การศึกษาเปรียบเทียบผลของคลื่นกระแทกชนิดเรเดียลกับคลื่นเสียงความถี่สูงในการลดอาการปวดในผู้ป่วยโรคข้อเข่าเสื่อม
การศึกษาเปรียบเทียบผลของคลื่นกระแทกชนิดเรเดียลกับคลื่นเสียงความถี่สูงในการลดอาการปวดในผู้ป่วยโรคข้อเข่าเสื่อม
Keywords:
radial shock wave therapy, ultrasound, knee osteoarthritisAbstract
Objectives: To compare the effectiveness of radial shock wave therapy (RSWT) versus ultrasound therapy (US) on pain reduction in patients with knee osteoarthritis (OA)
Study design: Randomized controlled trial Setting: Department of Rehabilitation Medicine, Faculty of Medicine
Siriraj Hospital
Subjects: Thirty-two OA knee patients with knee pain (visual analogue scale ≥5 cm.), during January – August 2015.
Methods: The recruited patients were randomized equally into 2 groups. Radial shock wave therapy group received RSWT once a week and US group received US therapy 3 times a week for 4 weeks. Both groups performed quadriceps exercise twice a day. Pain score (VAS) on walking and WOMAC score were
assessed at baseline and 4 weeks.
Results: Subjects were 29 females and 3 males. The demographic data including sex, age, body mass index, prior treatment, baseline VAS pain and WOMAC scores were not different between groups. However, the mean symptom duration of the RSWT group was longer than ultrasound group (5.12±3.65 and 2.66±2.33 years, p=0.01). At 4 weeks, both groups showed a signifi cant reduction in VAS pain and WOMAC scores (p< 0.001). Although the VAS pain score after treatment of the RSWT group was lower than the US group 0.25 (95% confi dence interval = -0.89 to 1.39, p=0.65) and the WOMAC score after treatment of the RSWT group was lower than the US group 5.40 (-1.76 to12.56, p=0.13), there was no signifi cant difference between
groups. Moreover, compliance of quadriceps exercise, and number of paracetamol and ibuprofen taken showed no signifi cance difference between groups (p>0.05).
Conclusion: Both RSWT and US therapy combined with quadriceps exercises were effective on pain reduction and functional improvement in patients with knee osteoarthritis with no signifi cant difference between groups.
References
2. Kon E, Filardo G, Drobnic M, Madry H, Jelic M, van Dijk N, et al. Non-surgical management of early knee osteoarthritis. Knee Surg SportsTraumato Arthrosc. 2012;20:436-49
3. Tascioglu F, Kuzgun S, Armagan O, Ogutler G. Short-term effectiveness of ultrasound therapy in knee osteoarthritis. J Int Med Res. 2010;38:1233–42.
4. Loyola-Sanchez A, Richardson J, Macintyre NJ. Effi cacy of ultrasound therapy for the management of knee osteoarthritis: a systematic review with meta-analysis. Osteo Carti. 2010;18:1117–26.
5. Maier M, Milz S, Wirtz DC, Rompe JD, Schmitz C. Basic research of applying extracorporeal shockwaves on the musculoskeletal system. An assessment of current status. Orthopedic. 2002;31:667-77.
6. Speed C. A systematic review of shockwave therapies in soft tissue conditions: focusing on the evidence. Br J Sports Med. 2014; 48:1538–42.
7. Schmitz C. Effi cacy and safety of extracorporeal shock wave therapy for orthopedic conditions: a systematic review on studies listed in the PEDro database. Br Med Bull. 2015;116:115–38.
8. Zhao Z, Jing R, Shi Z, Zhao B, Ai Q, Xing G. Effi cacy of extracorporeal shockwave therapy for knee osteoarthritis: a randomized controlled trial. J Sur Res. 2013;185:661-6.
9. Magdolin M, Shenouda SS. Effi cacy of extracorporeal shockwave therapy versus mobilization with movement on pain, disability and range of motion in patients with knee osteoarthritis. Bull Fac Ph Th
Cairo Univ. 2013;18:65-74.
10. Carlsson AM. Assessment of chronic pain. Aspects of the reliability and validity of the visual analogue scale. Pain. 1983;16:87-101.
11. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K. et al. The American College of Rheumatology criteria for the classifi cation and reporting of osteoarthritis of the knee. Arthritis Rheum.
1986;29:1039-49.
12. Kellgren JH, Lawrence JS. Radiological assessment of osteoarthritis. Ann Rheum Dis. 1957;16:494–501.
13. Bellamy N. Osteoarthritis – an evaluative index for clinical trials. MSC Thesis, McMaster University, Hamilton, Ontario, 1982.
14. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic
drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–40.
15. Augsaranuclau S. Modifi ed WOMAC scale for knee pain. J Thai Rehabil Med. 2000:9:82-5.
16. Kuptniratsaikul V, Rattanachaiyanont M. Validation of a modified Thai version of the Western Ontario and McMaster (WOMAC) osteoarthritis index for knee osteoarthritis. Clin Rheumatol. 2007;26:1641–45.
17. Kim JH, Kim JY, Choi CM, Lee JK, Kee HS, Jung KI, et al. The dose-related effects of extracorporeal shock wave therapy for knee osteoarthritis. Ann Rehabil Med. 2015;39:616-23.
