Diz osteoartriti tedavisinde iyontoforezin etkinliği
Loading...
Date
2011
Authors
Raif, Serap Latif
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışma diz osteoartriti (OA) tedavisinde farklı ajanlarla uygulanan iyontoforez yönteminin etkinliğinin karşılaştırmalı olarak incelenmesi amacıyla yapıldı.Randomize, çift kör, plasebo kontrollü çalışmaya polikliniğimize diz ağrısı yakınması ile başvuran 40-80 yaş arasında diz OA tanısı almış 80 hasta (17 erkek, 63 kadın) alındı.Randomizasyon sonrası 1. gruba (n=20) %2,5 diklofenak sodyum (DKLF), 2. gruba (n=20) %0,4 deksametazon sodyum fosfat (DEKS), 3. gruba (n=20) %2 lidokain (LDKN), 4. gruba (n=20) plasebo olarak serum fizyolojik (PLSB) iyontoforezi 0,04 mA/cm2 akım yoğunluğunda, elektrot pedlerine 3 ml solüsyon emdirilerek, 2 hafta süreyle haftada 5 gün toplam 10 seans uygulandı. Hastalar tedavi öncesi, tedavi sonrası, 3 ve 6. aylarda istirahat ve aktivite ağrısı (Vizüel Analog Skala-VAS), Western Ontario ve McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC), kısa form?36 (SF-36), 15 m yürüme süresi ve zamanlı ayağa kalkma yürüme (ZAKY) süresi ile değerlendirildi.DKLF, DEKS ve LDKN gruplarında istirahat ve aktivite ağrısında tedavi sonrasında tüm vizitlerde, PLSB grubunda sadece tedavi sonrası ilk vizitte anlamlı düzelme saptandı. DKLF ve DEKS gruplarında 6. ayda aktivite ağrısında LDKN ve PLSB gruplarına göre daha fazla düzelme saptandı. DKLF, DEKS, LDKN gruplarında WOMAC ağrı, tutukluk, fonksiyonel kısıtlılık, toplam SF-36 fiziksel fonksiyon, ağrı alt ölçeklerinde tedavi sonrası tüm vizitlerde, PLSB grubunda ise sadece WOMAC ağrı alt ölçeğinde tedavi sonrası ilk vizitte anlamlı düzelme saptandı. DKLF ve DEKS gruplarında fiziksel rol kısıtlaması, sosyal fonksiyon, genel sağlık alt ölçeklerinde tedavi sonrası tüm vizitlerde anlamlı düzelme saptandı. SF-fiziksel fonksiyon alt ölçeğinde 6. ayda düzelme diğer gruplara göre daha fazlaydı.Sonuçta iyontoforez diz OA tedavisinde etkili bir tedavi seçeneğidir ve steroid iyontoforezinin fiziksel fonksiyon üzerine etkisi uzun dönemde daha belirgindir.
The the aim of this study was to investigate the effectiveness of iontophoresis using different agents in the treatment of knee osteoarthritis (OA).A total of 80 patients (17 men, 63 women) with the ages between 40-80 diagnosed as knee OA were included in this randomized, double-blind, placebo controlled trial.Patients were randomly assigned to four group and iontophoresis was performed five days a week for two weeks at 0,04 mA/cm2 current density by 3 ml of solution applied to electrode pads using 2,5% diclofenac sodium (DCLF) in Group 1 (n=20), 0,4% dexametasone (DEXM) in Group 2 (n=20), 2% lidocaine (LDCN) in Group 3 (n=20) and physiological saline (PLCB) in Group 4 (n=20). Patients were assessed at baseline, after treatment, 3 and 6 months after treatment by rest and activity pain (Visual A nalog Scale), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), short form-36 (SF-36), 15 m walking time and timed up and go (TUG) tests.Significant improvements in rest pain and activity pain were noted in all visits in all treatment groups meanwhile significant improvements establised only in post treatment visit in PLCB group. Significantly more improvement was observed in activity pain in DCLF and DEXM groups at 6 months compared to LDCN and PLCB groups. Significant improvements were noted in WOMAC pain, stiffness, functional limitation and total domains, SF-36 physical function and pain subscales in all treatment groups and additionally in SF-36 physical role limitations, social function and general health subscales in DEXM and DKLF groups in all visits. Significant improvements were noted WOMAC pain subscale in PLCB group only in post treatment visit. . Significantly more improvement was observed in SF-36 physical function subscale in DEXM at 6 months.In conclusion, iontophoresis is an effective alternative treatment of knee OA. Steroid iontophoresis has a more promiment effect on physical function in long-term.
The the aim of this study was to investigate the effectiveness of iontophoresis using different agents in the treatment of knee osteoarthritis (OA).A total of 80 patients (17 men, 63 women) with the ages between 40-80 diagnosed as knee OA were included in this randomized, double-blind, placebo controlled trial.Patients were randomly assigned to four group and iontophoresis was performed five days a week for two weeks at 0,04 mA/cm2 current density by 3 ml of solution applied to electrode pads using 2,5% diclofenac sodium (DCLF) in Group 1 (n=20), 0,4% dexametasone (DEXM) in Group 2 (n=20), 2% lidocaine (LDCN) in Group 3 (n=20) and physiological saline (PLCB) in Group 4 (n=20). Patients were assessed at baseline, after treatment, 3 and 6 months after treatment by rest and activity pain (Visual A nalog Scale), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), short form-36 (SF-36), 15 m walking time and timed up and go (TUG) tests.Significant improvements in rest pain and activity pain were noted in all visits in all treatment groups meanwhile significant improvements establised only in post treatment visit in PLCB group. Significantly more improvement was observed in activity pain in DCLF and DEXM groups at 6 months compared to LDCN and PLCB groups. Significant improvements were noted in WOMAC pain, stiffness, functional limitation and total domains, SF-36 physical function and pain subscales in all treatment groups and additionally in SF-36 physical role limitations, social function and general health subscales in DEXM and DKLF groups in all visits. Significant improvements were noted WOMAC pain subscale in PLCB group only in post treatment visit. . Significantly more improvement was observed in SF-36 physical function subscale in DEXM at 6 months.In conclusion, iontophoresis is an effective alternative treatment of knee OA. Steroid iontophoresis has a more promiment effect on physical function in long-term.
Description
Keywords
Diz osteoartriti, Ağrı, İyontoforez, SF 36, Knee osteoarthritis, Pain, Iontophoresis, WOMAC
Citation
Raif, S. L. (2011). Diz osteoartriti tedavisinde iyontoforezin etkinliği. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.