A Comparative Study On The Action Potential Simulation (APS) Therapy And The Routine Physiotherapy Protocol In Knee Osteoarthritisin Elderly People

Document Type : Original article

Authors

1 Dept. of Physiotherapy, Faculty of Rehabilitation Sciences, Physiotherapy Research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran (corresponding author)

2 BSc in Physiotherapy, Alghadir Hospital, Tehran, Iran

3 BSc in Physiotherapy, Faculty of Rehabilitation Sciences, Physiotherapy Research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Abstract

Background and Aim: Knee osteoarthritis is the most common cause for which the elderly people refere to physiotherapy outpatient clinics. This study aimed to investigate the effects of the Action Potential Stimulation (APS) Therapy and the routine physiotherapy (PT) protocol on relieving pain and swelling as well as the duration of the relief period in patients with knee osteoarthritis.
Materials and Methods: 69 patients (62 females & 7 males) with knee osteoarthritis were recruited in this study. The subjects were divided into two groups including APS Therapy (n=37, mean age: 55±13 years old) and the routine PT protocol (n=32, mean age: 61±14 years old) groups. A 10-session treatment period was carried out for each group; and their pain and swelling were measured at the first, fifth and tenth sessions and also one-month after the last session (follow up). The swelling was measured using measuring the circumference of the knee on the patella, 5 Cm above and 5 Cm below the patella. The routine PT protocol consisted of hot pack, ultrasound, TENS and exercise; and the APS therapy protocol included hot pack, APS Therapy and the same exercise. During the follow up, 50 out of 61 subjects were called on the phone and any pain changes were recorded.
Results: In terms of swelling, the results showed significant reduction just on the patella only in the APS Therapy group (P<0.05). Visual Analogue Pain Scale (VAPS) indicated a significant pain reduction in both groups. However, the APS Therapy group showed significantly pain reduction at the end of sessions five, ten and the follow up session (P<0.05). It was also revealed that while routine PT subjects showed no significant pain changes between the tenth and the follow up session, a gradual pain reduction was seen in the APS therapy group during this period (P<0.05). A gradual dosage reduction was recorded only in the APS therapy group, indicating a slight correlation with pain reduction (r=0.4).
Conclusion: The findings of this study showed significantly better results following the use of APS therapy protocol relative to the routine PT protocol in patients with knee osteoarthritis and hence are recommended to these patients.  

Keywords

References

1. Scarborough J. Roman Medicine. New York: Cornal University Press; 1969. Chapter1.
2. Pipitone N, Scott DL. Magnetic pulse treatment for knee osteoarthritis: a randomised, double-blind, placebo-controlled study. Curr Med Res Opin. 2001; 17(3): 190-196.
3. Thamsborg G, Florescu A, Oturai P, et al . Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study. Osteoarthritis and Cartilage. 2005 ; 13(7):575-581.
4.  Chep p. Action potential stimulation. 2012. APS therapy Online. Availabe at: URL:http://www.apstherapy.com/index.php?lang=en. Accessed Jan 31, 2012.
5. Afshani A.H, Meyar Naeemi A, Afsharpas A. APS therapy booklet. Tehran: Dastavard Sina Publishing ; 1381. [Persian]
6. Oweye, Spielholz and Nelson R. Low-intensity Pulsed Galvanic Current and the Healing of Tenotomized Rat Achilles Tendons: A Preliminary Report Using Load-to-Breaking Measurements. Archives Physical Med Rehab. 1987; 68: 415-418.
7. Heffernan M. Comparative Effects of Microcurrent Stimulation on EEG Spectrum and Correlation Dimension. Integrative and Behavioural Science. 1996. 31 (3): 202-209.
8. Ebnzar John. Essential of orthopaedics for physiotherapist. India: Juypee Brothers Medical Publishers; 2003. Chapters 11, 26.
9. Melzac R, Wall PD. Pain mechanism: a new theory. Science. 1965 ;150(3699):971-979.
10. Mannheimer C, Carlsson C. The analgesic effect of transcutaneus electrical nerve stimulation (TENS) in patients with rheumatoid arthritis. A comparative study in different pulse patterns. Pain. 1979; 6(3): 329–334.
11. Nelson R, Dean C. Principles of electrical stimulation, clinical electrotherapy. 3rd edition. Appleton &Lange Publishers; 1987. P 59-65.
12.  Benedetti F, Amanizo M, Casadio C, et al. Control of postoperative pain by transcutaneous electrical nerve stimulation after thoracic operations. Ann Thorac Surg, 1997; 63: 773-776.
13. Seegers JC, ML Lottering, AM Joubert,et al. The effects of a small pulsed DC electric field on ATP and cAMP levels in in vitro and in vivo systems. Medical Hypothesis. 2002; 58(2): 171-176.
14. Papendorp D.Van, C. Maritz and N. Dippenaar, Plasma levels of beta-endorphin, substance P and low encephalin in patients with chronic pain –Geneeskunde-The Medicine Journal. 2002: P 36-40.
15. Zizic TM, Hoffman KC, Holt PA, et al. Treatment of Osteoarthritis of the Knee with pulsed Electrical Stimulation. J Rheumatol 1995; 22: 1757-1761.
16. Berger and L. Matzner, Introducing action potential currents. South African Journal of Anesthesiology and analgesia. 1999; 5(2): 26-36.
17. Papendorp DH van. Assessment of Pain Relief on 285 patients with chronic pain. Biomedical Research (Japan). 2002;26(6):249-253.
18. Bernard C. Award winning pain relief. 2009. APS therapy UK online. Available at:http://www.apstherapy.com. Accessed: Jan 12, 2009.
19. SeegersJC, C. A. Engelbrecht, D. H. van Papendorp. Activation of signal-transduction mechanisms may underlie the therapeutic effects of an applied electric field. Medical Hypotheses. 2001; 57(2): 224-230.
20. Hamilton SG, McMahon SB. - ATP as a peripheral mediator of pain. J Auton Nerve Syst. 2000; 81(1): 187-194.
21. Papendorp D.H.van, A.M. Joubert, A.  Koorts, et al. A comparative study between a DC, MET electrical field (APS Therapy) and conventional TENS on ATP levels in an in vitro system. Biomedical Research (Japan). 2002; 26(6): 249-253.
The Scientific Journal of Rehabilitation Medicine
Volume 1, Issue 1 - Serial Number 1
March and April 2012
Pages 22-34

Files

History

  • Receive Date: 02 February 2011
  • Revise Date: 14 May 2011
  • Accept Date: 31 August 2011
  • First Publish Date: 20 March 2012

Share

How to cite

Statistics