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An Examination of the Value of Shortwave Diathermy and Hydrotherapy for Patients With Osteoarthritis of Their Knees

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00726492
Recruitment Status : Completed
First Posted : August 1, 2008
Last Update Posted : August 1, 2008
Information provided by:
University College Dublin

Brief Summary:
Osteoarthritis, a common disorder increasing in prevalence with advancing age, is particularly debilitating when the knees are affected. This study examined the value of hydrotherapy (exercise in water) and continuous short-wave diathermy (an electrical deep heat treatment) for the relief of osteoarthritic symptoms.

Condition or disease Intervention/treatment Phase
Knee Osteoarthritis Other: Continuous short wave diathermy (CSWD) Other: Hydrotherapy Not Applicable

Detailed Description:

Osteoarthritis is a common disabling disorder increasing in prevalence with advancing age (Blixen and Kippes, 1999). As there is a rapid increase in the percentage of people over 55 years in Western countries (Okma-Keulen and Hopman-Rock, 2001) it has become increasingly important to address issues which relate to older people. In 2010, the projected percentage of the population aged 60 years or older in Europe will be approximately 25%. The increased incidence of arthritis among older people, which is a significant health care problem today, is set to become an even greater concern in the coming years (Reginster, 2002). Rheumatic diseases are a huge encumbrance on the health care systems of countries worldwide and account for significant disability, lost productivity and reduction in quality of life (Sangha, 2000). The burden of disease relates not only to its prevalence but also to the cost of the disease to the health care system of the country, these costs include direct costs, such as the costs associated with drugs, medical care, hospitals, research, pensions and benefits and indirect costs, such as premature mortality and chronic disability (Reginster, 2002). Neither census statistics nor statistics from the Department of Health and Children revealed the true prevalence of osteoarthritis in Ireland. A search was also carried out using the Hospital Inpatient Enquiry (HIPE) system of The Economic and Social Research Institute of Ireland (ESRI) which likewise did not reveal the frequency of osteoarthritis in the population.

Osteoarthritis is characterised by progressive loss of articular cartilage, appositional subchondral bone development and osteophyte formation at the joint margins. The resulting pain, stiffness and functional limitations (Jakobsson and Hallberb, 2002) lead to diminished quality of life. The knee is a particularly common site of involvement in osteoarthritis. Osteoarthritic knee pain has been found to be associated with poor perceived health and significant disability, while psychological distress strongly associates with both pain and disability (O'Reilly et al, 1998; Sangha, 2000). Restricted knee joint mobility, in particular flexion appears to be an important determinant of disability in patients with osteoarthritis (Steultjens et al, 2000). Minor et al (1999) noted that lower extremity impairments in older adults have been linked to the reduced ability to use public transportation, climb stairs, perform household chores, shop and engage in leisure activities. Similarly van Barr (1998) noted that disability in patients with lower limb osteoarthritis is significantly related to pain and joint range of motion. Due to the chronic nature of osteoarthritis, physical modalities, lifestyle modification and patient self-management in terms of education and exercise are considered important approaches to treatment (Sangha, 2000).

Physiotherapists have an important role to play in the clinical management of osteoarthritis (Green et al, 1993) however, the effect of their involvement has rarely been assessed in terms of randomised controlled trials. Chard et al (2000) examined the research output in relation to a number of physiotherapy interventions available to patients with osteoarthritis of their knees and established that between 1950 to 1998 only 60 research articles were published, the majority of which occurred between 1985 and 1998. Advice (Maurer et al, 1999; Manek and Lane, 2000) and exercise (Puett and Griffin, 1994; Clarke, 1999; O'Reilly et al, 1999) have been clearly identified as beneficial in terms of relieving the impairments experienced by individuals with knee osteoarthritis. Indeed there is a some evidence supporting the use of a number of physiotherapy interventions including hydrotherapy (Ahern et al, 1995; Norton et al 1997; Alexander et al, 2001) and continuous short-wave diathermy (CSWD) (Wright, 1964; Lankhorst et al, 1982) for the treatment of knee osteoarthritis but there are difficulties regarding the design of many of these studies thus undermining the conclusions that have been drawn. This study presents the results of a randomised controlled factorial trial (Polger and Thomas, 2000) designed to examine hydrotherapy and/or continuous short wave diathermy (CSWD) for patients with knee osteoarthritis while also examining the perceptions of patients participating in a physiotherapy programme.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 77 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Randomised Controlled Trial Evaluating the Effects of Shortwave Diathermy and Hydrotherapy for Patients With Osteoarthritis of Their Knees
Study Start Date : June 2001
Actual Primary Completion Date : April 2003
Actual Study Completion Date : April 2003

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: CSWD + Hydro
Continuous short wave diathermy and hydrotherapy
Other: Continuous short wave diathermy (CSWD)
CSWD applied twice a week for 4 weeks

Other: Hydrotherapy
Hydrotherapy (exercise in water) attended twice a week for 4 weeks

Experimental: Hydro alone
Hydrotherapy alone
Other: Hydrotherapy
Hydrotherapy (exercise in water) attended twice a week for 4 weeks

Experimental: CSWD alone
Continuous short wave diathermy alone
Other: Continuous short wave diathermy (CSWD)
CSWD applied twice a week for 4 weeks

No Intervention: Control
No treatment

Primary Outcome Measures :
  1. Six-minute walk test [ Time Frame: 4 and 8 weeks ]

Secondary Outcome Measures :
  1. Visual analogue pain scale (10 cm line) [ Time Frame: 4 and 8 weeks ]
  2. Knee range of motion [ Time Frame: 4 and 8 weeks ]
  3. Arthritis Impact Measurement Scale 2 (AIMS 2) [ Time Frame: 4 and 8 weeks ]
  4. Patient interview [ Time Frame: 4 and 8 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years to 70 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients had to have a documented diagnosis of osteoarthritis of their knees.
  • Patients had to be between 50 and 70 years inclusive.
  • Patients had to have X-ray evidence of osteoarthritis of their knees.

Exclusion Criteria:

  • Patients with another rheumatological condition other than osteoarthritis.
  • Patients who were unable to understand the concepts, assessment and treatment involved.
  • Patients who had received a cortisone injection into the knee in the previous 30 days.
  • Patients for whom CSWD or hydrotherapy has been contraindicated.
  • Patients who have had either CSWD or hydrotherapy in the past.
  • Patients who had undergone a surgical procedure on either lower limb in the past 6 months.
  • Patients who were receiving other physiotherapy treatment.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00726492

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Mater Misericodriae University Hospital
Dublin, Ireland, 7
Sponsors and Collaborators
University College Dublin
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Principal Investigator: Tara Cusack, MMedSc PhD University College Dublin
Principal Investigator: Conor J McCarthy, MD Mater Misericordiae University Hospital
Principal Investigator: Leslie Daly, BSc MSc PhD University College Dublin
Principal Investigator: Mary F McAteer, MEd PhD University College Dublin
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Responsible Party: Dr Conor J McCarthy, Consultant Rheumatologist, Mater Misericordiae University Hospital Identifier: NCT00726492    
Other Study ID Numbers: 1/378/664
First Posted: August 1, 2008    Key Record Dates
Last Update Posted: August 1, 2008
Last Verified: July 2008
Additional relevant MeSH terms:
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Osteoarthritis, Knee
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases