EFFECTS OF PHONOPHORESIS WITH DICLOFENAC SODIUM AND THERAPEUTIC ULTRASOUND WITH TRADITIONAL PHYSIOTHERAPY IN KNEE OSTEOARTHRITIS

Abstract

Background: Osteoarthritis of the knee is a common painful condition of the knee. The primary treatment for knee osteoarthritis has been conventional physiotherapy but, other types of adjunct therapy including therapeutic ultrasound and phonophoresis are also combined with physiotherapy. Objective: This study aimed to determine the effects of diclofenac sodium phonophoresis and therapeutic ultrasound with traditional physiotherapy in symptomatic knee osteoarthritis. Methods: A randomized controlled trial was carried out on 30 males (50-60 years) who had bilaterally confirmed clinically and radiologically, knee osteoarthritis (Kellgren Lawrence Grade II to IV). They were randomly divided into two groups (n = 15). A ten day (10 sessions) physiotherapy program was given to them. Therapeutic ultrasound was administered to them, while the ones were administered diclofenac sodium phonophoresis. Pain and function was measured pre- and post-intervention with the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analyzed in terms of paired and independent samples t-test (p < 0.05). In addition, the effect size (Cohen's d) was also calculated. Results: There was improvement in pain and function in both groups. And the improvement in the VAS score was greater in the phonophoresis group than the ultrasound group (p < 0.001) with a large effect size (d = 1.58). There was an improvement in the WOMAC scores in both groups, but no difference in the change in the two groups at post treatment (p = 0.334). This is a result of a difference in the WOMAC score at baseline. Conclusion: The effect of diclofenac sodium phonophoresis is more significant than therapeutic ultrasound and traditional physiotherapy in pain reduction of patients with knee osteoarthritis. Both interventions also have improved function but needs to be studied further with larger sample size and longer follow up period to establish these effects.

Keywords: Diclofenac sodium, Phonophoresis, Osteoarthritis, Ultrasound, Knee Osteoarthritis.