OA knee

[physioshweta]

A 40 years F presents with a history of pain in both knees since 6 months and X-ray shows degenrative changes{OA}

well i have just started practising and would like to know the exact treatment plan including exerciseand electrothearpy best sited to the condition.
actually there are many patients out here having mentallity that this is life long and i just need to change it
please help

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[arkesh_physio]

hi shweta,
go 4 some VMO muscle training,it assists to clear the swelling.it can be done with faradic stim also.
in my opinion IFT(dipole vector) is good 4 pain relief.
Ergonomic advice is most imp,avoid squatting,etc
go 4 hams stretching & u could also go 4 gr1-2 mob to relieve pain.
hope this helps,
regards
ark.

[utkarsh777]

hey shweta,
U are absolutely right... OA shdnt be considered a life long problem and total rehab shd be possible but in my practice i've seen that until the patient is well educated its difficult to keep'em going with the exercises and precautions they need..

I feel u can try SWD and IFt.. combo works well for pain relief and removing symptoms.. gradually strenghten the Quads particularly VMO..
+as arkesh has said ergonomic advice is important.. prevent cross leg sitting, squatting, giving excess strain to knees..

One thing i wid like to know shd we use muscle stimulator to strengthen VMO or give manual exercise.. Wat is the role of muscle stimulator in OA...

I've tried some mobilizations of the knee too... they seem to work well.. esp. patellar and little joint distractions.. rhythmic...

Hope this helps...
Take physios to the top<img border=0 src="http://www.ezboard.com/images/emoticons/glasses.gif" />...

[physioshweta]

thanx for the help!

so it think the treatment plan shld go like this

first 4 days-HC packs,ATM,static quadriceps,other advice.

later5-10 days-all the above things +stimulation,some dynamic exc,("massage")??,manual knee traction

10 to 20 days -above+TENS (wld that work???),resisted exc


WOULD THIS BE THE PLAN? add somethign if required
AND DO U MEAN vastus medialis by VMO????/

[utkarsh777]

Hey shweta,
well 1st of all practicing in india, i've never had a patient who is ready to go beyond 10 treatment sessions that too if i charge em a meagre 100 bucks a session or probably 125..
so i wud say start with IFT and SWD from day 1 till day 5... by day 5 pain gone.. i hope... then move to stimuln of muscles and SWD.. u can ask for isometrics during 1st 5 days as many times possible but hold of only bout 5 sec... progress further gradually..

Put a hot pack on the knee during IFT and stimuln follow it by patellar mobilization and mannual traction...

This shd be good enough.. u can space the sessions in the 2nd half of the 10 days.. that is call the patient alternate days during last 5 sessions... ask patient to do some Hot water fomentation on the off days with proper exs.. by this u can intervene for a longer time take proper fees and get results...

This works for me.. might not work for others.. i always feel there is no protocol for any patient, a (patient-therapist) makes a new one everytime...

VMO is VAstus medialis obliqe... jz care bout vastus medialis..

hope i've been good help...


<blockquote><strong><em>Quote:</em></strong><hr>TAKE PHYSIOTHERAPY TO THE TOP<hr></blockquote>

[sdkashif]

Have a look over that article

Physiotherapy for Osteoarthritis

[physioshweta]

i am really thankful to both Ashif sir and Utkarsh sir,thanx a lot for your help.

I hope the site given below would help some of the visitors

http://www.physsportsmed.com/issues/...etrella_pa.htm

Sir could You specify something,other than the things mentioned above for a OA patient having sudden severe pain once or twice in a fortnight.
X-ray- dose not show any loose bodies.