Comparison of isokinetic exercise with isookinetic exercise and pulsed ultrasound therapy in patients with knee osteoarthritis

Osteoarthritis is a degeneratif joint disease, characterized by erosions of articular cartilage, reactive new bone formation at joint surface, subcondral sclerosis and morphologic and biochemical changes of sinovial membrane and joint capsule. Osteoarthritis is a common disease associated with significant morbidity, and its prevalence increases with age. Knee osteoarthritis result in disability more than other joint osteoarthritis.The purpose of this study is to investigate the effects of ultrasound in isokinetic muscle strengthening exercise programs on functional status and symptoms of patients with knee osteoarthritis. Fourty-four patients with bilateral knee osteoarthritis were included in the study. Patients were randomly assigned to two groups. Group I recieved isokinetic exercise and placebo ultrasound, group II recieved isokinetic exercise and pulsed ultrasound treatment (1 MHZ, 1.5 W/cm², 1:5) for both sides three times weekly for six weeks, totally 18 sessions.The patients in each treated group evaluated by visual analog scale, isokinetic and isometric extensor and fleksor muscle peak torques, Western Ontorio McMaster Osteoarthritis Index (WOMAC), active knee range of motion (ROM), ambulation activity, quality of life index Short Form-36 (SF-36) before the treatment, after the treatment and at 3. month follow up.Each treated group had, the pain significantly reduced and range of motion significantly increased after treatment and at 3. month follow up. No statistical significant difference was observed between two groups. Significant increase was noted in 60 °/s angular velocity extensor peak torques, 180 °/s angular velocity extensor and flexor peak torques and isometric extensor peak torques after treatment. Significant increase was observed in both groups when we compared peak torque values of before treatment and 3. month follow up, significant decrease was observed when we compared peak torque values of after treatment and at 3. month follow up. No statistical significant difference was observed betwen two groups. A statistical significant improvement in pain, stiffness and functionality sections of WOMAC was observed after treatment and at 3. month follow up. There was no statistical significant difference betwen two groups. Statistical significant improvement in ambulation activity was observed after treatment and at 3. month follow up. No statistical significant difference was observed betwen two groups. Statistical significant improvements in physical functioning, physical role, pain, general health, vitality, social function, emotional status and mental health sections of SF-36 were determined after treatment. Statistical significant improvement in pain, general health, vitality, social function and mental health sections of SF-36 continued in both groups at 3. month follow up. No statistical significant difference was observed betwen two groups after treatment and at 3. month follow up.In conclusion, isokinetic training is safe and efficient in the treatment of knee osteoarthritis. Also it has possitive effects on pain, function, muscle strenght and quality of life. In this study, pulsed ultrasound treatment showed no statistical significantly increase in effectiveness of isokinetic training for pain, ROM, muscle strenght, stiffness, function, ambulation and quality of life parameters in knee osteoarthritis.