Reduce Pain and Improve Quality of Life in Patient With Knee Osteoarthritis by Light, Sound and Brain Stimulation

Summary

Patients affected with osteoarthritis knee have associated with pain and inflammation of the joint capsule, impaired muscular stabilization, decrease range of motion and functional disability. Laser therapy, phonophoresis, transcranial direct current stimulation (tDCS) and conventional physiotherapy exercises has innumerable benefits to the patients with knee osteoarthritis (KOA).However, it is still not clear which treatment is effective among them in rehabilitating the patients with chronic knee osteoarthritis (KOA). Aim is to establish the benefits of High intensity Laser therapy, phonophoresis, tDCS and conventional physiotherapy in the treatment of patient with chronic KOA living in the hilly terrain. A total of 160 patients with chronic KOA will be recruited by the simple random sampling (random number generator) to participate in randomized, double blind randomized controlled, study. Recruited patients with chronic KOA will be randomly divided into four groups, high intensity-laser therapy (HILT) group, ibuprofen gel phonophoresis (IGP) group, transcranial direct current stimulation (tDCS) group and conventional physiotherapy (CPT) group. Duration of the treatment will be 8 minutes in one session/knee joint for HILT and IGP and 30 minutes in one session for tDCS each day for 3 days/week for 8 weeks. Thus, each patient with chronic KOA will receive 24 sessions in total. The Western Ontario and Mc Master Universities Osteoarthritis Index (WOMAC), Digitalized pain pressure algometer (ALGO-DS-01) and 36-Item Short Form Health Survey (SF-36) questionnaire are the outcome measures will be recorded at baseline, end of 8-week post-intervention period.

Conditions

• Knee Osteoarthritis

Interventions

OTHER

High Intensity LASER Therapy (HILT)

The total energy will be delivered to the patient during one session will be 1,250 J through three phases of treatment. 1. Initial phase (710 and 810 mJ (millijoule)/cm2 for a total of 500 J) 2. Intermediate phase (handpiece will be applied on the joint line just proximal to the medial and lateral tibial condyles with 25 J, a fluency of 610 mJ/cm2, and a time of 14 s for each point and a total of 250 J) 3. Final phase (same as the initial phase (500 J) except that scanning will be slow manual scanning ) The application time for all three phases will be approximately 15 min with the total energy delivered to the patient during one session of 1,250 J

OTHER

Ibuprofen Gel Phonophoresis (IGP)

Continuous ultrasound set at a frequency of 1 MHz and an intensity of 1 W/cm2 was applied on a circular basis. (8 min/ one session each day for 3 days/week for 8 weeks).

OTHER

Transcranial Direct Current Stimulation (tDCS)

Anode electrode -C3/C4 (contralateral side of the most affected knee), Cathode electrode- contralateral supraorbital area. (2 mA intensity for 20 minutes, one session/day for 3 days/week for 8 weeks)

OTHER

Conventional Physiotherapy (CPT)

1. Warm-up exercises: Walking at the usual speed on a flat surface for 10 min ( 3sets X10 Reps X 3 min rest in between) 2. Hamstring and calf gentle stretches. ( 3sets X10 Reps X 3 min rest in between) 3. Straight leg raise (SLR) ( 3sets X10 Reps X 3 min rest in between) 4. Quadriceps setting ( 3sets X10 Reps X 3 min rest in between) 5. Pillow squeeze ( 3sets X10 Reps X 3 min rest in between) 6. Heel raise ( 3sets X10 Reps X 3 min rest in between) 7. One leg balance ( 3sets X10 Reps X 3 min rest in between) 8. Step ups ( 3sets X10 Reps X 3 min rest in between) 9. Quadriceps strengthening exercises ( 3sets X10 Reps X 3 min rest in between)

Sponsors & Collaborators

• Maharishi Markendeswar University (Deemed to be University)

  collaborator OTHER

• Asir John Samuel

  lead OTHER

Principal Investigators

• Adarsh K Srivastav, MPT · Maharishi Markandeshwar Medical College and Hospital

• Asir J Samuel, MPT, Ph.D · Maharishi Markandeshwar Medical College and Hospital

• Vipin Saini, Ph.D · Maharishi Markandeshwar Medical College and Hospital

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

45 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2022-04-01

Primary Completion

2022-10-31

Completion

2023-08-02