Učinki naprave za trakcijo in vibracijo kolka pri starejših bolnikih s simptomatsko primarno koksartrozo

Josipović, Petra (author), Moharić, Metka (mentor)

Uvod: Terapija z vlečenjem in vibracijami kolka (TVT) je neinvazivna ročna tehnika v fizioterapiji, ki kaže obetavne rezultate pri lajšanju bolečin in izboljšanju premikanja pri zdravljenju osteoartroze (OA) kolka. Ročna TVT kolka je zahtevna tehnika, pri kateri fizioterapevt uporablja nadzorovano vlečenje in ritmične vibracije. Njena učinkovitost temelji na strokovnosti in moči fizioterapevta, kar lahko vodi do različnih rezultatov zdravljenja. Namenskih medicinskih naprav, prilagojenih za izvajanje TVT kolka, še ni, zato se morajo zdravstveni delavci med TVT kolka zanašati na svojo fizično moč in dodatne pripomočke. Zaradi tega smo želeli razviti medicinsko napravo za TVT kolka ter primerjati učinke TVT kolka, izvedene z napravo, ročne TVT kolka in lažne TVT (placebo terapije) pri starejših odraslih s primarno simptomatsko OA kolka. Predpostavljali smo, da bo TVT, izvedena z napravo, vodila do zmanjšanja okvare kolka, zmanjšanja bolečine, izboljšanja ravnotežja in hoje, izboljšanja funkcionalne mobilnosti in zmanjšanja pogostosti uporabe zdravil v primerljivi meri kot ročna TVT kolka, placebo terapija pa ne bo imela opaznega učinka. Metode: V bločno randomiziranem kontroliranem poskusu s tremi skupinami, ki je trajal tri mesece, je sodelovalo 28 starejših udeležencev s simptomatsko primarno OA kolka, razdeljenih v tri skupine. Prva (n=10) je prejela TVT kolka, izvedeno z napravo, druga (n=10) ročno TVT in tretja (n=8) lažno (placebo) terapijo. Oviranost zaradi okvare kolka (z lestvico Harris Hip Score, HHS, in podlestvico dnevnih aktivnosti lestvice Hip Outcome Score – HOS ADL), jakost bolečine (z vidno analogno lestvico, VAL), premičnost in ravnotežje (z lestvico Functional Gait Assessment in Časovno merjenim testom vstani in pojdi – VIP) ter porabo zdravil smo ocenjevali na začetku raziskave, po treh tednih brez terapije in po trimesečni terapiji. Učinkovitost terapije smo ocenili na podlagi najmanjše dejanske razlike (Minimum Real Difference, MRD) in najmanjše klinično pomembno razliko (Minimum Clinically Important Difference, MCID). Rezultati: Prvo hipotezo smo potrdili. TVT kolka, izvedena z napravo, je znatno izboljšala funkcijo pri starejših odraslih s simptomatsko primarno OA kolka, kar kažejo statistično značilni in klinično pomembni učinki, opaženi pri HHS (p < 0,001), HOS ADL (p = 0,008) in VIP (p = 0,018). Uporaba TVT, izvedena z napravo, je prav tako vodila do znatnega zmanjšanja bolečin v kolčnem sklepu, kar kažejo ocene bolečine na VAL (p < 0,001). Glede pogostosti uporabe zdravil nismo opazili statistično značilnega učinka terapije (p = 0,239), torej do zmanjšanja bolečine ni prišlo na račun povečane uporabe protibolečinskih zdravil. Tudi hipotezo, da bo uporaba TVT, izvedenega z napravo, privedla do primerljivega izboljšanja izidov kot ročna TVT kolka, smo potrdili, pri čemer morebitnih učinkov placeba po pričakovanju nismo opazili. Tako skupina, ki je prejela TVT, izvedeno z napravo, kot skupina, ki je prejela ročno TVT, sta pokazali pomembne izboljšave glede izvajanja dnevnih aktivnosti, intenzivnosti bolečine, ravnotežja in premičnosti ter oviranosti zaradi okvare kolka, med tema dvema skupinama pa nismo opazili statistično značilne razlike, čeprav se je pri nekaterih izidih nakazoval nekoliko večji učinek TVT, izvedene z napravo. Zaključek: TVT, izvedena z napravo, je pri starejših osebah s simptomatsko primarno OA kolka v splošnem vsaj tako učinkovita kot ročno izvedena TVT, obe pa nedvomno presegata morebitni učinek placeba.

• Language: Slovenian
• Keywords: Osteoartroza kolka, Vlečenje, Vibracija, Oprema in pripomočki, Medicinska
• Work type: Doctoral dissertation
• Organization: MF - Faculty of Medicine
• Year: 2026
• PID: 20.500.12556/RUL-183546
• Publication date in RUL: 14.06.2026

Secondary language

• Language: English
• Title: Effects of hip traction and vibration device in elderly patients with primary coxarthrosis

Abstract

Introduction: Hip traction-and-vibration-therapy (TVT) is a non-invasive manual technique of physiotherapy that exhibits promising results in alleviating pain and enhancing mobility in the treatment of hip osteoarthritis (OA). The manual hip TVT is a high-demanding technique in which a physiotherapist applies controlled traction and rhythmic vibrations to the hip region of the patient. Its effectiveness relies on the expertise and strength of the physiotherapist, which can lead to variability in treatment outcomes. Dedicated medical devices tailored to deliver the device-performed hip TVT do not exist yet, so health professionals must rely on their own physical strength and supplementary tools during hip TVT. For this reason, we wanted to develop a medical device for hip TVT and compare the effects of device-performed hip TVT, manual hip TVT, and sham TVT (placebo therapy) in older adults with primary symptomatic hip OA. We hypothesized that device-performed TVT would lead to decreased hip impairment, reduced pain, improved balance and gait, improved functional mobility and reduced frequency of drug use to an extent comparable to that of manual hip TVT, while the placebo intervention would have no notable effect. Methods: Twenty-eight older adults with symptomatic primary hip OA, divided into three groups, participated in a block-randomized controlled trial that lasted three months. One group (n=10) received device-performed TVT, one (n=10) received manual TVT, and one (n=8) sham/placebo therapy. Hip impairment (using Harris Hip Score and the Activities of Daily Living subscale of the Hip Outcome Score – HOS ADL), pain intensity (using visual-analog-scale, VAS), functional mobility and balance (using Functional Gait Assessment and Timed-Up-and-Go-test, TUG) and drug consumption were assessed at baseline, after 3 weeks without intervention, and after 3-month intervention. To assess the effectiveness of the performed interventions, we employed Minimum Real Difference (MRD) and Minimum Clinically Important Difference (MCID). Results: We confirmed the first hypothesis. The application of device-performed TVT substantially improved functioning in older adults with symptomatic primary hip OA, as indicated by the statistically significantly and clinically importantly main effects observed in terms of the HHS (p < 0.001), HOS ADL (p = 0.008) and TUG (p = 0.018). The application of device-performed TVT also lead to a substantial reduction in hip joint pain levels, as evidence by VAS ratings (p < 0.001). Because the frequency of drug use did not exhibit a statistically significant treatment effect (p = 0.239), the observed pain reduction cannot be attributed to increased consumption of analgesic medications. The hypothesis that the application of device-performed hip TVT will have a comparably beneficial effect compared to manual hip TVT was also confirmed, while potential placebo effects were not observed. The device-performed TVT and as well as the manual TVT group exhibited important improvements regarding ADL performance, pain intensity, balance and functional mobility, and hip impairment, whereby there were no statistically significant differences between these two groups, though some outcomes indicated the possibility of a somewhat larger effect in the device-performed TVT group. Conclusion: In older adults with primary symptomatic hip OA, device-performed TVT is in general at least as effective as manual TVT, while both clearly outperform any possible placebo effect.

• Keywords: Osteoarthritis, Hip, Traction, Vibration, Equipment and Supplies, Medical