Isokinetic knee osteoarthritis exercise, laser application, iontophoresis, and effectiveness of treatment modalities pseudoiontophoresis

ABSTRACTThe aim of our study is to examine the effects of isokinetic exercise, low-level laser, diclofenac iontophoresis and pseudoiontophoresis methods in the treatment of patients with knee osteoarthritis, and to compare these effects with each other.In our study, we used VAS, Lequense and WOMAC indexes. We investigated the effects of those on pain, stiffness, physical functions, daily living activities, and walking distances.The study was conducted in 320 knees of 160 patients diagnosed with knee osteoarthritis. Patients were randomly divided into four equal groups. In first group we applied an isokinetic exercise programme consisting of 18 sessions which are executed 3 times per week for 6 weeks. Diclofenac gel application via iontophoresis for 18 sessions with the same interval for 6 weeks conducted in second group; and laser therapy by diode laser at equal doses and at equal periods of time applied at identified 8 different points around knee with 3 times per weeks for 6 weeks in third group. In fourth (control) group, diclofenac gel was applied with switched off iontophoresis device for the same interval and duration of time as the other groups.As a result of our study, a decline in all scores of all four groups of patients is obtained when compared to baseline levels. After comparing the scores among the groups, we found that the most effective method was isokinetic exercise, while the less effective one was pseudoiontophoresis. The treatments of diclofenac iontophoresis with the laser provided significant superiority in all scores except stiffness when compared to pseudoiontophoresis. When iontophoresis group was compared with the laser group, we found that laser group was superior to diclofenac iontophoresis in all scores, even this difference is statistically insignificant. While the most effective method was isokinetic exercise in WOMAC stiffness score, there was no significant difference between laser, iontophoresis, and pseudoiontophoresis methods regarding the same parameters.As a result, these treatment modalities of all four groups were effective. Isokinetic exercises being the best modality of our study, the laser and iontophoresis methods were more effective and superior than pseudoiontophoresis in symptoms of knee osteoarthritis.KEY WORDS, Primary knee osteoarthritis, isokinetic exercise, laser, iontophoresis, pseudoiontophoresis