Učinkovitost terapevtskega ultrazvoka pri zmanjševanju bolečine pri artrozi kolena : pregled literature

Blas, Marjeta (author), Jakovljević, Miroljub (mentor), Weber, Daša (co-mentor)

Uvod: Artroza je degenerativni proces, ki lahko privede do deformacije kolenskega sklepa ter predvsem pri starejših povzroči težave pri vsakodnevnih opravilih in zmanjša kakovost njihovega življenja. Glavni simptom je bolečina. Pomembno vlogo pri zdravljenju ima fizioterapija. Inštrumentalna fizioterapija, kot je ultrazvok, se pogosto uporablja za zmanjševanje bolečine ali kot predpriprava na vadbo. Namen: Namen diplomskega dela je na osnovi pregleda objavljene strokovne in znanstvene literature predstaviti učinkovitost terapevtskega ultrazvoka pri zmanjševanju bolečine pri artrozi kolena. Metode dela: Članki so bili iskani v podatkovnih zbirkah PubMed, PEDro in Cochrane Library. Vključene so bile randomizirane kontrolirane raziskave, izvedene med letoma 2005 in 2017, v katerih so proučevali vpliv ultrazvoka ali ultrazvoka v kombinaciji z vadbo na bolečino pri pacientih z artrozo kolena. Rezultati: V analizo je bilo vključenih osem raziskav. Od tega so v petih raziskavah ugotavljali učinke ultrazvoka na zmanjševanje bolečine v primerjavi s placebo ultrazvokom, v preostalih treh pa so ugotavljali vpliv ultrazvoka in vadbe na bolečino v primerjavi s kontrolno skupino, ki je bila deležna placebo ultrazvoka z ali brez vadbe. Za ugotavljanje učinkovitosti ultrazvoka pri zmanjševanju bolečine sta bila uporabljena vidna analogna lestvica in vprašalnik WOMAC. V šestih raziskavah so dokazali statistično pomembno zmanjšanje bolečine, v eni raziskavi je do statistično pomembne razlike med skupinama prišlo le pri določenih rezultatih meritev, v eni raziskavi pa statistično pomembnih razlik med skupinama ni bilo. Razprava in sklep: Pri vseh skupinah, tudi kontrolnih, je prišlo do zmanjšanja bolečine, kar nakazuje, da ima placebo učinek velik vpliv. Rezultati raziskav kažejo, da je pulzna oblika ultrazvoka učinkovitejša kot kontinuirana. Zaradi heterogenosti uporabljenih parametrov ultrazvoka je težko izpostaviti najučinkovitejše parametre za zmanjševanje bolečine pri artrozi kolena. Prav tako je težko govoriti o dolgoročnih učinkih ultrazvoka na bolečino kot samostojni terapiji ali v kombinaciji z vadbo. Kljub zmanjšanju bolečine pa obstaja premalo dokazov o učinkovitosti ultrazvočne terapije pri artrozi kolena, zato so potrebne dodatne raziskave višje kakovosti.

• Language: Slovenian
• Keywords: artroza kolena, terapevtski ultrazvok, vadba, bolečina
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-99925
• COBISS.SI-ID: 5391979
• Publication date in RUL: 23.02.2018

Secondary language

• Language: English
• Title: The efficacy of therapeutic ultrasound for the reduction of pain in knee osteoarthritis : literature review

Abstract

Introduction: Osteoarthritis is a degenerative process that can lead to the deformation of the knee joint and particularly in the elderly cause problems with everyday activities and reduce the quality of life. The main symptom is pain. Physiotherapy has an important role in its treatment. Instrumental physiotherapy, like ultrasound, is often used for the reduction of pain or as a pre-preparation for exercise. Purpose: The purpose of the thesis is to present the efficacy of therapeutic ultrasound for the reduction of pain in knee osteoarthritis, based on the review of published professional and scientific literature. Methods: The articles were searched for in the databases PubMed, PEDro and Cochrane Library. Included were randomised controlled trials, conducted between 2005 and 2017, where they have analysed the influence of ultrasound in combination with exercises on pain in patients with knee osteoarthritis. Results: The analysis included eight studies. Five of them were analysing the effects of ultrasound on the reduction of pain in comparison with a placebo ultrasound and the remaining three were analysing the effect of ultrasound and exercising on pain compared to the control group, which received a placebo ultrasound with or without exercises. For the assessment of efficacy of the ultrasound for the reduction of pain were used the visual analogue scale and questionnaire WOMAC. In six studies they proved a statistically significant reduction of pain, in one study, statistically significant differences between groups only for certain results of the measurements and in one study there were no statistically significant differences between the two groups. Discussion and conclusion: All the groups, including the control groups, experienced a reduction of pain, which implies that the placebo effect has a major influence. The results of the studies show that the pulsed ultrasound is more effective than the continuous one. Due to the heterogeneity of the used parameters of ultrasound it is hard to identify the most effective parameters for the reduction of pain in knee osteoarthritis. It is also difficult to speak about the long-term effects of ultrasound as an individual therapy or in combination with exercise on pain. Despite the reduction of pain, there is a lack of evidence about the efficacy of the ultrasound therapy in knee osteoarthritis, therefore, additional high quality studies are needed.

• Keywords: knee osteoarthritis, therapeutic ultrasound, exercise, pain