بررسي مقايسه اي بين درمان معمول فيزيوتراپي و اي پي اس تراپي در استيوآرتروز زانو

A Comparative Study on the Action Potential Simulation (APS) Therapy and the Routine Physiotherapy Protocol in Knee Osteoarthritisin Elderly People

مقدمه و اهداف شايع ترين مورد مراجعه افراد مسن به درمانگاههاي فيزيوتراپي استيوآرتروز مي باشد. هدف از انجام اين تحقيق مقايسه بين نتايج درمان معمول فيزيوتراپي و اي پي اس تراپي بر روي كاهش درد و تورم و نيز پايايي اين كاهش در مبتلايان به استيوآرتروز زانو مي باشد. مواد و روش ها در اين مطالعه 69 بيمار مبتلا به استيوآرتروز زانو در دو گروه درماني اي پي اس تراپي و گروه درمان معمول فيزيوتراپي تحت درمان قرار گرفتند. جلسات درماني مجموعاً 10 جلسه بود و ميزان درد و تورم در جلسات اول، پنجم ، دهم و يك ماه پس از اتمام درمان اندازه گيري گرديد. يافته ها نتايج تحقيق نشان داد كه در گروه اي پي اس تراپي كاهش معني دار تورم و فقط در محل روي كشكك روي داد (05/0 < P). ميزان درد در هر دو گروه درماني كاهش داشت و گروه اي پي اس تراپي به طور معني داري نسبت به گروه ديگر درد را كاهش داده بود (05/0 < P). در ضمن در گروه اي پي اس تراپي كاهش پيشرونده درد تا يك ماه پس از اتمام درمان وجود داشت در حالي كه در گروه درمان معمول فيزيوتراپي درد تقريباً ثابت مانده بود ( 05/0 < P ). بحث و نتيجه گيري با توجه به يافته هاي به دست آمده از اين تحقيق تاثير اي پي اس تراپي بر روي كاهش تورم و درد زانو و نيز پايايي كاهش درد در افراد مبتلا به استيوآرتروز، آرتروز زانو بيش از درمان معمول فيزيوتراپي مي باشد. لذا استفاده از اين دستگاه بر روي بيماران فوق توصيه مي شود.

ABSTRACT Background and Aim: Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS) Therapy and the routine physiotherapy (PT) protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis. Materials and Methods: 69 patients (62 females & 7 males) with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old) and the routine PT protocol (n=32, mean age: 61±14 years old) groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up). The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded. Results: In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P < 0.05). Visual Analogue Pain Scale (VAPS) indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P < 0.05). It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P < 0.05). A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4). Conclusion: The findings of this study showed significantly better results following the use of APS therapy protocol relative to the routine PT protocol in patients with knee osteoarthritis and hence are recommended to these patients.