Ultrasound for Osteo-arthritis of the Knee

Ultrasound with mineral water or aqua gel to reduce pain and improve the WOMAC of knee osteoarthritis

AIMS

Osteoarthritis is the most degenerative joint disease. The aim was to investigate the effects of ultrasound using mineral water or aqua sonic gel on severity of knee pain, measured by the visual analog scale and the Western Ontario and McMaster Universities Arthritis Index (WOMAC).

MATERIALS AND METHODS

Thirty women with bilateral osteoarthritis of the knee were assigned to two groups: ultrasound with mineral water (group 1, n = 15) or with aqua sonic gel (group 2, n = 15). Both groups underwent 4 weeks intervention, three per week. The participants were assessed using the visual analog scale and the WOMAC. Tests were performed before and after interventions.

RESULTS

Both groups had significantly reduced pain and improved WOMAC compared with preintervention values.

DISCUSSION

The ultrasound with mineral water group had more pronounced improvement at p-value < 0.001.

CONCLUSION

Ultrasound with mineral water is preferable in treatment of knee OA.

Experimental Verification of Modeled Thermal Distribution Produced by a Piston Source in Physiotherapy Ultrasound

Objectives. To present a quantitative comparison of thermal patterns produced by the piston-in-a-baffle approach with those generated by a physiotherapy ultrasonic device and to show the dependency among thermal patterns and acoustic intensity distributions. Methods. The finite element (FE) method was used to model an ideal acoustic field and the produced thermal pattern to be compared with the experimental acoustic and temperature distributions produced by a real ultrasonic applicator. A thermal model using the measured acoustic profile as input is also presented for comparison. Temperature measurements were carried out with thermocouples inserted in muscle phantom. The insertion place of thermocouples was monitored with ultrasound imaging. Results. Modeled and measured thermal profiles were compared within the first 10 cm of depth. The ideal acoustic field did not adequately represent the measured field having different temperature profiles (errors 10% to 20%). Experimental field was concentrated near the transducer producing a region with higher temperatures, while the modeled ideal temperature was linearly distributed along the depth. The error was reduced to 7% when introducing the measured acoustic field as the input variable in the FE temperature modeling. Conclusions. Temperature distributions are strongly related to the acoustic field distributions.

Comparing different physical factors on serum TNF-α levels, chondrocyte apoptosis, caspase-3 and caspase-8 expression in osteoarthritis of the knee in rabbits

OBJECTIVE

To study the therapeutic effects that different physical factors may have on rabbits with osteoarthritis of the knee.

METHODS

A total of 64 rabbits were randomised and organised into eight groups, eight of which were each assigned a different physical factor, in which the rabbits received one type of physical therapy: millimetre waves for 20 min, pulsed electromagnetic fields, millimetre waves for 40 min, ultrasound, low-level laser therapy or ultrashort wave diathermy. The two remaining groups, the normal group and the model group, served as controls. The efficacy of the different treatments were determined by observing the configuration and structure of the cartilaginous tissue by haematoxylin and Eosin staining, measuring the serum tumour necrosis factor-α levels by enzyme immunoassay, evaluating the expression levels of caspases-3 and -8 by immunohistochemistry, and calculating the ratio of chondrocytes apoptosis by TdT-mediated dUTP nick end labelling. The values obtained for each assessment of the eight groups were analysed by a One-way ANOVA.

RESULTS

By applying upmentioned physical treatments, the organisational configuration and structure of cartilage cells from the knees of rabbits with osteoarthritis increased. These treatments also decreased serum tumour necrosis factor-α levels, reduced the expression of caspase-3 and caspase-8 and reduced chondrocyte apoptosis, resulting in an overall delay in osteoarthritis development.

CONCLUSION

The application of pulsed electromagnetic fields, millimetre waves for 40 min, ultrasound, or low-level laser therapy had significant effects in improving osteoarthritis; in particular, treatment with pulsed electromagnetic fields or ultrasound yielded the greatest therapeutic effect.

Efeitos do ultrassom terapêutico em modelo experimental de ciatalgia

A ciática possui grande prevalência geral e seu tratamento tende a resolver as causas de compressão nervosa. A fisioterapia objetiva reduzir os sintomas causados pela compressão. O presente estudo teve como objetivo avaliar a eficácia do ultrassom terapêutico sobre a dor, em animais submetidos a modelo experimental de ciatalgia. Foram usados 18 ratos neste estudo, divididos em três grupos: GS (n = 4), submetido a modelo de ciatalgia e tratados com ultrassom desligado; GUP (n = 7), submetido à ciatalgia e tratados com ultrassom pulsado 2W/cm² (SATP; 0,4 - SATA); e grupo GUC (n = 7), submetido à ciática e ultrassom contínuo (0,4W/cm²). O nervo ciático do membro posterior direito foi exposto à compressão com fio categute em quatro pontos. No 3º dia pós-operatório (PO), iniciou-se tratamento indireto por quatro dias. No 9º dia PO, o tratamento direto começou sobre a área do procedimento cirúrgico, por cinco dias consecutivos. O tempo de elevação da pata, durante a marcha, foi avaliado antes e após a ciatalgia, no 3º, 6º, 9º e 13º PO. Os resultados demonstraram que a aplicação do ultrassom reduziu a dor com ambos os tratamentos efetivos e tendeu a ser mais eficaz na forma pulsada.