Post on 21-Mar-2022
EVALUATION OF THE EFFECTS OF CAPACITIVE AND RESISTIVE DIATHERMY ON KNEE OSTEOARTHRITIS
Gianpaolo Ronconi, Alessandro Specchia, Loredana Maggi, Alessia Rabini, Paola Emilia Ferrara, Eugenia Amabile, Diana Barbara Piazzini, Carlo Bertolini
A. Gemelli” University Hospital– Catholic University of the Sacred Heart – Rome
Materials and methods From November 2010 we are carrying on a single-center study on the effectiveness of diathermy in the treatment of knee OA. We recruited 56 patients aged
between 43 and 85 years. We randomily assigned all recruited patients into two groups. The first group of patients were treated with diathermy on a daily
basis, Monday through Friday, for a total of 10 sessions with a total duration of the treatment course of two weeks. Each session had the total duration of 20
minutes. The patients of the second group underwent a cycle of 6 sessions of treatment on alternate days for a total duration of the treatment of two weeks. Each
session has had the total duration of 20 minutes. The treatment was performed by setting the machine in a “free" modality, letting the therapist to operate in total
autonomy of power. Patients were evaluated before (T0), at the end (T1) and after one month (T2) after treatment, by assessment of joint ROM and muscle
strength (BMRC) and administration of rating scales (VAS, KOOS , WOMAC and DI).
Introduction Osteoarthritis (OA) is the most common chronic degenerative disease of the knee in older age.
In the international guidelines the conservative treatment of knee OA is becoming
increasingly important. Recently it has been introduced in the field of physical
therapy in Rehabilitation Medicine diathermy therapy (Resistive Capacitive Energy Transfer), which
is a therapy based on energy and heat transfer. It is a technique that stimulates energy production
from biological tissues, reactivating the cellular metabolism and natural anti-
inflammatory and reparative processes.
Bibliografia 1. Benizet M.P., Colmer J.F.,”Tecarterapia®nella patologia del ginocchio e della colonna vertebrale” Centro di Medicina Omeopatica e Biologica, Barcellona. 2. Parolo E, Onesta MP. “Ipertermia a transferimento energetico resistivo e capacitivo nel trattamento di lesioni muscolo-scheletriche acute e croniche”. La Riabilitazione 1998. 3. Marchese D. e altri, “Valutazione dell’efficacia del trattamento energetico capacitivo e resistivo nella sindrome del piriforme: prime esperienze” EUR MED PHYS, Vol. 44 - Suppl. 1 to No. 3,2008. 4. Brotzman S.B, Wilk K.E. “La riabilitazione in ortopedia” II Ed. Excerpta Medica Italia Srl, 2004.
Conclusions Our study confirmed the positive effects of Diathermy in the treatment of knee OA, as observed in various studies. We also could say that the 6 sessions protocol can be preferable to the 10 sessions protocol as it leads to similar results, but it has the advantage to use
a reduced amount of costs and energy. Another important and encouraging tip is that we observed a great compliance of patients with respect to the therapy and its immeadiate effectiveness, bringing it among the fast-therapies.
Moreover, the diathermy machine is operator-dependent, so it is important to emphasize the role of the therapist in the treatment, as it has the possibility to adjust the parameters during each session depending on the tissue responses and the feelings reported by the
patient.
Results
We observed a general upward trend throughout the sample. In most of the
evaluated items, we observed a slightly increased efficacy in the
“6 sessions” group, compared to the “10 sessions” group.
We observed a general improvement both in “motion” VAS and ” at
rest” VAS. This finding was partially confirmed by the analysis of the KOOS
domains (pain, ADL, quality of life) but not in the domain "symptoms" (where
the treatment was more effective than 10 sessions). This trend is also
confirmed by the WOMAC Osteoarthritis INDEX scale. In fact, among the
three domains composing the scale (pain, stiffness and ADL) only the
stiffness domain demonstrates an advantage of the 10 sessions
protocol. The study of motion and muscle strength confirms the
recovery of function observed in the other scales, particularly it is
interesting to note that in the 10 sessions protocol there is an
improvement after one month from the end of treatment. this allows us to
state that these subjects have acquired greater stability and security, and
feel less pain. The trend of general improvement is confirmed by the
analysis of the "Deambulation Index“ scale. The trend towards
improvement in deambulation was also confirmed not only at the end of
treatment but also in the evaluation after one month.
31,91
33,5619,04
13,9417,6113,68
0
10
20
30
40
50
60
pu
nte
gg
io
T0 T1 T2
tempo
WOMAC ADL
10 SEDUTE
6 SEDUTE
WOMAC ADL
10 SESSIONS
6 SESSIONS
TIME
3,914,38
2,002,06
1,962,06
0
1
2
3
4
5
6
7
8
pu
nte
gg
io
T0 T1 T2
tempo
WOMAC RIGIDITA'
10 SEDUTE
6 SEDUTE
WOMAC STIFFNESS
10 SESSIONS
6 SESSIONS
TIME
5,96 6,47 6,26 6,56 6,22 6,71
1
2
3
4
5
6
7
pu
nte
gg
io
T0 T1 T2
tempo
DEAMBULATION INDEX
10 SEDUTE
6 SEDUTE
DEAMBULATION INDEX
10 SESSIONS
6 SESSIONS
TIME
9,39
9,12
5,484,09
5,094,00
0
2
46
8
10
12
14
1618
20
pu
nte
gg
io
T0 T1 T2
tempo
WOMAC DOLORE
10 SEDUTE
6 SEDUTE
WOMAC PAIN
10 SESSIONS
6 SESSIONS
TIME
6,65
7,15
2,87
2,62
2,74
1,62
0
1
2
3
4
5
6
7
8
9
10
pu
nte
gg
io
T0 T1 T2
tempo
VAS MOVIMENTO
10 SEDUTE
6 SEDUTE
10 SESSIONS
6 SESSIONS
VAS MOTION
TIME