OA of geriatric diabetis case

[DamaPhysio]

I have 75 years old male patient, over wight 73kgs, history of diabetic (under medicaion)diagnosed with bilateral OA, more pain in the RT knee, his x-ray showed reduced in joint spaces in both knees, medial border of the both knees showed no joint space at all, he has been advised to do a surgery (Total Knee replacement) but he refused, patient complain of continous pain in both knees more at night, patien also complain of numbness in both feet,

I started treating him with TENS on both knees, MH, and free ROM exercises, i have a plane to give him static quads exercises an ankle puumb Exercises, i asked him to buy a cycle to start doing cycling at home.

please if you have any suggesstions for treating this case let me know...

Thank you , waiting for your advises...

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[arkesh_physio]

I would advice u to go 4 gentle mobilization of knee to facilitate synovial fluid motion.
u can go for faradic stimulation of VMo,dipole vector to reduce pain.

[jwilso]

if his joint space is completely worn then what do you think you can do for him. if you can reverse the degenerative changes that he has then you are a miracle worker. you can only give ROM and quads/hamstings exercises. why doesnt he want knee replacements? they would give him a new lease of life. i would counsel him on the sugery and his fears. Maybe introduce him to other patients that have had TKR surgery.

[charlize29]

Usually elderly patients would be scared of going thru operations. Maybe you could try explaining to her that knee replacements would prove beneficial as to her ambulation. Patients sometimes wouldn't follow an exercise regimen or refuse to go for surgery due to the fact that they have not been informed thorougly of what arthritis is all about. Discussing the goals,and the treatment available for her like what jwilso mentioned will be the main key in improving her quality of life.

Rehabilitation of the individual with arthritis is most often directed toward restoring or maintaining joint mobility and strength, and emphasizes functional retraining,eps. patient education , which promotes the highest possible level of functional independence.



REgards,
Charlize29

[guru_utkarsh]

I've got a question.. Is cycling the right exercise in OA cases.. or is swimming better..
And in cases wen we cant ask the patient to swim then is it better to just do strentghening exercises than to cycle.. Thanks.

[charlize29]

Cycling on a stationary bicycle is good as well as swimming. Swimming is better because it puts less stress on the joints. You are on the right track guru, just avoid high impact activites

Regards,
Charlize29