Knee Electrotherapy: Difference between revisions
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The majority of the literature surrounding the used of PSWT in the knee looks at Knee OA, and due to the lack of evidence found it and guidance from NICE the use of PSWT cannot be recommended from the literature. <br> | The majority of the literature surrounding the used of PSWT in the knee looks at Knee OA, and due to the lack of evidence found it and guidance from NICE the use of PSWT cannot be recommended from the literature. <br> | ||
This [http://www.physio-pedia.com/Pulsed_Shortwave_Therapy Physiopedia page] looks at the suggested effects of PSWT | |||
== References == | == References == | ||
<references /> | <references /> | ||
Revision as of 18:10, 27 November 2016
Introduction[edit | edit source]
This page will look at each method of electrotherapy and the evidence to support it in the use of knee conditons specifically.
Pulsed Shortwave Therapy [edit | edit source]
Pulsed shortwave therapy is an electrotherapy modality that is used in practice, and there are 2 types off effects suggested.
- Electric field – upon literature reviewing there is very little evidence to support this theory, and almost all of the literature supports the magnetic field effect.
- Magnetic field – the main effect of the pulsed magnetic field has been documented to work at a cellular level at the cell membrane. It has been suggested to assist in the transportation of ions across the membrane.
The effects are said to be in the acute and inflammatory process and documented effects are on:
- Muscles
- Nerves
- Areas of oedema
- Haematosis
- Effusion [1]
Therefore this would suggest that the use of pulse short wave therapy in knee conditions that resulted in effusions and oedema is effective: i.e. ligamentous injuries, arthritis and meniscal lesions, as these can all produce inflammation and swelling. A study in 2010 by Al – Mandeel and Watson found that there were significant physiological changes (blood volume) through the use of low and high doses of pulsed shortwave therapy. Limitations of this study was that this was done in healthy subjects therefore there were no pathology within the joint and people with excess adipose tissue were ecluded as this was identified to effect the effectiveness of the therapy. [2]
Whereas Callaghan et al in 2005 looked at the effects of PSWT on levels of inflammation in patients with OA knee. The primary outcome used was sophisticated radioleucoscintigraphy to identify levels of inflammations pre and post treatments. They found that there was little inflammation in those with OA knee to start with but that there was no significant change in their levels after PSWT. [3]
The National Institute for Clinical Excellence (NICE) has not recommended the used of PSWT for OA but the use of TENS as an adjunct only. [4]
There is limited evidence looking at the effect of PSWT on knee conditions specifically, therefore a search was conducted on the effectiveness of PSWT on oedema and effusions, a study was identified that looked that the use of cryotherapy versus PSWT on swelling post calcaneal fractures. There were no differences found in either group and swelling had significantly improve by day 5 anyway. Cryotherapy was recommended from this study as this was a cheaper alternative which could be transported anywhere. [5]
The majority of the literature surrounding the used of PSWT in the knee looks at Knee OA, and due to the lack of evidence found it and guidance from NICE the use of PSWT cannot be recommended from the literature.
This Physiopedia page looks at the suggested effects of PSWT
References[edit | edit source]
- ↑ Electrotherapy. Pulsed Shortwave Therapy. http://www.electrotherapy.org/modality/pulsed-shortwave-therapy (accessed 27 Nov 2016)
- ↑ Al‐Mandeel MM, Watson T. The thermal and nonthermal effects of high and low doses of pulsed short wave therapy (PSWT). Physiotherapy Research International. 2010 Dec 1;15(4):199-211
- ↑ Callaghan MJ, Whittaker PE, Grimes S, Smith L. An evaluation of pulsed shortwave on knee osteoarthritis using radioleucoscintigraphy: a randomised, double blind, controlled trial. Joint Bone Spine. 2005 Mar 31;72(2):150-5.Ultrasound
- ↑ NICE. Osteoarthritis: Care and Management: Non-pharmacological management. https://www.nice.org.uk/guidance/cg177/chapter/1-Recommendations#non-pharmacological-management-2 (accessed 27 Nov 2016)
- ↑ Buzzard BM, Pratt RK, Briggs PJ, Siddique MS, Tasker A, Robinson S. Is pulsed shortwave diathermy better than ice therapy for the reduction of oedema following calcaneal fractures?: Preliminary trial. Physiotherapy. 2003 Dec 31;89(12):734-42.
