Influence of Using Physical Therapy Resources for Knee Osteoarthritis

Study Overview
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Brief Summary
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Osteoarthritis is a chronic, multifactorial characterization, which changes in bone alignment, cartilage and structures that provide joint stability appear to be strongly correlated with the origin of this disease.This project will aim to verify the effectiveness of interferential current, short wave and low level laser therapy on an exercise program for mobility and pain in knee osteoarthritis. Blind randomized, placebo controlled. Five groups: exercise group, exercise group + Ultrasound therapy, exercise group + interferential current, exercise group + short-wave diathermy, exercise group + Low level laser therapy. Before and after the trial protocol by the following instruments: Western Ontario and McMaster Universities osteoarthritis index (WOMAC), numerical scale of pain assessment (END), Visual Analogue Scale Fatigue (VAS-F), issue F2.2 Instrument assessment of quality of life of the World Health Organization (WHOQOL-100) test sitting and standing + numerical rating pain scale, algometry. This project hypothesizes that the inclusion of photothermal and electrical agents in an exercise program will provide an improvement in pain, mobility and knee function in individuals diagnosed with knee osteoarthritis.

Official Title
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Influence of Using Physical Therapy Resources for Knee Osteoarthritis

Conditions
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Osteoarthritis, Physical Therapy Modalities

Intervention / Treatment
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* Other: exercise
* Device: interferential current
* Device: short-wave diathermy
* Device: Low level laser therapy
* Device: Ultrasound therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: knee pain to at least six months and minimum of 4 points in pain scale Diagnosed with osteoarthritis in unilateral knee according to the criteria established by the American College of Rheumatology and confirmed by radiographic examination for identification Kellgren-Lawrence grade 2 or 3 (Kellgren & Lawrence, 1957). Exclusion Criteria: Any type of physical therapy therapy with intra-articular corticosteroids or therapeutic chondroprotective drugs last year, before the start of the study. history of trauma on his knees, cognitive disorder or psychological disorder, neurological (sensory or motor) cancer diabetes, or any state of adverse acute health osteoarthritis signs of hip cardiopulmonary disease that prevents the conducting exercises require auxiliary device for performing gait. Yet who undertake physical activity in the last two months. Physical activity is defined as strength training and / or more than 20 minutes of aerobic activity twice a week.

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: exercise group<br>An exercise protocol drawn up with the objective will be held to strengthen the musculature: flexor and extensor of the knee; extension, abduction, hip side rotator, using the weight and the elastic band. | Other: exercise<br>* exercises designed with the objective of strengthening the musculature: flexor and extensor of the knee; extensor, abductor, lateral rotator of the hip.<br>|
| Placebo Comparator: exercise group + Ultrasound therapy<br>Apart from intervening in the exercise group, an ultrasound device is used . | Other: exercise<br>* exercises designed with the objective of strengthening the musculature: flexor and extensor of the knee; extensor, abductor, lateral rotator of the hip.<br>Device: Ultrasound therapy<br>* Ultrasound (US) is a form of mechanical energy, not electrical energy and therefore strictly speaking, not really electrotherapy at all but does fall into the Electro Physical Agents grouping.<br>|
| Experimental: exercise group + interferential current<br>Besides the intervention of the exercise group after the exercises will be applied to interferential current through the device. Will be positioned 4 electrodes (8x5 cm), two upper and two lower (forming a square) around the center of the knee. | Other: exercise<br>* exercises designed with the objective of strengthening the musculature: flexor and extensor of the knee; extensor, abductor, lateral rotator of the hip.<br>Device: interferential current<br>* The basic principle of Interferential Therapy (IFT) is to utilise the significant physiological effects of low frequency (<250pps) electrical stimulation of nerves without the associated painful and somewhat unpleasant side effects sometimes associated with low frequency stimulation<br>|
| Experimental: exercise group + short-wave diathermy<br>Besides the intervention of the exercise group after the exercises will be applied diathermies short wave in continuous mode. For that will be used apparatus, 27.12 megahertz, by means of vulcanized rubber electrodes (12x17 cm) with gentle warming for 30 minutes. | Other: exercise<br>* exercises designed with the objective of strengthening the musculature: flexor and extensor of the knee; extensor, abductor, lateral rotator of the hip.<br>Device: short-wave diathermy<br>* Is a modality that produces deep heating via conversion of electromagnetic energy to thermal energy<br>|
| Experimental: exercise group + Low level laser therapy<br>Apart from intervening in the exercise group, will be applied to Low level laser therapy, through the laser unit, Class 3b, gallium-aluminum-arsenide, continuous mode, wavelength: 830 nanometer, power: 30 watts. | Other: exercise<br>* exercises designed with the objective of strengthening the musculature: flexor and extensor of the knee; extensor, abductor, lateral rotator of the hip.<br>Device: Low level laser therapy<br>* Laser treatment in which the energy output is low enough so that the temperature of the treated tissue does not rise above 98.6°F (36.5° C) or normal body temperature.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain | The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used in the evaluation Knee Osteoarthritis. | Change from Baseline in The Western Ontario and McMaster Universities Arthritis Index at 8 weeks | 
| stiffness | The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used in the evaluation Knee Osteoarthritis. | Change from Baseline in The Western Ontario and McMaster Universities Arthritis Index at 8 weeks | 
| physical functional | The Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used in the evaluation Knee Osteoarthritis. | Change from Baseline in The Western Ontario and McMaster Universities Arthritis Index at 8 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| intensity of pain | The Numerical rating pain scale, a simple, easily administered scale evaluates the perceived intensity of pain, using an 11-point scale from 0, representing 'no pain', to 10, which is the 'worst possible pain'. | Change from Baseline in The Numerical rating pain scale at 8 weeks | 
| Self-perceived fatigue | a visual analog scale (VAS-F). | Change from Baseline in the self-perceived fatigue at 8 weeks | 
| Functional capacity for sitting and standing | sitting-rising test | Change from Baseline in The Functional capacity for sitting and standing at 8 weeks | 
| level of pressure pain | Pressure Pain Threshold in the knee with algometer dynamometer. | Change from Baseline in ThePressure Pain Threshold at 8 weeks | 
| Self-perceived fatigue | The question of F2.2 instrument for assessing quality of life World Health Organization (WHOQOL-100). | Change from Baseline in The question of F2.2 instrument for assessing quality of life World Health Organization (WHOQOL-100) at 8 weeks |