Introduction
Physical therapist clinicians select, prescribe, and implement use of physical agents for a number of therapeutically beneficial reasons.1 According to Cameron,2 physical agents are defined as energy or materials physically applied to patients to assist in rehabilitation. They include heat, cold, water, pressure, sound, electromagnetic radiation, and electrical currents. This study will focus on the use of therapeutic ultrasound (US) to treat osteoarthritis (OA) of the knee. Therapeutic US is regularly used passively by physical therapist clinicians3 to treat knee OA, but its use lacks substantial evidence of positive therapeutic effect in people with knee OA.4-6
Ultrasound
US is a sound wave with a frequency of greater than
…show more content…
The knee has the highest prevalence of OA of all of the joints in the human body. Knee OA regularly causes people to experience troubling pain and/or loss of physical function to varying degrees,5 and often results in total knee arthroplasty8 after years of distress and economic burden to the patient and society.9 During 2005 in Ontario, Canada, knee OA costs for an individual averaged $12,200 annually, including personal expenses as well as lost wages.10 It is estimated that as the world’s population ages and as the obesity epidemic grows, the burden of OA on the healthcare system, and therefore the economy, will continue to increase, barring improvements in knee OA management.8
Choosing Wisely
Therapeutic US is regularly used by physical therapist clinicians3 to treat knee OA, 4-6 although its use lacks substantial evidence of positive therapeutic effect in people with knee OA.4-6 In September 2014, the American Physical Therapy Association (APTA) and American Board of Internal Medicine (ABIM) released a list of recommendations titled “Choosing Wisely: five things physical therapists and patients should question”11 (Choosing Wisely) recommending that physical therapists should not
Joint pain, particularly in the knees and shoulders as well as back pain constitute the large majority of patients who present to their doctor's office with a complaint of pain. Many of these patients proceed to have surgery, all too often with less than optimal outcomes. Many of these patients still have the same pain
OrthoOklahoma is an orthopedic medical clinic with a physical therapy branch that provides outpatient physical therapy care. The facility has a staff of three licensed physical therapists and a physical therapy assistant along with four physical therapy techs. I was able to observe all three physical therapists, Megan Ripley, Joe Ogle and Ken Roberts. At OrthoOklahoma, the most common patients are post-surgery from repairs of muscles, bones or joints. While shadowing these therapists, I observed cases of total knee replacement, total hip replacement, ACL/meniscus repair, rotator cuff repair, frozen shoulder, labrum repair, and other ailments from wear-and-tear and aging. This experience allowed me to talk to physical therapists about the ins and outs of their job, learn about different exercises and routines for treatment of injuries, and really get an idea of the work it takes to become a well-respected physical therapist.
According to Su et all (2009), knee replacement is an effective way to find relief of pain and improve mobility, but most importantly giving the patient education and skills during early recovery. In comparison, all articles focused on the need of improving mobility after surgery. Assessing the patient’s abilities and the need for physical therapy and keeping an eye out for complications. A main focus was pain relief and that recovery for each patient varies, but it is important to get them ambulating with assistive devices soon after surgery. My patient at Kindred, had continuous assessment and an interdisciplinary team that assisted in her road to
An Orange County orthopedic surgeon has the specialized skills and expertise to correct your problem, to stop the pain, and to restore your ability to walk, sit, stand, climb steps, and sleep naturally. Your orthopedist will analyze your particular pain symptoms, accurately diagnose the extent of your precise knee injury, and advise you on the most effective knee procedure to correct your condition.
Imagine that you have torn your ACL, or your anterior crucial element ligament. An athletic trainer will help you until a doctor can be seen for X-rays. A surgeon will repair the injury. An anesthesiologist will keep you pain free throughout a procedure. After this, somebody is needed to assist in improving movement. That is what a physical therapist is for. Physical therapists, or PTs, are a crucial part of rehabilitation, treatment and prevention for patients with physical ailments. Individualized programs are developed by PTs that may follow a doctor’s referral, as well as a patient’s concerns and physical evaluation. Treatment plans can be made for individuals with sprained ankles to arthritis to neurological disorders. Physical therapy varies from patient to patient, as no two injuries are exactly the same, but the goal is always the same: a completely recovered patient.
In physical therapy, the modality may seem as a minimal risk procedure when an experienced clinician correlates the risk benefit as being low. When using ultrasound for treating kidney stones, the risks are higher, therefore, the benefit is higher. The treatment is formally known as Lithotripsy, a non-invasive procedure that uses sound waves to break down kidney stones. Previously, kidney stones were considered a serious medical condition that required surgery. Therefore, the risk of treatment has higher significant loss and longer-term kidney injury can arise (J Ultrasound Med, 2012, p 10). Subsequently, medical procedures are viewed thoroughly to establish and compare of the risk and benefit for each patient. Ultimately, without the information about the risk to the patient, no procedure can take place (International Congress Series 1274, 2004, p.
The doctors and authors had strong evidence that when patients visited the treatment center and when directed to do physical exercise at home by a doctor, all patients whether directed to come into a clinic or do their exercises at home, all patients had shown significant improvements with the recovery of their knees. The study had proven that the patients who were directed to come into a clinic instead of doing physical therapy at home had proven to be a better off then the patients who did their physical therapy in the comfort of their own home. The patients progress was tested by a six minute walk that they completed a couple times during and after physical therapy was finished. “Both groups showed clinically and statistically significant improvements in six minute walk distances and WOMAC scores at 4 weeks; improvements were still evident in both groups at eight
However5, the amount of younger patients receiving the surgery grew between the decades 1990 and 2000. Relieving pain and improving quality of life are the primary goals for the procedure. According to Colby and Kisner’s text book, Therapeutic Exercise,5(778) common indications for the TKA include: severe joint pain when weight bearing, deterioration of articular cartilage secondary to severe arthritis, deformity of the knee, instability or range of motion limitations, and failure of nonoperative management or a previous surgical procedure. The patient chosen for this case study had four out of the five indications for surgery. For the TKA, the patient received an implant of a stryker triathlon, a #4 PCL substituting femur, a number 4 tibial tray, a number 13x3 polyethylene, and a 29mm patella button. In other words, she had a femoral component, tibial component, and patella button implanted into her left knee. General anesthesia and a hemovac drain were used during the surgery. The patient also had a cemented prosthesis, so she was weight bearing as tolerated in the maximum phase of
According to Petterson and Jacobsson (2002), degenerative joint disease (DJD) or osteoarthritis is the most common joint disorder seen in humans, affecting 60% of adults 60 years of age and older. Many studies have attempted to treat patients with DJD in a number of different ways including the use of the drug glucosamine, glucosamine and alendronate. Hamid Reza Arti and Mohammad Ebrahim Azemi undertook their own research in 2012 by comparing the effect of glucosamine and glucosamine with alendronate in symptomatic relieve of degenerative knee joint disease. They believed that due to the high prevalence of osteoarthritis especially knee osteoarthritis identification of effective treatment methods was an important factor in medical treatment of knee osteoarthritis. According to Arti and Azemi (2012) no previous study had addressed these issues.
Should osteoarthritis, tendinitis, bursitis and other joint conditions be treated with cortisone, and to what extent should treatment take place? Skeletal problems are intertwined in treatment before cortisone treatments are administered. There are several treatments besides cortisone, and they include massage, chiropractic, natural remedies, and physical therapy. One can measure quality by how safe it is for patients and question how effective, efficient, and timely, does service revolve around the patient, and equitable treatment and service is to the patient.
Osteoarthritis is a leading cause of muscle pain and disability and is most common in adults over 65 (Brakke, Singh, Sullivan 2012). According to the Centers for Disease Control and Prevention, osteoarthritis is the most common type of arthritis affecting over 12.4 million people over the age of 65. Brakke, Singh, and Sullivan (2012) explain that as those who have this diagnosis is usually treated with physical therapy to decrease pain and disability. Different modalities used including strength training, electrical stimulation, manual therapy, and aquatic therapy are used by therapists to increase physical function, physical activity levels, quality of life, and muscle strength (Brakke, Singh, Sullivan 2012).
Also, the severity of the knee pain of the participant was assessed by use of Kujala questionnaire and OSTRC Overuse injury questionnaire (Appendix 3).
Ultrasound therapy generates high frequency waves that deliver vibrations into tissues. A special ultrasound gel is positioned on the skin to amplify contact, preventing to overheat, and providing the wand to glide through skin smoothly. The ultrasound therapy treatment wand is traveled throughout the surface of the skin. The wand transmits energy for three to five minutes around the zone of injury. The therapy can be treated twice daily depending if the patient has been diagnosed with acute pain or chronic pain.
Ultrasound is a therapeutic modality that uses vibrations which are produced mechanically at a higher frequency than sound waves. These waves are referred to as ultrasonic as they are unable to be heard by humans (Robertson et al, 2006). The success of the use of ultrasound has been recorded as early as the 1930’s, when in Berlin, sciatica in patients had been shown to have improved greatly. This evidently resulted in further research and new treatment methods being created (Stanley, 1958). Since then a lot of research has been carried out and advances in the use of ultrasound has been made and are continuing to be made all the time. The effects of ultrasound in rehabilitation will be researched and examined to understand its effectiveness.
With regards to treating knee torment, there are a wide range of choices that are accessible. Knee Pain Treatment is critical in helping a large number of individuals either wipe out or adapt to their knee issue. It is urgent to build up a project that objectifies the foundation of their knee. In the event that he or she is not certain of the reason for their extreme knee pain then he or she ought to counsel a doctor before discovering their own medicines.