A Survey On The Effects Of Iontophoresis Of Piroxicam Gel On Pain And Knee Muscles Strengthn Patients With Knee Osteoarthritis

Document Type : Original article

Authors

1 Dept. of physiotherapy. Faculty of Rehabilitation Sciences, Physiotherapy Research center, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 MSc in physiotherapy. Faculty of Rehabilitation Sciences, Physiotherapy Research center, Shahid Beheshti University of Medical Sciences,Tehran, Iran

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

Abstract

Background and Aim: Knee osteoarthritis is the most common cause of disability in many societies. Therapeutic measures such as using anti-inflammation drugs and physiotherapy programs have been used to suppress knee pain and improve knee joint function in patients with knee osteoarthritis. The aim of this study was to compare the effects of iontophoresis of piroxicam gel, galvanic current with or without  piroxicam gel on pain, functional ability and knee muscle strength in patients with knee osteoarthritis.
Materials and Method: This study was a clinical trial conducted in Akhtar hospital. Forty two female patients (mean age 58.52 years old) with knee osteoarthritis participated in this study. The protocol was performed in Physiotherapy Clinic of Mazandaran Medical University, Mazandaran, Iran. All patients were randomly assigned to three groups. Iontophoresis of piroxicam gel was applied for group 1 (n=14), proxicam gel for group 2 (n=14) and galvanic current for group 3 (n=14). The procedure was carried out for 20-minutes, three times a week and for two following weeks. Knee pain and functional ability were estimated by knee injury and osteoarthritis outcome score (KOOS) questioner and the strength of knee extensor and flexor muscles by an isometric device just before the first treatment and immediately after the last treatment times.
Results:A significant decrease in pain and a significant increase in functional ability and the strength of knee extensor muscles were resulted in all studied groups (P < 0.05).  According to ANOVA test, the level of the percentage difference which was computed for KOOS and knee muscle strength before and after treatments was significantly higher in group 1 than the other two (P < 0.01).
Conclusion:  Pain and knee functional ability were significantly improved in patients in all three methods. But iontophoresis of piroxicam gel appeared to be more effective in relieving pain and improving knee functional abilities than the application of galvanic current or piroxicam gel alone. Iontophoresis facilitated the transmission of piroxicam gel through the skin.

Keywords


1. Nisha G, Nancy E. Osteoarthritis: Current Concepts in Diagnos  and Managemen. AmFam physician. 2000; 61(6): 1795- 1804.
 
2. Banwell B.F, Gall V. Physical therapy management of arthritis. First Edition. New York: Churchill Living Stone, 1998;  p 8-11.
 
3. David C, Lioyd J. Rheumatological physiotherapy. First Edition.  London: Mosby, 1999; p 83-96.
 
4. Akinbo S.R, Aiyejusunle  C.B, Akinyemi O.AAdesegun  S.A .Comparison of  the  therapeutic  efficacy of phonophoresis and iontophoresis using dexamethasone sodium phosphate in the management of patients with knee osteoarthritis. Journal of Niger Postgrad Medicine. 2007; 14(3): 190-194.
 
5. Rahimi A .The new of Osteoarthritis. First Edition.Tehran: Sarmadi, 1385: p 18-42. [in Persian]
6. Bijlsma J.W.J, Knahr K .Strategies for the prevention and management of osteoarthritis hip and knee. Best Practice & Research Clinical Rheumatology.  2007; 21(1): 59-76.
 
7. Kopec J, Mushfiqur R. Epidemiology of osteoarthritis in British. Journal of Rheumathology. 2007; 37(2): 386-393.
 
8. Armando M, Eduardo E .Double-blind controlled clinical trial of oral S-adenosylmethionine versus piroxicam in knee osteoarthritis. The American Journal of Medicine. 1987; 83(5): 72-77.
 
9. Gibson J. A. Survey of patients’ knowledge of gastrointestinal side-effects of NSAIDs in a rheumatology clinical. Quality in Primary Care. 2006; 14(2): 95-97.
 
10. Haynes S, Gemmell H .Topical treatments for osteoarthritis of the knee. Clinical Chiropractic. 2007; 10(3): 126-138.
 
11. Bakhtiary A. H. Principles and Practice of electrical current. First Edition. Samnan; Bakhtiary, 1381: 31- 45. [in Persian]
12. Curdy C, Yogeshvar K. Piroxicam delivery into human stratum corneum in vivo: iontophoresis versus passive diffusion. Journal of Controlled Release. 2001; 76 (1-2): 73-79.
13. Aiyejusunle  C.B, Kola T.A, Ajiboye O.A. Comparison of the effects of   tens and sodium salicylate iontophoresis in the management of osteoarthritis of the knee. Journal of Nig Q Hosp Medicine. 2007; 17(1): 30-4.
14. Nelson R. Clinical Electrotherapy. Third edition .United States of America: Mary Ellen McCourt, 1999; p 116-117.
 
15. Fransen M, Crosbie J. Isometric  Muscle  Force  Measurement  for Clinicians Treating  Patients With Osteoarthritis  of  the  Knee . Journal of Arthritis & Rheumatism. 2003; 49(1): 29-31.
 
16. Cosignani  F, Cossu M, Pancer  E, Rega V, Conti  B.Clinical study on effect of  ketoprofen  administered by iontophoresis. Riabilitazione. 1987; 20 (4): 269-273.
17. Başkurt F, Ozcan  A, Algun  C. Comparison of effects of phonophoresis and iontophoresis of naproxen in the treatment of lateral epicondylitis. Clinical Rehabilitation. 2003; 17(1): 96-100.
18. Hurley  MV,  Scott   Dl . Rehabilitation reduces disability in patients with knee osteoarthritis . Journal Citations Anu Meet Int Soc Technol Assess Health Care, Int Soc Technol Assess Health Care Meet. 1999; 15: 153.
 
19. Fransen  M , Crosbie J . Isometric  Muscle  Force  Measurement  for Clinicians Treating  Patients With Osteoarthritis  of  the  Knee . Journal of Arthritis & Rheumatism  2003 ; 49(1): 29-35.
Volume 1, Issue 1 - Serial Number 1
March and April 2012
Pages 35-43
  • Receive Date: 20 July 2011
  • Revise Date: 26 August 2011
  • Accept Date: 20 October 2011
  • First Publish Date: 20 March 2012