Journal Article

Efficacy and Safety of a Stimulator Using Low-Intensity Pulsed Ultrasound Combined with Transcutaneous Electrical Nerve Stimulation in Patients with Painful Knee Osteoarthritis

Park, Sung-Hee, Won, Yu Hui, Kim, Eu-Deum, Kim, Da-Sol, Kim, Gi-Wook, Seo, Jeon-Hwan, Ko, Myoug-Hwan

2019

Overview

Objective. Studies regarding the combination of ultrasound and transcutaneous electrical nerve stimulation (TENS) are rarely reported. In this study, we aimed to elucidate the efficacy and safety of a stimulator using low-intensity pulsed ultrasound (LIPUS) combined with TENS in patients with painful knee osteoarthritis (OA). We evaluated the effectiveness of this therapy against pain, physical function, and cartilage regeneration. Moreover, we aim to prove the superiority of the effects of LIPUS combined with TENS therapy compared with only TENS therapy. Methods. Of the 40 included patients, aged 45–85 years with painful knee OA, 20 patients received only TENS therapy and 20 patients received LIPUS combined with TENS therapy for 8 weeks (a total of more than 80 treatment sessions). We evaluated visual analogue scale (VAS), Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, MOS 36-Item Short-Form Health Survey (SF-36), and femoral articular cartilage (FAC) thickness. The evaluation was performed at three visits: visit 1 (V1, pretreatment, within 28 days after screening), visit 2 (V2, posttreatment period 1, ±3 days after treatment), and visit 3 (V3, posttreatment period 2, 21 ± 3 days after treatment). Results. We expected that LIPUS combined with TENS therapy would be superior to only TENS therapy. However, there was no significant difference between the two therapies. In the within-group comparison, both treatments (only TENS therapy and LIPUS with TENS therapy) demonstrated statistical differences from baseline values for pain and physical function outcomes. FAC thickness showed no significant differences after treatment in both groups. Conclusion. The effects of a stimulator using LIPUS with TENS on pain relief and functional improvement were not superior to the only TENS therapy. Cartilage regeneration, which was expected as an additional benefit of LIPUS, was also not significantly evident. Therefore, further investigation is warranted to determine whether the combination therapy is beneficial. This trial is registered with KCT0003883.

• Publisher: Hindawi Publishing Corporation,Hindawi,John Wiley & Sons, Inc,Hindawi Limited,Wiley
• Subject: Aged / Aged, 80 and over / Arthritis / Care and treatment / Clinical Study / Combined Modality Therapy - adverse effects / Combined Modality Therapy - methods / Comparative analysis / Family medical history / Female / Humans / Knee / Male / Medicine / Middle Aged / Nonsteroidal anti-inflammatory drugs / Ontario / Osteoarthritis / Osteoarthritis, Knee - therapy / Pain / Pain management / Pain Management - methods / Physical therapy / Rehabilitation / Single-Blind Method / Statistical analysis / Systematic review / Transcutaneous Electric Nerve Stimulation - adverse effects / Transcutaneous Electric Nerve Stimulation - methods / Transcutaneous electrical nerve stimulation-TENS / Treatment Outcome / Ultrasonic imaging / Ultrasonic Therapy - adverse effects / Ultrasonic Therapy - methods / Ultrasonic Waves - adverse effects / Wound healing