Article

OBJECTIVE: To compare the effectiveness of transcutaneous electrical nerve
stimulation (TENS), interferential currents (IFCs), and shortwave diathermy (SWD)
against each other and sham intervention with exercise training and education as
a multimodal package. DESIGN: A double-blind, randomized, controlled, multicenter
trial. SETTING: Departments of physical medicine and rehabilitation in 4 centers.
PARTICIPANTS: Patients (N=203) with knee osteoarthritis (OA). INTERVENTIONS: The
patients were randomized by the principal center into the following 6 treatment
groups: TENS sham, TENS, IFCs sham, IFCs, SWD sham, and SWD. All interventions
were applied 5 times a week for 3 weeks. In addition, exercises and an education
program were given. The exercises were carried out as part of a home-based
training program after 3 weeks' supervised group exercise. MAIN OUTCOME MEASURES:
Primary outcome was a visual analog scale (0-100mm) to assess knee pain. Other
outcome measures were time to walk a distance of 15m, range of motion, Western
Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Nottingham Health
Profile, and paracetamol intake (in grams). RESULTS: We found a significant
decrease in all assessment parameters (P<.05), without a significant difference
among the groups except WOMAC stiffness score and range of motion. However, the
intake of paracetamol was significantly lower in each treatment group when
compared with the sham groups at 3 months (P<.05). Also, the patients in the IFCs
group used a lower amount of paracetamol at 6 months (P<.05) in comparison with
the IFCs sham group. CONCLUSIONS: Although all groups showed significant
improvements, we can suggest that the use of physical therapy agents in knee OA
provided additional benefits in improving pain because paracetamol intake was
significantly higher in the patients who were treated with 3 sham interventions
in addition to exercise and education.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS