ﻧﺘﺎﯾﺞ ﺑﺎﻟﯿﻨﯽ ارﺗﻌﺎش ﻣﻮﺿﻌﯽ ﻋﻀﻠﻪ ﭼﻬﺎر ﺳﺮ درﮐﺎرﮐﻨﺎن ﻧﻈﺎﻣﯽ ﻣﺒﺘﻼ ﺑﻪ اوﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺘﻮﺳﻂ زاﻧﻮ : ﯾﮏ ﮐﺎرآزﻣﺎﺋﯽ ﺑﺎﻟﯿﻨﯽ

Clinical Outcomes of Local Quadriceps Vibration in Military Personnel with Moderate Knee Osteoarthritis: A Clinical Trial Study

اوﺳﺘﺌﻮآرﺗﺮﯾﺖ زاﻧﻮ ﯾﮏ ﺑﯿﻤﺎري دژﻧﺮاﺗﯿﻮ ﺷﺎﯾﻊ اﺳﺖ ﮐﻪ اﻓﺮاد ﻣﺒﺘﻼ را دﭼﺎر ﻧﺎﺗﻮاﻧﯽ ﻣﯽ ﮐﻨﺪ. ﻫﺪف اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮرﺳﯽ ﻧﺘﺎﯾﺞ ﺑﺎﻟﯿﻨﯽ ارﺗﻌﺎش ﻣﻮﺿﻌﯽ ﻋﻀﻠﻪ ﭼﻬﺎر ﺳﺮ درﮐﺎرﮐﻨﺎن ﻧﻈﺎﻣﯽ ﻣﺒﺘﻼ ﺑﻪ اوﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺘﻮﺳﻂ زاﻧﻮ ﺑﻮد. روشﻫﺎ: در اﯾﻦ ﮐﺎرآزﻣﺎﺋﯽ ﺑﺎﻟﯿﻨﯽ ﺗﺼﺎدﻓﯽ ﺷﺪه 76 ﻧﻔﺮ از ﮐﺎرﮐﻨﺎن ﻧﻈﺎﻣﯽ ﻣﺒﺘﻼ ﺑﻪ اوﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺘﻮﺳﻂ زاﻧﻮ از ﻃﺮﯾﻖ ﻧﻤﻮﻧﻪ ﮔﯿﺮي ﺗﺼﺎدﻓﯽ ﺳﺎده در دو ﮔﺮوه 38 ﻧﻔﺮه ﻣﺪاﺧﻠﻪ )ﮔﺮوه ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ روﺗﯿﻦ ﺑﻪ ﻫﻤﺮاه ﻟﺮزش ﻣﻮﺿﻌﯽ ﻋﻀﻠﻪ ﭼﻬﺎرﺳﺮ( و ﮔﺮوه ﮐﻨﺘﺮل )ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ روﺗﯿﻦ( ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺘﻨﺪ. اﺑﺰارﻫﺎي ﻣﻮرد اﺳﺘﻔﺎده ﻋﺒﺎرت ﺑﻮدﻧﺪ از: ﭘﺮﺳﺸﻨﺎﻣﻪ اي ﻣﺮﺑﻮط ﺑﻪ اﻃﻼﻋﺎت ﻓﺮدي، دﻣﻮﮔﺮاﻓﯿﮏ و اﻃﻼﻋﺎت ﺑﺎﻟﯿﻨﯽ، ﭘﺮﺳﺸﻨﺎﻣﻪ ﻫﺎي اﺳﺘﺎﻧﺪارد SF36 ،WOMAC و ﮔﻮﻧﯿﺎﻣﺘﺮ. ﻣﺘﻐﯿﺮﻫﺎي ﻣﻮرد ﺑﺮرﺳﯽ ﺷﺎﻣﻞ ﺷﺪت درد، ﺷﺪت ﻧﺎﺗﻮاﻧﯽ زاﻧﻮ، ﻣﯿﺰان داﻣﻨﻪ ﺣﺮﮐﺘﯽ ﺧﻢ ﺷﺪن زاﻧﻮ، و ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ ﺑﯿﻤﺎر ﺑﻮدﻧﺪ. اﯾﻦ ﻣﺘﻐﯿﺮﻫﺎ ﻗﺒﻞ و ﺑﻌﺪ از ﭘﺎﯾﺎن ﻣﺪاﺧﻠﻪ در ﻫﺮ دو ﮔﺮوه اﻧﺪازهﮔﯿﺮي ﺷﺪﻧﺪ. آﻧﺎﻟﯿﺰ ﻧﺘﺎﯾﺞ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮنﻫﺎي ﮐﻠﻤﻮﮔﺮوف اﺳﻤﯿﺮوﻧﻮف )T-Test ،Paired T-Test ،(K-S ﺻﻮرت ﮔﺮﻓﺖ. ﯾﺎﻓﺘﻪﻫﺎ: ﻧﺘﺎﯾﺞ دﻣﻮﮔﺮاﻓﯿﮏ ﭘﺎﯾﻪ ﻣﺎﻧﻨﺪ ﺟﻨﺴﯿﺖ )0/112=P(، ﺳﻦ )0/290=P(، و ﺷﺎﺧﺺ ﺗﻮده ﺑﺪﻧﯽ )0/870=P( ﺗﻔﺎوت آﻣﺎري ﻣﻌﻨﺎداري ﺑﯿﻦ دو ﮔﺮوه ﻣﺪاﺧﻠﻪ و ﮐﻨﺘﺮل ﻧﺸﺎن ﻧﺪاد )دو ﮔﺮوه ﺷﺮاﯾﻂ ﯾﮑﺴﺎﻧﯽ داﺷﺘﻨﺪ(. ﻣﯿﺎﻧﮕﯿﻦ ﻣﺘﻐﯿﺮﻫﺎي ﺷﺪت درد )0/001=P(، ﺷﺪت ﻧﺎﺗﻮاﻧﯽ زاﻧﻮ )0/003=P(، ﻣﯿﺰان داﻣﻨﻪ ﺣﺮﮐﺘﯽ ﺧﻢ ﺷﺪن زاﻧﻮ )0/011=P(، و ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ )0/017=P( ﺑﯿﻤﺎران )ﻗﺒﻞ و ﺑﻌﺪ از ﻣﺪاﺧﻠﻪ( در ﻫﺮ دو ﮔﺮوه ﺗﻔﺎوت ﻣﻌﻨﯽداري )روﻧﺪ ﺑﻬﺒﻮدي ﻧﺴﺒﺖ ﺑﻪ ﻗﺒﻞ ( را ﻧﺸﺎن داد. ﻣﯿﺎﻧﮕﯿﻦ درﺻﺪ ﺗﻐﯿﯿﺮات ﻣﺘﻐﯿﺮﻫﺎي ﺷﺪت درد )0/003=P(، ﺷﺪت ﻧﺎﺗﻮاﻧﯽ زاﻧﻮ )0/005=P(، ﻣﯿﺰان داﻣﻨﻪ ﺣﺮﮐﺘﯽ ﺧﻢ ﺷﺪن زاﻧﻮ )0/72=P(، و ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ)0/013=P( ﺑﯿﻦ دو ﮔﺮوه ﺗﺤﻘﯿﻖ )ﺟﺰ در ﻣﺘﻐﯿﺮ ﻣﯿﺰان داﻣﻨﻪ ﺣﺮﮐﺘﯽ ﺧﻢ ﺷﺪن زاﻧﻮ )0/72=P( ( در ﺑﻘﯿﻪ ﻣﺘﻐﯿﺮﻫﺎ ﻣﻌﻨﺎدار ﺑﻮد . ﻣﯿﺰان درﺻﺪ ﺗﻐﯿﯿﺮات اﯾﻦ ﻣﺘﻐﯿﺮﻫﺎ ﺑﻌﺪ از اﺗﻤﺎم ﺗﺤﻘﯿﻖ در ﮔﺮوه ﻣﺪاﺧﻠﻪ ﺑﯿﺸﺘﺮ از ﮔﺮوه ﮐﻨﺘﺮل و ﻣﻌﻨﺎدار ﺑﻮد )0/004=P(. ﻧﺘﯿﺠﻪﮔﯿﺮي: ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ روﺗﯿﻦ ﺑﻪ اﺿﺎﻓﻪ ﻟﺮزش ﻣﻮﺿﻌﯽ ﻋﻀﻠﻪ ﭼﻬﺎرﺳﺮ )ﻧﺴﺒﺖ ﺑﻪ ﻓﯿﺰﯾﻮﺗﺮاﭘﯽ روﺗﯿﻦ ﺗﻨﻬﺎ( ﻣﯽ ﺗﻮاﻧﺪ ﺑﺎﻋﺚ ﮐﺎﻫﺶ ﺑﯿﺸﺘﺮ ﺷﺪت درد، ﮐﺎﻫﺶ ﻣﯿﺰان ﻧﺎﺗﻮاﻧﯽ زاﻧﻮ، ﺑﻬﺒﻮد ﻣﯿﺰان داﻣﻨﻪ ﺣﺮﮐﺘﯽ ﺧﻢ ﺷﺪن زاﻧﻮ، و ﺑﻬﺒﻮد ﻧﻤﺮه ﮐﯿﻔﯿﺖ زﻧﺪﮔﯽ در اﻓﺮاد ﻣﺒﺘﻼ ﺑﻪ اوﺳﺘﺌﻮآرﺗﺮﯾﺖ ﻣﺘﻮﺳﻂ زاﻧﻮ ﮔﺮدد.

Knee osteoarthritis is a common degenerative disease that disables affected people. The purpose of this study was to evaluate the clinical outcome of local quadriceps vibration in military personnel with moderate knee osteoarthritis. Methods: In this randomized clinical trial, 76 military personnel with moderate knee osteoarthritis were studied through simple random sampling in two intervention groups (routine physiotherapy group with local quadriceps vibration) and control group (routine physiotherapy). The tools used were: demographic and clinical information questionnaire, standard WOMAC and SF36 questionnaires, and goniometer. The variables studied were: pain severity, severity of knee disability, knee flexion range of motion, and patient quality of life score. These variables were measured before and after the intervention in both groups. The results were analyzed by KS Test, Paired T-Test, and T-Test. Results: Baseline demographic results such as gender (P = 0.112), age (P = 0.290), and BMI (P = 0.870) showed no statistically significant difference between the two groups (the two groups were similar). The mean of pain severity (P = 0.001), knee disability severity (P = 0.003), knee flexion range of motion (P = 0.011), and quality of life (P = 0.017) scores before and after intervention in both groups showed a significant difference (recovery process). The change percentage in variables was higher and significant in the intervention group than the control group (P = 0.004). Conclusion: Routine physiotherapy plus local quadriceps vibration (compared to routine physiotherapy) can reduce pain severity, reduce knee disability, improve knee flexion range, and improve quality of life in people with moderate knee osteoarthritis.