Comparison of the therapeutic efficacy of phonophoresis and iontophoresis using dexamethasone sodium phosphate in the management of patients with knee osteoarthritis.
OBJECTIVE
Many treatment options, including non-pharmacological and pharmacological measures, have been recommended in the management of osteoarthritis (OA). Among the non-pharmacological approach is physiotherapy, which involves the use of physical modalities like, heat therapy, exercise therapy, electrical stimulation, therapeutic ultrasound, iontophoresis, and phonophoresis. This study was therefore designed to compare the effectiveness of 0.4% Dexamethasone sodium phosphate (DEX-P) phonophoresis (PH) with 0.4% DEX-P iontophoresis (ION) therapy in the management of patients with knee joint OA.


METHODS
Fifty patients (19 males and 31 females) with a mean age of 53.6 +/- 8.9 years were randomly assigned to PH or ION groups with 25 patients in each group. Ultrasound waves of 1 MHz frequency was applied for 5 minutes to the target knee, so also was the direct current for 10 minutes for 10 sessions treatment period. Western Ontario and McMaster University Osteoarthritis Index (WOMAC) scores, 20 meters ambulatory time, and knee range of motion (ROM) were evaluated before and after therapy as the outcome measures.


RESULTS
At the end of two weeks, significant improvement in total WOMAC scores was observed in 15 (60%) and 16 (64%) patients in the PH and ION groups respectively, indicating no significant difference in the improvement rate. Twenty (20) metres ambulatory time and knee range of motion also improved significantly in both groups, yet these variables showed no significant difference between the two groups.


CONCLUSIONS
Both therapeutic modalities were found to be effective and generally well tolerated after 10 treatment sessions. DEX-P phonophoresis was not superior to DEX-P iontophoresis in the treatment of patients with OA of the knee.
Akinbo
S R A
SR
Department of Physiotherapy, College of Medicine University of Lagos. sonnyakinbo@yahoo.com
Aiyejusunle
C B
CB
Akinyemi
O A K
OA
Adesegun
S A
SA
Danesi
M A
MA
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007478:Iontophoresis; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000628:therapy*; D015612:Phonophoresis; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; C004180:dexamethasone 21-phosphate; D003907:Dexamethasone