AB1002 CLASSIC VERSUS AQUATIC REHABILITATION IN GONARTHROSIS: WOMAC SCORE

Abstract

BackgroundGonarthrosis is the most frequent and common condition of the lower limb, responsible for gonalgia, stiffness, leading sometimes to major functional impotence. The WOMAC with its three domains (pain, stiffness and function) is a valid index for the evaluation of lower limb osteoarthritis [1].The management of gonarthrosis is multidisciplinary with rehabilitation as the mainstay.Currently, aquatic gymnastics is more and more prescribed in the management of this pathology.ObjectivesThe objective of our work was to compare the contribution of aquatic rehabilitation to classical one in patients with gonarthrosis through the WOMAC score.MethodsThis is a prospective, comparative study conducted over a period of 15 months, between September 2016 and December 2017, including 120 patients recruited at the Physical Medicine and Functional Rehabilitation Department of The HMPIT, in whom the diagnosis of gonarthrosis was made according to the ACR criteria.The patients were randomly divided into 2 groups of 60 patients each. The first group, called G1, received a conventional rehabilitation program. The second group, called G2, received aquatic rehabilitation.Two evaluations were made, the first (T1) before the beginning of the rehabilitation and the second (T2) at the end of the eight weeks of treatment.ResultsThe average age of the general population was 54.85 ± 9.5 years [40- 81 years].The average age of G1 was 59.07 ± 10.2 years versus 50.63 ± 6.4 years for G2.Among the 120 patients, 28 were male (23%) and 92 were female(77%) There were 6 males and 54 females in group 1 versus 22 males and 38 females in group 2.Initially, the average WOMAC pain was 15.1 ± 3.9 in G1 and 12.3 ± 1.22 in G2.There was a statistically significant difference between the 2 groups (p=0.01). After rehabilitation, there was an improvement in the WOMAC pain score of 17% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).The average WOMAC score for stiffness was initially 5.1 ± 2 in G1 and 3.2 ± 2 in G2 with no statistically significant difference between the 2 groups (p=0.076).After rehabilitation, an improvement of this score was noted in both groups, it was 19% in G1 and 50% in G2 with a statistically significant difference between the 2 groups (p<0.001).The average initial WOMAC function score was 42.32 ±15.7 in G1 and 33 ± 11 in G2 with a statistically significant difference between the 2 groups (p=0.002).After conventional rehabilitation, this score had improved by 10% and after hydrotherapy, the improvement was 46% with a statistically significant difference between the 2 groups (p<0.001).ConclusionThese results were aligned with the literature and confirmed the effectiveness of functional treatment whether aquatic or classic with better outcome for aquatic rehabilitation. The best would be to combine the different methods according to the needs of the patient and their functional capacities in order to ensure a better adherence.