Ultrasound and Exercises in Knee Osteoarthritis
Condition: Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      The aim of this investigation is to compare the effects of continuous (CUS) and pulsed (PUS)
      ultrasound associated with a program of exercises on pain, range of motion, muscle strength,
      functionality, mobility and activity in patients with knee osteoarthritis. Participants were
      randomized into five groups: Group I (in the first month, continuous ultrasound was applied),
      Group II (in the first month, pulsed ultrasound was applied), Group III (in the first and
      second month, the continuous ultrasound was applied), Group IV (in the first and second
      month, the pulsed ultrasound was applied) and Group V (patients received only exercise
      sessions for eight weeks).
    

Detailed description: 
      Strong evidence suggests that joint exercises reduce pain and disability in patients with
      osteoarthritis. There is evidence that exercise is responsible for muscular strengthening and
      better flexibility, improved global function as well as better performance in activities of
      daily living (ADL).

      There are two modes of US, continuous and pulsed. Continuous US (CUS) generates thermal
      effects by stimulating the process of tissue regeneration, changing cell membrane
      permeability and increasing intracellular calcium, while pulsed US (PUS) mainly produces
      non-thermal effects to increase tissue metabolism, enhance fibrous tissue extensibility and
      elevate pain threshold
    

Intervention name(s): Group I; Group II; Group III; Group IV; Group V
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): Group I In the first month, continuous ultrasound was applied three times a week. In the second month, patients performed only exercise sessions three times a week. In the ultrasound treatment, the following parameters were used: frequency of 1 MHz, intensity of 1.5 W/cm2 (temporal and spatial mean SATA), duty cycle of 100%, with application time of 5 minutes on the medial side and 5 minutes on lateral side of knee.
Exercises
The intervention was divided into three phases: P-1, P-2 and P-3 during eight weeks with three sessions a week. Each session lasted 45 minutes:
10 minutes warming-up (treadmill, ergometer bike or rowing machine);
30 minutes 2-3 sets with P-1, P-2 or P-3;
5 minutes stretching (hamstrings, quadriceps, adductors, and gastrocmenius).; Group II In the first month, pulsed ultrasound was applied three times a week. In the second month, patients performed only exercise sessions three times a week. In the treatment with the US, the following parameters were used: 1 MHz frequency, 2.5 w / cm2 intensity (temporal and spatial mean SATA), pulsed mode (25%), 5 minutes on the medial side and 5 minutes on the lateral side of the knee.
Exercises
The intervention was divided into three phases: P-1, P-2 and P-3 during eight weeks with three sessions a week. Each session lasted 45 minutes:
10 minutes warming-up (treadmill, ergometer bike or rowing machine);
30 minutes 2-3 sets with P-1, P-2 or P-3;
5 minutes stretching (hamstrings, quadriceps, adductors, and gastrocmenius).; Group III In the first month, the continuous ultrasound was applied 3 times a week. In the second month, 3 times a week, the continuous ultrasound was applied associated with exercises. The parameters were used: frequency of 1 MHz, intensity of 1.5 w / cm2 (temporal and spatial mean SATA), continuous mode (100%), with application time of 5 minutes on the medial side and 5 minutes on lateral side of knee.
Exercises
The intervention was divided into three phases: P-1, P-2 and P-3 during eight weeks with three sessions a week. Each session lasted 45 minutes:
10 minutes warming-up (treadmill, ergometer bike or rowing machine);
30 minutes 2-3 sets with P-1, P-2 or P-3;
5 minutes stretching (hamstrings, quadriceps, adductors, and gastrocmenius).; Group IV In the first month, the pulsed ultrasound was applied three times a week. In the second month, three times a week, the pulsed ultrasound associated with exercises was applied. In the treatment with the US, the following parameters were used: 1 MHz frequency, 2.5 w / cm2 intensity (temporal and spatial mean SATA), pulsed mode (25%), 5 minutes on the medial side and 5 Minutes on the lateral side of the knee.
Exercises
The intervention was divided into three phases: P-1, P-2 and P-3 during eight weeks with three sessions a week. Each session lasted 45 minutes:
10 minutes warming-up (treadmill, ergometer bike or rowing machine);
30 minutes 2-3 sets with P-1, P-2 or P-3;
5 minutes stretching (hamstrings, quadriceps, adductors, and gastrocmenius).; Group V Patients received only exercise sessions three times a week for two months.
Exercises
The intervention was divided into three phases: P-1, P-2 and P-3 during eight weeks with three sessions a week. Each session lasted 45 minutes:
10 minutes warming-up (treadmill, ergometer bike or rowing machine);
30 minutes 2-3 sets with P-1, P-2 or P-3;
5 minutes stretching (hamstrings, quadriceps, adductors, and gastrocmenius).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: Osteoarthritis, Knee; Ultrasonic Therapy; Exercise Therapy; Randomized controlled trial.