A Survey on the Effects of Iontophoresis of Piroxicam Gel on Pain and Knee Muscles Strengthn Patients with Knee Osteoarthritis

Abstract

Background and Aim: Knee osteoarthritis is the most common cause of disability in many societies. Therapeutic measures such as using anti-inflammation drugs and physiotherapy programs have been used to suppress knee pain and improve knee joint function in patients with knee osteoarthritis. The aim of this study was to compare the effects of iontophoresis of piroxicam gel, galvanic current with or without piroxicam gel on pain, functional ability and knee muscle strength in patients with knee osteoarthritis. Materials and Method: This study was a clinical trial conducted in Akhtar hospital. Forty two female patients (mean age 58.52 years old) with knee osteoarthritis participated in this study. The protocol was performed in Physiotherapy Clinic of Mazandaran Medical University, Mazandaran, Iran. All patients were randomly assigned to three groups. Iontophoresis of piroxicam gel was applied for group 1 (n=14), proxicam gel for group 2 (n=14) and galvanic current for group 3 (n=14). The procedure was carried out for 20-minutes, three times a week and for two following weeks. Knee pain and functional ability were estimated by knee injury and osteoarthritis outcome score (KOOS) questioner and the strength of knee extensor and flexor muscles by an isometric device just before the first treatment and immediately after the last treatment times. Results : A significant decrease in pain and a significant increase in functional ability and the strength of knee extensor muscles were resulted in all studied groups (P p) ولی نتایج حاصله نشان داد كه در بین سه گروه نيز اختلاف معنی داری آماری وجود داشت (01/0> P) و استفاده از یونتوفورزیس پیروکسیکام برای کاهش درد، بهبود عملکرد زانو از دیگر روش ها موثرتر بوده است. واژگان کلیدی یونتوفورزیس، ژل پیروکسیکام، درد، قدرت عضلات، استئوارتریت زانو [1] . Knee injury and Osteoarthritis Outcome Score 1. Nisha G, Nancy E. Osteoarthritis: Current Concepts in Diagnos and Managemen. AmFam physician. 2000; 61(6): 1795- 1804. 2. Banwell B.F, Gall V. Physical therapy management of arthritis. First Edition. New York: Churchill Living Stone, 1998; p 8-11. 3. David C, Lioyd J. Rheumatological physiotherapy. First Edition. London: Mosby, 1999; p 83-96. 4. Akinbo S.R , Aiyejusunle C.B , Akinyemi O.A , Adesegun S.A .Comparison of the therapeutic efficacy of phonophoresis and iontophoresis using dexamethasone sodium phosphate in the management of patients with knee osteoarthritis. Journal of Niger Postgrad Medicin e. 2007; 14(3): 190-194. 5. Rahimi A .The new of Osteoarthritis. First Edition.Tehran: Sarmadi, 1385: p 18-42. [in Persian] 6. Bijlsma J.W.J, Knahr K .Strategies for the prevention and management of osteoarthritis hip and knee. Best Practice & Research Clinical Rheumatology. 2007; 21(1 ): 59-76. 7. Kopec J, Mushfiqur R. Epidemiology of osteoarthritis in British. Journal of Rheumathology. 2007; 37(2): 386-393. 8. Armando M, Eduardo E .Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. The American Journal of Medicine . 1987; 83(5) : 72-77. 9. Gibson J. A. Survey of patients’ knowledge of gastrointestinal side-effects of NSAIDs in a rheumatology clinical. Quality in Primary Care . 2006; 14(2): 95-97. 10. Haynes S, Gemmell H .Topical treatments for osteoarthritis of the knee. Clinical Chiropractic . 2007; 10(3): 126-138. 11. Bakhtiary A. H. Principles and Practice of electrical current. First Edition. Samnan; Bakhtiary, 1381: 31- 45. [in Persian] 12. Curdy C, Yogeshvar K. Piroxicam delivery into human stratum corneum in vivo: iontophoresis versus passive diffusion. Journal of Controlled Release . 2001; 76 (1-2): 73-79. 13. Aiyejusunle C.B , Kola T.A , Ajiboye O.A . Comparison of the effects of tens and sodium salicylate iontophoresis in the management of osteoarthritis of the knee. Journal of Nig Q Hosp Medicin e. 2007; 17(1): 30-4. 14. Nelson R. Clinical Electrotherapy. Third edition .United States of America: Mary Ellen McCourt, 1999; p 116-117. 15. Fransen M, Crosbie J. Isometric Muscle Force Measurement for Clinicians Treating Patients With Osteoarthritis of the Knee . Journal of Arthritis & Rheumatism. 2003; 49(1): 29-31. 16. Cosignani F , Cossu M , Pancer E , Rega V , Conti B. Clinical study on effect of ketoprofen administered by iontophoresis. Riabilitazione . 1987; 20 (4): 269-273. 17. Baskurt F , Ozcan A , Algun C . Comparison of effects of phonophoresis and iontophoresis of naproxen in the treatment of lateral epicondylitis. Clinical Rehabilitation . 2003; 17(1): 96-100. 18. Hurley MV, Scott Dl . Rehabilitation reduces disability in patients with knee osteoarthritis . Journal Citations Anu Meet Int Soc Technol Assess Health Care, Int Soc Technol Assess Health Care Meet. 1999; 15: 153. 19. Fransen M , Crosbie J . Isometric Muscle Force Measurement for Clinicians Treating Patients With Osteoarthritis of the Knee . Journal of Arthritis & Rheumatism 2003 ; 49(1): 29-35.