojima N, Ishizaki T, et al. Effectiveness of exercise with or without thermal therapy for community-dwelling elderly Japanese women with non-specific knee pain: a randomized controlled trial. Arch Gerontol Geriatr. 2013;57:352-9. https://doi.org/10.1016/j.archger.2013.06.008
  17. Akyol Y, Durmus D, Alayli G, Tander B, Bek Y, Canturk F, et al. Does short-wave diathermy increase the effectiveness of isokinetic exercise on pain, function, knee muscle strength, quality of life, and depression in the patients with knee osteoarthritis? A randomized controlled clinical study. Eur J Phys Rehabil Med. 2010;46:325-36.
  18. Laufer Y, Zilberman R, Porat R, Nahir AM. Effect of pulsed short-wave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial. Clin Rehabil. 2005;19:255-63. https://doi.org/10.1191/0269215505cr864oa
  19. Lavelle ED, Lavelle W, Smith HS. Myofascial trigger points. Anesthesiol Clin. 2007;25:841-51. https://doi.org/10.1016/j.anclin.2007.07.003
  20. TRAVELL J, RINZLER SH. The myofascial genesis of pain. Postgrad Med. 1952;11:425-34. https://doi.org/10.1080/00325481.1952.11694280
  21. Simons D, Travell J, Simons L. Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. Philadelphia: Williams & Wilkins; 1999.
  22. Dor A, Kalichman L. A myofascial component of pain in knee osteoarthritis. J Bodyw Mov Ther. 2017;21:642-7. https://doi.org/10.1016/j.jbmt.2017.03.025
  23. McCray RE, Patton NJ. Pain relief at trigger points: a comparison of moist heat and shortwave diathermy. J Orthop Sports Phys Ther. 1984;5:175-8. https://doi.org/10.2519/jospt.1984.5.4.175
  24. Lee HR, Shim JH, Oh DW. Effects of High-frequency Diathermy Integrated into Suboccipital Release on Tenderness and Neck Mobility and Disability in People with Chronic Tension-type Headache. Phys Ther Korea 2017;24:37-47 https://doi.org/10.12674/ptk.2017.24.2.037
  25. Kwon K, Kim CM, Park SJ. The Effect of Diathermy Treatment through Physiotherapist's Hand on the Pain and Disability Index in Chronic Lumbar Pain Patients. Journal of the Korea Convergence Society. 2018;9:289-94.
  26. Kim YJ, Park JH, Kim JH, Moon GA, Jeon HS. Effect of High-frequency Diathermy on Hamstring Tightness. Phys Ther Korea. 2021;28:65-71 https://doi.org/10.12674/ptk.2021.28.1.65
  27. Gallagher EJ, Bijur PE, Latimer C, Silver W. Reliability and validity of a visual analog scale for acute abdominal pain in the ED. Am J Emerg Med. 2002;20:287-90. https://doi.org/10.1053/ajem.2002.33778
  28. McConnell S, Kolopack P, Davis AM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC): a review of its utility and measurement properties. Arthritis Rheum. 2001;45:453-61. https://doi.org/10.1002/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W
  29. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med. 2005;37:75-82. https://doi.org/10.1080/16501970410017215
  30. Salbach NM, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards CL. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil. 2001;82:1204-12. https://doi.org/10.1053/apmr.2001.24907
  31. Kuru T, Yaliman A, Dereli EE. Comparison of efficiency of Kinesio® taping and electrical stimulation in patients with patellofemoral pain syndrome. Acta Orthop Traumatol Turc. 2012;46:385-92. https://doi.org/10.3944/AOTT.2012.2682
  32. Tao XG, Bernacki EJ. A randomized clinical trial of continuous low-level heat therapy for acute muscular low back pain in the workplace. J Occup Environ Med. 2005;47:1298-306. https://doi.org/10.1097/01.jom.0000184877.01691.a3
  33. Valdes K, Marik T. A systematic review of conservative interventions for osteoarthritis of the hand. J Hand Ther. 2010;23:334-51. https://doi.org/10.1016/j.jht.2010.05.001
  34. Van Der Heijden RA, Lankhorst NE, Van Linschoten R, Bierma-Zeinstra SM, Van Middelkoop M. Exercise for treating patellofemoral pain syndrome: an abridged version of Cochrane systematic review. Eur J Phys Rehabil Med. 2016;52:110-33.
  35. Rabini A, Piazzini DB, Tancredi G, Foti C, Milano G, Ronconi G, et al. Deep heating therapy via microwave diathermy relieves pain and improves physical function in patients with knee osteoarthritis: a double-blind randomized clinical trial. Eur J Phys Rehabil Med. 2012;48:549-59.
  36. Hassan BS, Doherty SA, Mockett S, Doherty M. Effect of pain reduction on postural sway, proprioception, and quadriceps strength in subjects with knee osteoarthritis. Ann Rheum Dis. 2002;61:422-8. https://doi.org/10.1136/ard.61.5.422
  37. Messier SP, Glasser JL, Ettinger WH Jr, Craven TE, Miller ME. Declines in strength and balance in older adults with chronic knee pain: a 30-month longitudinal, observational study. Arthritis Rheum. 2002;47:141-8. https://doi.org/10.1002/art.10339
  38. Wellsandt E, Golightly Y. Exercise in the management of knee and hip osteoarthritis. Curr Opin Rheumatol. 2018;30:151-9. https://doi.org/10.1097/BOR.0000000000000478
  39. Zhang QB, Zhou Y, Zhong HZ, Liu Y. Effect of Stretching Combined With Ultrashort Wave Diathermy on Joint Function and Its Possible Mechanism in a Rabbit Knee Contracture Model. Am J Phys Med Rehabil. 2018;97:357-63. https://doi.org/10.1097/PHM.0000000000000873
  40. McGorm H, Roberts LA, Coombes JS, Peake JM. Turning Up the Heat: An Evaluation of the Evidence for Heating to Promote Exercise Recovery, Muscle Rehabilitation and Adaptation. Sports Med. 2018; 48:1311-28. https://doi.org/10.1007/s40279-018-0876-6
  41. Alburquerque-Garcia A, Rodrigues-de-Souza DP, Fernandez-de-las-Penas C, Alburquerque-Sendin F. Association between muscle trigger points, ongoing pain, function, and sleep quality in elderly women with bilateral painful knee osteoarthritis. J Manipulative Physiol Ther. 2015;38:262-8. https://doi.org/10.1016/j.jmpt.2014.10.018
  42. Hinman RS, Bennell KL, Metcalf BR, Crossley KM. Balance impairments in individuals with symptomatic knee osteoarthritis: a comparison with matched controls using clinical tests. Rheumatology (Oxford). 2002;41:1388-94. https://doi.org/10.1093/rheumatology/41.12.1388
  43. Hall MC, Mockett SP, Doherty M. Relative impact of radiographic osteoarthritis and pain on quadriceps strength, proprioception, static postural sway and lower limb function. Ann Rheum Dis. 2006;65:865-70. https://doi.org/10.1136/ard.2005.043653
  44. Kim D, Park G, Kuo LT, Park W. The effects of pain on quadriceps strength, joint proprioception and dynamic balance among women aged 65 to 75 years with knee osteoarthritis. BMC Geriatr. 2018;18:245. https://doi.org/10.1186/s12877-018-0932-y
  45. Gezginaslan O, Ozturk EA, Cengiz M, Mirzaoglu T, Cakci FA. Effects of isokinetic muscle strengthening on balance, proprioception, and physical function in bilateral knee osteoarthritis patients with moderate fall risk. Turk J Phys Med Rehabil. 2018;64:353-61. https://doi.org/10.5606/tftrd.2018.2422
  46. Witvrouw E, Danneels L, Asselman P, D'Have T, Cambier D. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. Am J Sports Med. 2003;31:41-6. https://doi.org/10.1177/03635465030310011801
  47. Hurwitz DE, Hulet CH, Andriacchi TP, Rosenberg AG, Galante JO. Gait compensations in patients with osteoarthritis of the hip and their relationship to pain and passive hip motion. J Orthop Res. 1997;15:629-35. https://doi.org/10.1002/jor.1100150421
  48. Debi R, Mor A, Segal G, Segal O, Agar G, Debbi E, et al. Correlation between single limb support phase and self-evaluation questionnaires in knee osteoarthritis populations. Disabil Rehabil. 2011;33:1103-9. https://doi.org/10.3109/09638288.2010.520805
  49. Mundermann A, Dyrby CO, Hurwitz DE, Sharma L, Andriacchi TP. Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity: reduced walking speed. Arthritis Rheum. 2004;50:1172-8. https://doi.org/10.1002/art.20132
  50. Robon MJ, Perell KL, Fang M, Guererro E. The relationship between ankle plantar flexor muscle moments and knee compressive forces in subjects with and without pain. Clin Biomech(Bristol, Avon). 2000;15:522-7. https://doi.org/10.1016/S0268-0033(00)00007-3
  51. Liu MQ, Anderson FC, Schwartz MH, Delp SL. Muscle contributions to support and progression over a range of walking speeds. J Biomech. 2008;41:3243-52. https://doi.org/10.1016/j.jbiomech.2008.07.031
  52. van Dijk GM, Veenhof C, Schellevis F, Hulsmans H, Bakker JP, Arwert H, et al. Comorbidity, limitations in activities and pain in patients with osteoarthritis of the hip or knee. BMC Musculoskelet Disord. 2008;9:95. https://doi.org/10.1186/1471-2474-9-95
  53. Lewek MD, Rudolph KS, Snyder-Mackler L. Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. J Orthop Res. 2004;22:110-5. https://doi.org/10.1016/S0736-0266(03)00154-2
  54. Suh MJ, Kim BR, Kim SR, Han EY, Nam KW, Lee SY, et al. Bilateral Quadriceps Muscle Strength and Pain Correlate With Gait Speed and Gait Endurance Early After Unilateral Total Knee Arthroplasty: A Cross-sectional Study. Am J Phys Med Rehabil. 2019;98:897-905. https://doi.org/10.1097/phm.0000000000001222