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Efficacy of Radial Shockwave Therapy for Treatment of Pain in Knee Osteoarthritis

4 oktober 2016 uppdaterad av: Marta Imamura
The objective of this study is to compare the results of 2000 impulses of radius shockwaves per week with 2000 placebo shockwaves on the treatment of pain and functional incapacity of patients with severe primary knee osteoarthritis, who did not satisfactory respond to previous conventional treatments.

Studieöversikt

Detaljerad beskrivning

  • Prospective, placebo controlled randomized and double-blind study.
  • Treatment Method:

Radial extracorporeal shockwaves will be applied using the Swiss Dolorclast (EMS Electro Medical Systems, Switzerland), generated by pneumatic waves.

Intervention:

  • Group 1 - Intervention group Patients will receive 2,000 impulses of radial shockwave per week, with pressure of 2.5bar to 4.0bar, at the frequency of 8Hz. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.
  • Group 2 - Control Group:

Patients will receive 2,000 impulses of placebo radial shockwave per week, without any energy flow intensity. Frequency of 8Hz will appear in the screen. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.

Post application program for both groups: Three consecutive days of:

  1. Hot packs (superficial heat) applied on the application site for 20 minutes;
  2. Simple analgesics, when needed (Acetaminophen 500mg every 6 hours, or analogue in case of allergy).

Outcome Evaluation:

The evaluation of pain intensity will be done according to the VAS (Visual Analog Scale) The influence of pain on the functional capacity of patients will be measured with WOMAC (Western Ontario and McMaster Osteoarthritis Index) for knee evaluation.

Another evaluation criteria will be the level of tolerance of pressure on several muscles and other parts as the pes anserinus and patellar tendon, the knee joint interface, and the supraspinal of L1 to S1 also on the dermatomal from T12 to S2. These measures will be done by the Fisher algometry.

The evaluations will be carried out before the treatment, immediately after the treatment and 3 months after the end of the treatment.

Analgesia drut will be prescribed, if patients feel pain during the days after the application.

Studietyp

Interventionell

Inskrivning (Faktisk)

105

Fas

  • Fas 2

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Sao Paulo, Brasilien, 05716-150
        • Instituto de Medicina Fisica e Reabilitacao HCFMUSP
      • Sao Paulo, Brasilien, 05403-010
        • Instituto de Ortopedia e Traumatologia HCFMUSP

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

60 år och äldre (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  • Clinical and radiological diagnosis of primary knee diagnosis.
  • Pain intensity: Visual Analog Scale (VAS) ≥ 6;
  • One of more failures with conventional treatment (drugs, Non-Steroidal Anti-inflammatory Drugs - NSAD, physiotherapy, stretching, acupuncture, orthosis and others);
  • Age over 60 years;
  • No use of corticosteroids in the prior 48 hours;
  • No major osteoarthritis events in other joints of lower limbs (waist and ankle) and lower back;
  • No clinical evidence of related neuropathy, including radiculopathy and peripheral neuropathy;
  • Absence of systemic inflammatory disease (Rheumatoid arthritis, Reiter, ankylosing spondylitis, generalized polyarthritis, cancer);
  • Absence of infection or cancer at the application site;
  • Absence of related endocrine and metabolic diseases;
  • Absence of fibromyalgia, diagnosed after the American College of Rheumatology, 1999;
  • Absence of severe blood dyscrasias;
  • Absence of severe psychiatric disturbances that requires psychiatric assessment;
  • Availability to comply with the clinic visits and follow up evaluations along the treatment

Exclusion Criteria:

  • Patients who withdraw the informed consent form at any time

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Extracorporeal radial shockwaves
Patients will receive 2,000 impulses of extracorporeal radial shockwave per week, with pressure of 2.5bar to 4.0bar, at the frequency of 8Hz. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.
Patients will receive 2,000 impulses of extracorporeal radial shockwaves or per week, with pressure of 2.5bar to 4.0bar, at the frequency of 8Hz. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.
Placebo-jämförare: Placebo Radial Shockwaves
Patients will receive 2,000 impulses of placebo radial shockwave per week, without any energy flow intensity. Frequency of 8Hz will appear in the screen. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.
Patients will receive 2,000 impulses of placebo extracorporeal radial shockwaves per week, without any pressure, therefore no energy will be applied, at the frequency of 8Hz. The impulses will be applied at the most painful site of the knee joint interface on manual palpation, for three consecutive weeks.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Visual Analog Scale
Tidsram: Before intervention and after 3 months of the end of intervention
The Visual Analog Scale consists of a straight line of 10cm length which presents the phrase "absence of pain" (0) at one extremity, and unbearable pain (10) at the other extremity.
Before intervention and after 3 months of the end of intervention

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Level of tolerance of pain
Tidsram: Immediately before the intervention, immediately after the intervention and 3 months after the intervention.
Measures will be taken with the Fisher algometry in the following muscles: vastus medialis, vastus lateralis, rectus femoris, gracilis, adductor longus, tibialis anterior, fibularis longus, quadratus lumborum, iliopsoas and popliteus; also at the pes anserinus and patellar tendon, the knee joint interface, the supraspinal of L1 to S1 and on the dermatomal from T12 to S2.
Immediately before the intervention, immediately after the intervention and 3 months after the intervention.

Andra resultatmått

Resultatmått
Tidsram
The influence of pain over the functional capacity of patients based on the WOMAC questionnaire
Tidsram: Immediately before the intervention and 3 months after the intervention.
Immediately before the intervention and 3 months after the intervention.

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Samarbetspartners

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 maj 2010

Primärt slutförande (Faktisk)

1 december 2015

Avslutad studie (Faktisk)

1 december 2015

Studieregistreringsdatum

Först inskickad

17 juli 2014

Först inskickad som uppfyllde QC-kriterierna

21 juli 2014

Första postat (Uppskatta)

23 juli 2014

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

5 oktober 2016

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

4 oktober 2016

Senast verifierad

1 oktober 2016

Mer information

Termer relaterade till denna studie

Andra studie-ID-nummer

  • Radial Shockwave

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