1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.
References
[1]
Shamsii M., Safari, A., Soroush, A. and Safari, Y. (2021) The Survey of Knee Osteoarthritis in the Population over Age 50 Visited in the Health Bus in Kermanshah, Iran. Journal of Aging Research, 2021, Article ID: 9809565. https://doi.org/10.1155/2021/9809565
[2]
Musumeci, G., Aiello, F., Szychlinska, M., Di Rosa, M., Castrogiovanni, P. and Mobasheri, A. (2015) Osteoarthritis in the Xxist Century: Risk Factors and Behaviours That Influence Disease Onset and Progression. International Journal of Molecular Sciences, 16, 6093-6112. https://doi.org/10.3390/ijms16036093
[3]
Johnston, S.A. (1997) Osteoarthritis: Joint Anatomy, Physiology, and Pathobiology. Veterinary Clinics of North America: Small Animal Practice, 27, 699-723. https://doi.org/10.1016/s0195-5616(97)50076-3
[4]
Roemer, F.W., Eckstein, F., Hayashi, D. and Guermazi, A. (2014) The Role of Imaging in Osteoarthritis. Best Practice & Research Clinical Rheumatology, 28, 31-60. https://doi.org/10.1016/j.berh.2014.02.002
[5]
Kucukguven, A. and A. Khalil, R. (2013) Matrix Metalloproteinases as Potential Targets in the Venous Dilation Associated with Varicose Veins. Current Drug Targets, 14, 287-324. https://doi.org/10.2174/138945013804998972
[6]
Felson, D.T., Chaisson, C.E., Hill, C.L., Totterman, S.M.S., Gale, M.E., Skinner, K.M., et al. (2001) The Association of Bone Marrow Lesions with Pain in Knee Osteoarthritis. Annals of Internal Medicine, 134, 541-549. https://doi.org/10.7326/0003-4819-134-7-200104030-00007
[7]
Miranda, V.S., deCarvalho, V.B., Machado, L.A. and Dias, J.M.D. (2012) Prevalence of Chronic Musculoskeletal Disorders in Elderly Brazilians: A Systematic Review of the Literature. BMC Musculoskeletal Disorders, 13, Article No. 82. https://doi.org/10.1186/1471-2474-13-82
[8]
Carovac, A., Smajlovic, F. and Junuzovic, D. (2011) Application of Ultrasound in Medicine. Acta Informatica Medica, 19, 168-171. https://doi.org/10.5455/aim.2011.19.168-171
[9]
Kingwill, A., Barker, G. and Wong, A. (2017) Point-of-Care Ultrasound: Its Growing Application in Hospital Medicine. British Journal of Hospital Medicine, 78, 492-496. https://doi.org/10.12968/hmed.2017.78.9.492
[10]
Mason, T.J. (2011) Therapeutic Ultrasound an Overview. Ultrasonics Sonochemistry, 18, 847-852. https://doi.org/10.1016/j.ultsonch.2011.01.004
[11]
Johns, L.D. (2002) Nonthermal Effects of Therapeutic Ultrasound: The Frequency Resonance Hypothesis. Journal of Athletic Training, 37, 293-299.
[12]
Rand, S.E., et al. (2007) The Physical Therapy Prescription. American Family Physician, 76, 1661-1666.
[13]
Muftic, M. and Miladinovic, K. (2013) Therapeutic Ultrasound and Pain in Degenerative Diseases of Musculoskeletal System. Acta Informatica Medica, 21, 170-172. https://doi.org/10.5455/aim.2013.21.170-172
[14]
Zeng, C., Li, H., Yang, T., Deng, Z.-., Yang, Y., Zhang, Y., et al. (2014) Effectiveness of Continuous and Pulsed Ultrasound for the Management of Knee Osteoarthritis: A Systematic Review and Network Meta-Analysis. Osteoarthritis and Cartilage, 22, 1090-1099. https://doi.org/10.1016/j.joca.2014.06.028
[15]
Zhang, C., et al. (2019) Effect of Ultrasound Therapy for Knee Osteoarthritis: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Clinical Trials. International Journal of Clinical and Experimental Medicine, 9, 30552-20561.
[16]
Watson, T. (2008) Ultrasound in Contemporary Physiotherapy Practice. Ultrasonics, 48, 321-329. https://doi.org/10.1016/j.ultras.2008.02.004
[17]
Draper, D.O., Klyve, D., Ortiz, R. and Best, T.M. (2018) Effect of Low-Intensity Long-Duration Ultrasound on the Symptomatic Relief of Knee Osteoarthritis: A Randomized, Placebo-Controlled Double-Blind Study. Journal of Orthopaedic Surgery and Research, 13, Article No. 257. https://doi.org/10.1186/s13018-018-0965-0
[18]
World Medical Association (2013) World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. JAMA, 310, 2191-2194.
[19]
Dixon, J.R. (1999) The International Conference on Harmonization Good Clinical Practice Guideline. Quality Assurance, 6, 65-74. https://doi.org/10.1080/105294199277860
[20]
Özgönenel, L., Aytekin, E. and Durmuşoǧlu, G. (2009) A Double-Blind Trial of Clinical Effects of Therapeutic Ultrasound in Knee Osteoarthritis. Ultrasound in Medicine & Biology, 35, 44-49. https://doi.org/10.1016/j.ultrasmedbio.2008.07.009
[21]
Tok, F., Aydemir, K., Peker, F., Safaz, İ., Taşkaynatan, M.A. and Özgül, A. (2009) The Effects of Electrical Stimulation Combined with Continuous Passive Motion versus Isometric Exercise on Symptoms, Functional Capacity, Quality of Life and Balance in Knee Osteoarthritis: Randomized Clinical Trial. Rheumatology International, 31, 177-181. https://doi.org/10.1007/s00296-009-1263-2
[22]
Fibel, K.H. (2015) State-of-the-Art Management of Knee Osteoarthritis. World Journal of Clinical Cases, 3, 89-101. https://doi.org/10.12998/wjcc.v3.i2.89
[23]
Zhang, C., Xie, Y., Luo, X., Ji, Q., Lu, C., He, C., et al. (2016) Effects of Therapeutic Ultrasound on Pain, Physical Functions and Safety Outcomes in Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis. Clinical Rehabilitation, 30, 960-971. https://doi.org/10.1177/0269215515609415
[24]
Rosemffet, M.G., Schneeberger, E.E., Citera, G., Sgobba, M.E., Laiz, C., Schmulevich, H., et al. (2004) Effects of Functional Electrostimulation on Pain, Muscular Strength, and Functional Capacity in Patients with Osteoarthritis of the Knee. JCR: Journal of Clinical Rheumatology, 10, 246-249. https://doi.org/10.1097/01.rhu.0000141831.40350.91
[25]
Cammarata, M.L. and Dhaher, Y.Y. (2012) Associations between Frontal Plane Joint Stiffness and Proprioceptive Acuity in Knee Osteoarthritis. Arthritis Care & Research, 64, 735-743. https://doi.org/10.1002/acr.21589
[26]
Elbaz, A., Debbi, E.M., Segal, G., Haim, A., Halperin, N., Agar, G., et al. (2011) Sex and Body Mass Index Correlate with Western Ontario and Mcmaster Universities Osteoarthritis Index and Quality of Life Scores in Knee Osteoarthritis. Archives of Physical Medicine and Rehabilitation, 92, 1618-1623. https://doi.org/10.1016/j.apmr.2011.05.009
[27]
Thorlund, J.B., Aagaard, P. and Roos, E.M. (2011) Muscle Strength and Functional Performance in Patients at High Risk of Knee Osteoarthritis: A Follow-Up Study. Knee Surgery, Sports Traumatology, Arthroscopy, 20, 1110-1117. https://doi.org/10.1007/s00167-011-1719-2
[28]
Qing, W., Shi, X., Zhang, Q., Peng, L., He, C. and Wei, Q. (2021) Effect of Therapeutic Ultrasound for Neck Pain: A Systematic Review and Meta-Analysis. Archives of Physical Medicine and Rehabilitation, 102, 2219-2230. https://doi.org/10.1016/j.apmr.2021.02.009
[29]
Fransen, M., McConnell, S. and Bell, M.M. (2001) Exercise for Osteoarthritis of the Hip or Knee. Cochrane Database of Systematic Reviews, No. 2, CD004376. https://doi.org/10.1002/14651858.CD004376
[30]
Ratnasabapathy, Y., et al. (2003) Blood Pressure Lowering Interventions for Preventing Dementia in Patients with Cerebrovascular Disease (Protocol). Cochrane Database of Systematic Reviews, No. 4, CD004034. https://doi.org/10.1002/14651858.CD004130
[31]
Cubukcu, D., Sarsan, A. and Alkan, H. (2012) Relationships between Pain, Function and Radiographic Findings in Osteoarthritis of the Knee: A Cross-Sectional Study. Arthritis, 2012, Article ID: 984060. https://doi.org/10.1155/2012/984060
[32]
Richmond, J., Hunter, D., Irrgang, J., Jones, M.H., Snyder-Mackler, L., Van Durme, D., et al. (2010) American Academy of Orthopaedic Surgeons Clinical Practice Guideline on the Treatment of Osteoarthritis (OA) of the Knee. The Journal of Bone and Joint Surgery-American Volume, 92, 990-993. https://doi.org/10.2106/jbjs.i.00982
[33]
Rannou, F. and Poiraudeau, S. (2010) Non-Pharmacological Approaches for the Treatment of Osteoarthritis. Best Practice & Research Clinical Rheumatology, 24, 93-106. https://doi.org/10.1016/j.berh.2009.08.013
[34]
Song, J., Hochberg, M.C., Chang, R.W., Hootman, J.M., Manheim, L.M., Lee, J., et al. (2013) Racial and Ethnic Differences in Physical Activity Guidelines Attainment among People at High Risk of or Having Knee Osteoarthritis. Arthritis Care & Research, 65, 195-202. https://doi.org/10.1002/acr.21803
[35]
Cisternas, M.G., Yelin, E., Katz, J.N., Solomon, D.H., Wright, E.A. and Losina, E. (2009) Ambulatory Visit Utilization in a National, Population-Based Sample of Adults with Osteoarthritis. Arthritis Care & Research, 61, 1694-1703. https://doi.org/10.1002/art.24897
