Effects of thermotherapy on symptoms of osteoarthritis of knee : systematic review

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Effects of thermotherapy on symptoms of osteoarthritis of knee : systematic review

 

Author: Siu, Heung-ying
Title: Effects of thermotherapy on symptoms of osteoarthritis of knee : systematic review
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Osteoarthritis -- Treatment.
Thermotherapy.
Department: School of Nursing
Pages: xvii, 107, [25] leaves : ill. ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2240464
URI: http://theses.lib.polyu.edu.hk/handle/200/5010
Abstract: Background: Osteoarthritis is a non-curable degenerative joint disease that affects the weight-bearing joints such as knees and hips. The affected joints will suffer from pain, stiffness, and decrease in range of movement. The treatments aim at improving the pain and function. Thermotherapy, which is the application of heat or cold, is a usual practice in reducing pain, so as to improve functional status. The purpose of this review was to review the effects of thermotherapy on symptoms of patients with Osteoarthritis of knee. Materials and Methods: A systematic review of the title was conducted. Various electronic databases were used to identify main articles, with reference lists of these articles were further examined for relevant literatures. The articles were searched according to predefined inclusion and exclusion criteria. Two reviewers assessed the quality of the trials selected according to Jadad's quality assessment scale. Trials scored three or above were included in this systematic review. The heterogeneity of the studies was assessed before considering whether or not to combine the studies' results. Data Analysis: Outcomes were continuous in nature (pain, stiffness, function) and were analyzed by weighted mean differences using fixed effects model. Results: Three randomized control trials, which fulfilled the selection criteria and scored three in Jadad's scale, were included in this systematic review. There were 178 patients with osteoarthritis of knee in total. The design of these three trials was not homogeneous, and they were not combined. In one trial, after the 3 days per week treatment for 3 weeks of applying ice packs (unspecified duration) and the use of short-wave diathermy as heat therapy, there was no statistical significant improvement in pain over placebo. In another trial, administration of 20 minutes ice massage, 5 days per week for 3 weeks, compared with control demonstrated clinical benefit stiffness, 50-foot walking time, muscle strength and knee flexion, but no statistical significant improvement in pain. In the third study, there was a statistical significant improvement in pain, stiffness and function for both the three-week and sixteen-week treatment by using heat therapy (superficial heat followed by deep heat therapy). However, the effectiveness of the treatment for functional improvement was not sustained upon the sixteenth week of assessment. Conclusion: There was evidence suggesting that thermotherapy, either by using heat or cold, was effective in improving some of the symptoms of osteoarthritis of knee by individual study. For heat therapy, there was significant clinical benefit on pain, stiffness and function by the exercise regimen with the use of superficial and deep heat treatment (Kadiye, 2006). For ice therapy, ice massage treatment showed clinical benefits on stiffness, muscle strength and knee flexion (Yurtkuran, 1999). However, relevant studies were heterogeneous in research design and were not combined. More studies were required to evaluate the effects of thermotherapy in the treatment of osteoarthritis of knee.

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