doctoral thesis
A comparison of effectiveness of kinesiotherapy and combination of kinesiotherapy and pulsed electromagnetic fields on pain and functional ability in patients with knee osteoarthritis

Tomislav Nemčić (2014)
University of Zagreb
Faculty of Kinesiology
Metadata
TitleUsporedba učinkovitosti kineziterapije i kombinacije kineziterapije i elektromagnetoterapije na bol i funkcijsku sposobnost bolesnika s osteoartritisom koljena
AuthorTomislav Nemčić
Mentor(s)Simeon Grazio
Abstract
Osteoartritis (OA) je najčešća bolest zglobova u razvijenim zemljama i vodeći je uzrok kronične onesposobljenosti, napose ukoliko je bolešću zahvaćeno koljeno ili kuk. Kako uzrok OA nije poznat, liječenje je prvenstveno usmjereno na uklanjanje simptoma i sprječavanje funkcijske nesposobnosti. Od nefarmakoloških terapijskih postupaka čvrsti dokazi o djelotvornosti postoje samo za kineziterapiju, no još uvijek nije utvrđena optimalna "doza" (frekvencija, intenzitet i trajanje) vježbanja kao niti najučinkovitija vrsta vježbi. U kliničkoj praksi se često primjenjuje i elektromagnetoterapija (EMT), o čijoj učinkovitosti u literaturi postoje kontradiktorni podatci. Cilj ovog istraživanja bio je usporediti učinkovitost osmišljenog kineziterapijskog programa i njegove kombinacije s EMT na bol i funkcijsku sposobnost bolesnika s OA koljena. U istraživanju su sudjelovala 92 ispitanika, metodom slučajnog izbora podijeljena u dvije skupine: jednu, koja je provodila kineziterapijski program i drugu, u kojoj je uz kineziterapijski program bila primijenjena i EMT. Rezultati su pokazali da je u obim skupinama nastupilo statistički značajno smanjenje intenziteta boli i osjećaja zakočenosti, poboljšanje bolesti mjereno globalnom ocjenom liječnika i poboljšanje funkcijske sposobnosti, mjereno "Timed up and go" (TUG) testom i WOMAC (od engl. Western Ontario and McMaster Universities Index of Osteoarthritis) upitnikom. Ispitanici koji su samo provodili vježbe naveli su i značajno poboljšanje bolesti prema vlastitoj globalnoj ocjeni, dok se u ispitanika koji su uz vježbe primali i EMT značajno povećao opseg fleksije bolnog koljena. Usporedbom skupina ispitanika pokazano je da nema statistički značajno većeg terapijskog učinka u ispitanika koji su dodatno primali EMT u odnosu na one koji su samo provodili kineziterapijski program, a poboljšanja u većini mjerenih varijabli bila su i izraženija u skupini ispitanika bez dodatne primjene EMT. Zaključno, u ovom je istraživanju dokazan pozitivan terapijski učinak osmišljenog kineziterapijskog programa na bol i funkcijsku sposobnost bolesnika s OA koljena, ali ne i hipoteza prema kojoj će kombinacija kineziterapije i EMT imati bolji učinak na iste parametre u odnosu na primjenu samo kineziterapije. Rezultati istraživanja mogu značajno utjecati na svakodnevni klinički rad i općenito na liječenje i rehabilitaciju bolesnika s OA koljena.
Keywordsknee osteoarthritis kinesiotherapy pulsed electromagnetic fields
Parallel title (English)A comparison of effectiveness of kinesiotherapy and combination of kinesiotherapy and pulsed electromagnetic fields on pain and functional ability in patients with knee osteoarthritis
Committee MembersDubravka Ciliga (committee chairperson)
Valentina Matijević (committee member)
Branka Matković (committee member)
Lana Ružić (committee member)
Tomislav Krističević (committee member)
GranterUniversity of Zagreb
Faculty of Kinesiology
PlaceZagreb
StateCroatia
Scientific field, discipline, subdisciplineSOCIAL SCIENCES
Kinesiology
Kinesiotherapy and Adapted Physical Activity
UDK615
APPLIED SCIENCES. MEDICINE. TECHNOLOGY
Pharmacology. Therapeutics. Toxicology
Study programme typeuniversity
Study levelpostgraduate
Study programmepostgraduate doctoral study of kinesiology
Academic title abbreviationdr. sc.
Genredoctoral thesis
Language Croatian
Defense date2014-10-30
Parallel abstract (English)
Osteoarthritis (OA) is the most common joint disease and a leading cause of chronic disability, in large part due to knee or hip involvement. Etiology is unknown, so the treatment is focused on symptoms elimination and functional disability prevention. Among nonpharmacologic modalities, only the kinesiotherapy effectiveness was confirmed while neither the optimal exercise „dosage“ (frequency, intensity and duration) nor the most effective type of exercise have been defined. Pulsed electromagnetic fields (PEMF) are frequently used in the treatment, although the literature provides contradictory data related to its effectiveness. The aim of this research was to compare the effect of designed kinesiotherapy program and its combination with PEMF on pain and functional ability in patients with knee OA. Ninety-two patients were randomly divided into two groups: in the first one the patients underwent kinesiotherapy program and in the second, besides that program, patients were treated with PEMF. In both groups results showed statistically significant reduction of pain intensity and stiffness, disease improvement measured by physician’s global assessment and improvement of functional ability measured by "Timed up and go" (TUG) test and WOMAC (Western Ontario and McMaster Universities Index of Osteoarthritis) questionnaire. Additionally, the patients that performed exercises only, declared statistically significant disease improvement according to their global assessment, while the patients that received PEMF therapy after the identical exercise program had statistically significant improvement of painful knee flexion. Comparison of the patient’s groups didn’t show any statistically significant improvements in therapeutic effect in group that combined exercises and PEMF therapy. On the contrary, increase in most measured variables was even emphasized in group without additional PEMF therapy. In conclusion, this research proved the positive therapeutic effect of clearly designed kinesiotherapy program on pain and function ability in patients with knee OA, while the hypothesis about better parameters indicators in group who underwent combined therapy (kinesiotherapy and PEMF) was not substantiated. The results of the research may be important for daily clinical practice in treatment and rehabilitation of patients with knee OA.
Parallel keywords (Croatian)osteoartritis koljena kineziterapija elektromagnetoterapija
Versionaccepted version
Resource typetext
Access conditionOpen access
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
Noteaccepted version
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:117:450784
CommitterIvan Crnjac