Burger Allen Exercises in Knee OA With Type II Diabetes
Condition: Knee Osteoarthritis; Type II Diabetes
MeSH terms: Osteoarthritis; Osteoarthritis, Knee; Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      There is a potential link between diabetes mellitus (DM) and severity of osteoarthritis .Type
      2 diabetes is a part of the metabolic syndrome (Mets) accompanied by ageing and mechanical
      stress are also a risk factor to osteoarthritis. Every anatomical component of the joint
      demonstrated faster joint deterioration and elevated inflammation at microcellular
      environment of individuals with DM. Normal chondrocytes capacity to adapt to the local
      glucose level is impaired by OA and there is a significant risk of glucose toxicity and
      increased glucose absorption. The most dependable and effective treatment for mild to early
      joint osteoarthritis is exercise. Active free exercises i.e. Buerger Allen exercises are used
      as a conservative perfusion therapy because they rely on how gravity affects the smooth
      muscles in the valves. Synovial fluid supports the joint's ability to recover while also
      reducing inflammation and enhancing overall joint function. The aim of the study is to
      determine the effect of Buerger Allen exercise and low intensity high repetition exercises on
      pain, range of motion and disability in knee osteoarthritis with type 2 diabetes. The study
      would be randomized controlled trial. Total thirty-six subjects will be assigned randomly by
      using lottery randomization into two groups. Group A will receive conventional therapy and an
      additional Buerger Allen exercise while Group B will be a control group receiving only
      baseline treatment. Numeric pain rating scale (NPRS), Ankle Brachial Index, KOOS and
      Goniometer will be used as outcome measure tools for pain, range of motion and disability.
      Measure will be taken at baseline and at the end of treatment session. The collected data
      will be analyzed in Statistical Package for the Social Sciences (SPSS) 25.0.If data will be
      normally distributed then parametric if not normally distributed than non-parametric
    

Detailed description: 
      One of the most common joint conditions, osteoarthritis (OA), causes diarthrodial articular
      cartilage to deteriorate, which in turn causes disability in adults. Osteoarthritis (OA) and
      Type 2 diabetes mellitus (T2DM) are common illnesses whose prevalence is projected to
      increase. The association between diabetes mellitus and OA was originally identified in
      1961.After adjusting for body mass index, type 2 diabetes was recently discovered to be an
      independent risk factor of severe OA, with a Hazard Ratio (HR) of 2.1. One of the most
      popular forms of exercise for diabetic patients is the Buerger Allen exercise, which improves
      lower extremity perfusion and alleviates symptoms in those with lower limbs arterial
      insufficiency by using postural changes, stimulation of peripheral circulation, and
      application of muscle contraction. It has been found that nurses can prevent foot ulcers and
      lower limb amputations by educating the public, screening high-risk individuals, and giving
      medical care.
    

Intervention name(s): thermotherapy+ TENS+ low intensity high repetition exercises and Buerger Allen; thermotherapy+ TENS+ low intensity high repetition exercises
Intervention type(s): Other; Other
Intervention description(s): Patient will be asked to lie down flat on the plinth with legs elevated from 45 degrees until the skin turns pale, it will take approximately 2 minutes to occur. Then the patient turns to sit at the edge of the plinth with feet hanging and doing the following exercises; dorsiflexion, plantar flexion, inversion, eversion, and flexion the extension of toes, this phase may also be maintained for 2 minutes. Finally, the patient lies flat with his leg rested in a horizontal position and covered with a warm blanket for about 5 minutes; The intervention will be repeated 3 times per day and the posttest will be conducted 5th day using KOOS, NPRS and goniometer.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Buerger Allen exercises; Diabetes mellitus; Knee osteoarthritis