Would the addition of voltaren emulgel to tens enhance its effectiveness of reducing OA knee pain?

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Would the addition of voltaren emulgel to tens enhance its effectiveness of reducing OA knee pain?

 

Author: Chan, Kin-lung
Title: Would the addition of voltaren emulgel to tens enhance its effectiveness of reducing OA knee pain?
Degree: M.Sc.
Year: 2007
Subject: Hong Kong Polytechnic University -- Dissertations.
Osteoarthritis -- Treatment.
Knee -- Wounds and injuries -- Treatment.
Department: Dept. of Rehabilitation Sciences
Pages: xiv, 131 leaves : ill. ; 31 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2090245
URI: http://theses.lib.polyu.edu.hk/handle/200/2472
Abstract: Transcutaneous electrical nerve stimulation (TENS) has been used for treatment of OA knee. Previous review done by Osiri et al. (2001) showed that TENS was more effective than placebo for relief of pain of OA knee. Accumulative effect of daily application of TENS was also reported by Cheing et al. (2002). For Voltaren Emulgel, previous study done by Bookman et al. (2004), Grace et al. (1999) and Roth et al. (2004) showed that symptoms of primary osteoarthritis of knee can be effectively treated by Voltaren Emulgel. This study was a double blinded, randomized controlled trial to investigate the relative effectiveness of TENS enhanced by addition of Voltaren Emulgel. Thirty-three subjects suffering from pain of OA knee were recruited and randomly allocated into two groups. Subjects in the TENS plus Voltaren group (n=17) received TENS (2 Hz, 200 us, modulated mode) plus Voltaren Emulgel on 4 acupuncture points. Subjects in the TENS plus placebo Voltaren (n=16) received TENS (2 Hz, 200 us, modulated mode) plus placebo Voltaren (electronic gel) on the same acupuncture points. The treatment duration was 40 minutes for both groups. The treatment frequency was three times per week for 3 weeks (9 sessions in total). Measurements were performed before intervention, after the first session, after the ninth session and at the 2-week follow-up session. The outcome measures included Visual Analogue Scale (VAS), pain limited range of OA knee, Timed up-and-go test (TUGT) and Western Ontario and McMaster Universities (WOMAC) Osteoarhtritis Index (WOMAC). Two way analysis of variance (ANOVA) was used to analyze the time effect and group effect on the outcomes. Our results indicated that there were trend of pain reductions, pain limited range of OA knee, TUGT and WOMAC in both TENS plus Voltaren and TENS plus placebo Voltaren (p=0.840, 0.109, 0.699 and 0.356 respectively). For the between-group differences, the data showed that TENS plus Voltaren group tends to produce greater VAS, TUGT and WOMAC reduction than TENS plus placebo Voltaren group after a single session and 9 sessions. In the 2-week follow-up, the carry over effect of TENS plus Voltaren group still have a greater VAS, TUGT and WOMAC reduction in trend than TENS plus placebo Voltaren group. However, there were no differences in VAS, TUGT and WOMAC between the two treatment groups. For the between-group differences of pain limited range of OA knee, there were no significant differences between-groups after session 1, session 9 and 2-week follow-up (p=0.915). TENS plus Voltaren had a trend of lesser reduction in pain after the ninth treatment session in compared with TENS plus placebo Voltaren. To conclude, both the TENS plus Voltaren and TENS plus placebo Voltaren group did not demonstrated significant pain alleviating effect on OA knee. We can only suggest that after 9 sessions, TENS plus Voltaren tends to produce more VAS reduction than TENS plus placebo Voltaren. Therefore, we postulated TENS plus Voltaren could be an alternative technique in order to obtain more pain relieving effect improving gait speed as reflect by TUGT and disability level as reflected by WOMAC. For obtaining significant differences, 68 subjects would needed respectively.

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