Establishment and Clinical Application Assessment of Symptoms and Functional Scale of Knee Osteoarthritis
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Abstract:
Objective: To establish the symptoms and the quantitative assessment rating scale of knee osteoarthritis patients and observe the clinical effect of massage manipulation on the patients,and make the application assessment of the massage manipulation.Methods: Self-made symptoms and functional assessment rating scales were used to observe and compare the clinical effect of 40 knee osteoarthritis patients before and after treatment.Results: The scores of these quantitative rating scales showed the clinical effect scores of the patients after the treatment were lower than that before the treatment(P0.01),indicating that the patients significantly improved.Conclusion: The self-made symptoms and the functional assessment rating scales of the knee osteoarthritis make the basic consistent assessment of the massage manipulation on the treatment of the knee osteoarthritis patients,which illustrates the clinical effect of the massage manipulation on the improvement of the knee osteoarthritis and shows these scales can make the objective assessment of the patient's clinical conditions,and provides a feasible way for the establishment of the quantitative functional assessment rating scales.Keywords:
Quantitative assessment
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Purpose To evaluate the responsiveness and determine the minimal clinically important changes (MCICs), anchored by the patient response to a 7-point global rating scale, for Knee Injury and Osteoarthritis Outcome Score (KOOS), and Tegner activity scale in athletes undergoing physiotherapy treatment after anterior cruciate ligament reconstruction (ACL-R). Methods: Fifty-four patients undergoing physiotherapy completed the Persian versions of KOOS and Tegner scales at weeks 6 and 10 post ACL-R. The 7-point global rating of change was also completed at week 10. Responsiveness was calculated via receiver operating characteristic curve and correlation analysis. Results: Acceptable responsiveness was reached by the KOOS sports and recreation subscale (Sport/Rec) (area under the curve (AUC) = 0.72; Gamma = 0.37) and Tegner scale (AUC = 0.75; Gamma = 0.59). The MCIC scores of KOOS subscales and Tegner scale were reported. Conclusion: Our findings demonstrated that the KOOS Sport/Rec subscale and Tegner scale have adequate responsiveness between weeks 6 and 10 of physiotherapy. Therefore, these scales should be used to evaluate the effects of physiotherapy treatment and the changes in activity levels in this population. The MCIC scores of the KOOS and Tegner scale can be used to detect changes significant to the patient while avoiding limitations of other methods.
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Study Design Prospective methodological study of repeated measures using a sample of consecutive patients. Objective To determine the test-retest reliability and responsiveness of the Anterior Knee Pain Scale (AKPS) and the Lower Extremity Functional Scale (LEFS) in patients with anterior knee pain. Background Anterior knee pain is one of the most common orthopedic complaints affecting the knee. Yet there is currently no self-report outcome measure that has well-established reliability and responsiveness, specifically for this population. As a result, clinicians and researchers may be making inappropriate conclusions regarding patient outcomes by using questionnaires that are misleading. Methods and Measures This multisite study involved 30 patients from 4 outpatient physical therapy clinics in Dallas, TX (24 women, 6 men; age range, 16–50 years; mean ± SD age, 35.2 ± 9.1 years). Patients receiving physical therapy for a chief complaint of anterior knee pain completed the AKPS and LEFS at their initial appointment and again 2 to 3 days later. Upon completion of physical therapy, the patients completed the AKPS, LEFS, and a global rating of change form. The treating therapist also completed a global rating of change form at the patient's final visit. The mean of the patient's and therapist's global rating of change was used as the criterion measure of change. Results Test-retest reliability was high for both questionnaires (ICC2,1 = 0.95 for the AKPS and 0.98 for the LEFS). A significant correlation was found between the criterion measure of change and both questionnaires. Receiver-operating characteristic curve analysis revealed that both questionnaires were moderately responsive with the area under the curve slightly higher for the LEFS (0.77) than the AKPS (0.69). Conclusion The LEFS and the AKPS both demonstrated high test-retest reliability and appear to be moderately responsive to clinical change in patients with anterior knee pain. Reliability and responsiveness were slightly higher in the LEFS than the AKPS. Further research is needed to determine if these measures could be modified, or new measures created, to produce an even more sensitive tool for this population. J Orthop Sports Phys Ther 2005;35:136–146.
Knee pain
Outpatient clinic
Anterior knee pain
Pain scale
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Modalities
Electrotherapy
Manual therapy
Knee pain
Hydrotherapy
Exercise therapy
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Title: Nurse Practitioner Led Identification and Treatment of Knee Pain Severity Based on Evidence Classification Protocols
Identification
Knee pain
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Background
The primary complaints of patients suffering from osteoarthritis of the knee are pain, stiffness, instability, and loss of function. In early disease, pain will be intermittent and mostly associated with joint use. For many people, symptomatic disease progresses and the pain become more chronic and may also be present at rest and during the night. joint will feel stiff, resulting in typical pain and difficulty when initiating movement after a period of rest.Objective
This report is based on two existing systematic reviews (from the Netherlands and Canada) and guidelines from The Philadelphia Panel, in addition to an updated systematic review on studies published from 1998 to January 2004. objective was to evaluate the effectiveness of physical therapy, restricted to electrotherapy and exercise, for osteoarthritis of the knee. clinical endpoints were pain, physical function, sickness days and quality of life.Search strategy
Relevant databases that were searched were Cochrane Library, Database of Abstracts of Reviews of Effectiveness (DARE), International Network of Agencies of Health Technology assessment (INAHTA) database, Physiotherapy Evidence Database (PEDro), National Guidelines Clearinghouse, Medline, Embase, OHE Economic Evaluations Database and NHS Economic Evaluation Database.The literature search for primary literature identified 770 abstracts that were reviewed. 180 possibly relevant studies were assessed, and 36 studies included in the report. Ten systematic reviews were also included.Results / Conclusions
Both home based exercise and exercise led by a physical therapist improved pain, function and quality of life in patients with osteoarthritis of the knee. exercise programs must last for a minimum of eight weeks to give significant effects. Most studies on exercise concentrate on strength training of the quadriceps and used 2-4 repetitions each week.Both laser and TENS gave significant effects on pain relief at the end of treatment (2-4 weeks). However, the evidence for the effect by laser is weaker than for TENS.There is a lack of evidence regarding effect on osteoarthritis of the knee after treatments including ultrasound and pulsed electromagnetic fields.The effect of physiotherapy (exercise, laser and TENS) persist for 1-3 months after the end of treatment.The conclusions regarding cost-effectiveness of physiotherapy on osteoarthritis of the knee are uncertain since no reliable data are available on this subject.
Electrotherapy
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Knee pain
Anterior knee pain
Pain scale
Patellofemoral Pain Syndrome
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Acupuncture for Chronic Knee Pain: A Critical Appraisal of an Australian Randomized Controlled Trial
Background: Chronic knee pain caused by osteoarthritis (OA) is common in the general population. For knee OA with chronic moderate-to-severe pain, acupuncture treatment is recommended. Previous randomized controlled trials (RCTs) and meta-analyses have indicated that acupuncture can decrease pain and improve function in patients with knee OA. Interestingly, a recent Australian RCT by Hinman et al. reported that acupuncture was not beneficial for knee OA. Objective: As the quality of the Hinman study is of significance to clinical decision-making, the current authors decided to perform a critical appraisal of this study. Methods: Critical appraisals were performed on the study design, statistical methods, and conclusions. Ethical concerns and the use of control groups are discussed in this article. Results: The RCT by Hinman et al. had multiple flaws in study design, acupuncture protocol, sample-size calculation, results analyses, and thus conclusions; in addition, there are ethical concerns regarding bias from a high likelihood of conflicts of interest for the researchers. Conclusions: Rather than adding to the understanding and information about acupuncture's benefits in knee OA at 12 weeks, the study by Hinman et al. added more confusion to the available evidence. The results and conclusions of this RCT, thus, may not be valid or appropriate. For the interests of patients, clinicians, and health care policy makers regarding the use of acupuncture for chronic knee pain, the abovementioned flaws should be taken into consideration. In addition, ethical concerns and conflicts of interest in the study may motivate medical scientists to reconsider the value of this study.
Critical appraisal
Knee pain
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The purpose of this study was to evaluate the effect of various non-operative modalities of treatment (transcutaneous electrical nerve stimulation (TENS); neuromuscular electrical stimulation (NMES); insoles and bracing) on the pain of osteoarthritis (OA) of the knee. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify the therapeutic options which are commonly adopted for the management of osteoarthritis (OA) of the knee. The outcome measurement tools used in the different studies were the visual analogue scale and The Western Ontario and McMaster Universities Arthritis Index pain index: all pain scores were converted to a 100-point scale. A total of 30 studies met our inclusion criteria: 13 on insoles, seven on TENS, six on NMES, and four on bracing. The standardised mean difference (SMD) in pain after treatment with TENS was 1.796, which represented a significant reduction in pain. The significant overall effect estimate for NMES on pain was similar to that of TENS, with a SMD of 1.924. The overall effect estimate of insoles on pain was a SMD of 0.992. The overall effect of bracing showed a significant reduction in pain of 1.34. Overall, all four non-operative modalities of treatment were found to have a significant effect on the reduction of pain in OA of the knee. This study shows that non-operative physical modalities of treatment are of benefit when treating OA of the knee. However, much of the literature reviewed evaluates studies with follow-up of less than six months: future work should aim to evaluate patients with longer follow-up. Cite this article: Bone Joint J 2016;98-B(1 Suppl A):89–94.
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Knee pain
Bracing
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Introduction
Osteoarthritis (OA) is the most common chronic degenerative joint disorder and is characterized by increasing joint pain, stiffness and limitations of range of motion (ROM). In order to reduce pain and disability by OA knee, the physical exercises with mobilization were tailored by physiotherapists to the knee osteoarthritis patients. Most of the patients do not receive any form of physical therapy prior to the total knee replacement but it is important to take. OA is the second most common degenerative problem and it is the most frequent joint disease with a prevalence of 22%-39% in India. It is more common in women than men.
Methodology
A patient with osteoarthritis was selected for this case study suffering from pain and knee dysfunction who met all the criteria for inclusion. The CARE guidelines were followed during the whole duration of this study. To evaluate the results, total five outcome measures were used. It has been included that Knee injury and Osteoarthritis Outcome Score, WOMAC scale, NPRS, ROM, and muscle strength. The measures would be taken before and after the end of treatment.
Results
There was significant improvement in the patient’s condition after the treatment. The scores in the outcome measures used showed significant improvement when the scores were assessed initially and later. Even the quality of life of the patient also improved.
Conclusion
The Multimodal therapy which included combine use of electrotherapy, manual therapy, Exercise therapy have significant impact on the knee osteoarthritis patients. Patient was able to do their activities with few symptoms.
WOMAC
Manual therapy
Electrotherapy
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Background/Purpose: - Knee osteoarthritis (OA) is the most commonly diagnosed form of arthritis in older adult. The purpose of this case study is to describe a conservative physical therapy and manual therapy approach towards alleviation symptomatic knee OA pain and achievement of functional outcomes. Case description: The patient was 52 years old female with complain of anterio-medial knee pain with a complex medical history. The patient goal for physical therapy and some manual therapy approach were to return to functional activities such as walking greater than 60 minutes and climbing stair pain free. Outcome:- upon completion of physical therapy and manual therapy the patient demonstrated slight increase in both flexion range of motion that were within functional limits, improvement in knee strength and improvement in the six minute walk test(6 MWT). and independence completing in home exercise program (HEP). Discussion: - these cases reports have shown how conservative physical therapy and manual therapy treatment through the application of various interventions may be used to rehabilitate symptomatic arthritis knee pain in 52 years old female. This was demonstrated by improvement of active range motion (AROM), muscle strength and the 6MWT allowing with decreased reports of symptomatic knee pain
Manual therapy
Knee pain
Conservative Management
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