A comparison of the effects of hi̇lt and ultrasound , short-wave diathermy on pain and functionality in knee osteoarthritis

Osteoarthritis is a common mediacal problen in populations by increasing age due to the developments in the treatment of cronic diseases. Osteoarthritis is the most common joint disorder and is one of the most important causes of disability with advancing age. It emerges on synovial, diarthrodial and especially load-carrying joints progressively and most often affects knee joints. Symptoms seen in patients with osteoarthritis are pain, fatigue, morning stiffness and limitation of motion. In terms of activities; mobility and self-care activities are limited and in the context of participation; social and occupational roles may be restricted. All of these problems associated with the disease and the involvement of activities and participation adversely affect patients' quality of life. Both systemic and local risk factors play role in development of osteoarthritis. Age, female gender, overweight, sport injury, repetetive use of joints, muscle weakness and joint laxity are risk factors which play roles in the development of osteoarthritis. Modifiying these risk factors may reduce the risk of osteoarthritis and prevent pain and disability. The number of people affected with symptomatic osteoarthritis is likely to increase due to the aging of the population and the increase in obesity. The diagnosis and follow-up of osteoarthritis is mostly performed by clinical findings and imaging modalities. Treatment of osteoarthritis consists of a combination of non-pharmacological and pharmacological approaches. According to guidelines, purposes of the current therapies for osteoarthritis (OA) are pain relief and reduction of secondary functional disability. During knee OA therapy medications, physical therapy modalities, exercises and surgical procedures are used. Exercise therapy is widely used for lower-limb and hand osteoarthritis to improve joint range of motion, muscle strength, aerobic performance and proprioception.the physical therapy agents including thermotherapy, laser and electrotherapeutic approaches are widely used in the treatmen of osteoarthritis. This study aimed evaluate the physical functional state of people with vi knee osteoarthritis and to investigate and compare the theurapeutic effects of physical agents ultrasound , short-wave diathermy, and HİLT on pain and physical function. Ultrasound is defined as sound with a frequency of greater than 20 000 Hz, and has a variety of thermal or nonthermal physiologic effects. Ultrasound stimulates the tissue repair, increases the extensibilty of collagen fibers and modulates the pain. Shortwave diathermy are physical therapy modalities that provide deep heating via conversion of electromagnetic energy to thermal energy. It has been used for therapeutic purposes for musculoskeletal disorders for many years. Laser therapy has analgesic, tissue healing, ligament repair, fibroblast proliferation, biostimulant effects and antiinflammatory effects. Therefore in recent years, laser treatment is used in many painful conditions. However, the results are controversial. Non-invasive and non-thermal laser therapy has negligible side effects. Laser therapy may be an effective therapy option when patients used in accordance with the appropriate disease. In study, those patients with KellgrenLawrence stage 2-3, who referred to Physical Therapy and Rehabilitation Department of Medical Faculty Hospital, Abant İzzet Baysal University and received the diagnose of "Primary Knee Osteoarthritis" according to American College of Rheumatology (ACR) criteria were enrolled. It was planned as a prospective and randomized. Patients to receive 2-week physical therapy and rehabilitation program were divided into 3 groups. Group 1 Ultrasound therapy group 2 Shortwave diathermy therapy and Group 3 HİLT therapy. Patients have been provided Ultrasound Shortwave diathermy and laser therapy for two weeks (5 days a week, a total of 10 sessions).Patients were evaluated before and immediately after treatment. All patients were evaluated with respect to pain (VAS) and Western Ontario and Mc Master Universities (WOMAC) Osteoarthritis Index. Statistically significant improvements were indicated in many parameters such as pain (evaluated with VAS) and function (evaluated with WOMAC) in the posttherapy period (at the second week) compared to pre-therapy in both Ultrasound Shortwave diathermy and laser groups. On the other hand there were no statistically significant difference between 3 therapy group. In conclusion, the results of this study indicate that treatment with us kdd hilt therapy a significant reduction in pain and improvement in function in patients with knee osteoarthritis (OA). For these interventions, further investigation will be necessary to define their place in the management of osteoarthritis. Key words: high power laser therapy, knee osteoarthritis, pain, WOMAC