[Chondroprotector transdermal magnetophoresis for osteoarthritis of the knee]

RATIONALE

Treatment of osteoarthritis (OA) is a relevant problem of rheumatology. Despite a significant number of medical approaches and the creation of new drugs, the effectiveness of treatment remains unsatisfactory, which necessitates the creation of complex treatment programs. Pulse low-frequency magnetotherapy is a modern method that makes it possible to potentiate the therapeutic effects of chondroprotectors for transdermal administration using magnetophoresis technology.

AIM

To evaluate the efficacy and tolerability of combination therapy using chondroprotective magnetophoresis using 'running' pulsed magnetic field (RPMF) and application of chondroxide (transdermal gel form) in patients with knee OA.

MATERIAL AND METHODS

A randomized, placebo-controlled clinical trial included 65 patients with grade II - III knee OA according to the Kellgren-Lwrence classification. The 1st group included 25 patients who received local therapy - chondroxide magnetophoresis using RPMF (20 mT, frequency 6.25 Hz, exposure time 20 min, No. 12); in the 2nd group - 20 patients who underwent placebo-magnetotherapy of chondroxide; in the 3rd group - 20 patients who used RPMF without local chondroprotective therapy. We used VAS, WOMAC scales, EQ-5D questionnaire, OMERACT-OARSI criterion in order to analyze the results.

RESULTS

A pronounced analgesic effect of the treatment was registered (according to the VAS and WOMAC scales) in patients receiving magnetotherapy (p<0.01). A significant improvement in functional parameters (according to WOMAC) was noted, more pronounced in patients who used chondroxide magnetophoresis (p<0.001). During the course of treatment, a positive effect of magnetotherapy on the indicators of quality of life (according to EQ-5D) was registered. A high percentage of response (68.1%) to therapy using magnetophoresis of the transdermal form of chondroxide (according to OMERACT-OARSI) was demonstrated. No adverse reactions were registered during treatment.

CONCLUSION

The use of the local therapy method in the form of magnetophoresis of the transdermal form of the chondroxide is an effective and safe treatment technology that improves the functional state and quality of life of patients with OA of the knee joint.

[Comparative evaluation of effectiveness of different magnetotherapy regimens in patients with osteoarthritis]

Impulse low-frequency magnetotherapy is a modern method of treating diseases of the musculoskeletal system, including osteoarthritis. The effectiveness of the therapeutic effect largely depends on the biotropic characteristics of the magnetic fields - the type of magnetic field, induction, frequency, pulse shape, exposure, exposure zone.

AIM OF STUDY

To conduct a comparative analysis of effectiveness of applying various modes of magnetotherapy using an impulse low-frequency magnetic field in patients with osteoarthritis.

MATERIALS AND METHODS

A randomized, placebo-controlled clinical trial included 262 patients with grade II-III knee osteoarthritis according to the Kellgren-Lawrence classification. The 1st group included 56 patients who received local magnetic therapy on the knee using a running pulsed magnetic field (RPMF) - 20 mT, frequency 6.25 Hz, exposure time 20 min. The 2nd group included 99 patients who were exposed to a magnetic field using a combination of modes: 5 days - an impulse magnetic field (IMF) with induction of 2 mT, frequency of 100 Hz, then RPMF mode - 20 mT, frequency of 6.25 Hz, duration 20 min, number of procedures - 12. The third group included 97 patients who received placebo-magnetotherapy on the knee joint area. When analyzing the results, the VAS (100 mm) and WOMAC scales were used, as well as the subjective assessment of the treatment results by patients (5-point scale).

RESULTS

A pronounced symptom-modifying effect of magnetotherapy (according to VAS and WOMAC) was established in the form of a decrease in the severity of pain in patients with gonarthrosis (p<0.01). There was a significant improvement in pain and stiffness indices, as well as functional characteristics (WOMAC), more pronounced in patients who received a combined regime of exposure to a magnetic field (p<0.01). The use of magnetotherapy using various modes is safe for patients and does not cause serious adverse events.

CONCLUSION

The application of magnetotherapy equipment, which allows the use of various biotropic characteristics of magnetic field, is an effective and safe technology for treatment of patients with osteoarthritis.

[The role of rehabilitation and apparatus physiotherapy in rheumatic disease treatment strategies]

Rheumatic diseases are a serious medical and social problem. The variability of mechanisms for the development of this group of diseases requires different approaches: strategies of drug and non-medicament therapy in modern rheumatology are designed to complement each other. EULAR recommendations pay insufficient attention to the use of non-medical methods of joint disease treatment. According to modern research, multi-disciplinary rehabilitation strategies, including, in addition to drug therapy, educational programmes, physical training of various intensities, as well as the use of apparatus rehabilitation methods, have proven to be the most effective. Hardware physiotherapy seems to be optimal for the treatment of rheumatic patients due to its higher accessibility and lower cost in comparison with classical balneo- and peloidotherapy. With the use of magnetotherapy there is also greater safety and fewer contraindications to the procedures. The method of using pulsed magnetic fields is the most justified in the treatment of joint diseases, since the sensitivity of biological tissues to them is the highest. The clinical effectiveness of pulsed magnetotherapy has been demonstrated in several randomized placebo-controlled multi-centre studies. Against the background of carried out magnetic field therapy in patients were statistically significant reduction of pain and stiffness, improvement of joint function, which indicates the expediency of including the physical factor in the strategy of treatment of rheumatic diseases in combination with drug therapy.

[Evaluation of the efficiency of magnetophoresis transdermal diclofenac delivery in patients with knee osteoarthritis]

Osteoarthritis (OA) is a serious sociomedical problem, one of the leading causes of persistent disability and reduced quality of life. Modern publications on the use of transdermal drug formulations for OA evaluate the efficiency and safety of isolated drug administration. Pulse magnetotherapy is a modern method for potentiating the therapeutic effects of both the drug and the magnetic field (MF) in the single magnetophoretic technique.

AIM

to determine the effect of pulsed MF on the clinical efficacy and tolerability of magnetophoretic transdermal diclofenac delivery in patients with gonarthrosis.

SUBJECTS AND METHODS

A clinical randomized placebo-controlled study was conducted in 65 patients with Kellgren-Lawrence grade 2-3 knee OA, who were divided into 3 groups. Group 1 including 25 patients received magnetophoretic diclofenac gel delivery using a traveling MF (intensity, 20 mT; frequency, 6.25 Hz; exposure. 20 min, 12 sessions); Group 2 consisting of 20 patients used placebo magnetotherapy with diclofenac without MF; Group 3 comprising 20 patients had low-frequency pulse magnetotherapy with traveling MF without topical diclofenac therapy. VAS and WOMAC and the EQ-5D questionnaire were used during the examination. The results of treatment were analyzed according to the OMERACT-OARSI criterion.

RESULTS

According to VAS and WOMAC scores, combination therapy showed a marked analgesic effect in the patients who had received magnetotherapy (p<0.01), as well as a significant reduction in stiffness and an improvement in functional characteristics, which were more pronounced in those who had magnetophoresis (p<0.001). According to the EQ-5D questionnaire, magnetotherapy was noted to have a positive impact on quality-of-life indicators. Analysis according the OMERACT-OARSI criterion demonstrated a high rate (67.8%) of response to magnetophoretic sis using diclofenac application formulations.

CONCLUSION

Magnetophoretic transdermal diclofenac delivery using low-frequency pulsed MF is effective and safe for patients with knee OA and causes no serious adverse events.

[The rationale for the application of magnetophoresis for the treatment of intra-articular pathology]

The present study was designed to elucidate the influence of the magnetic field on the spectroscopic characteristics of nimesulide and glucosamine sulfate preparations. The secondary objective of the study was to evaluate the clinical effectiveness of the combined application of magnetotherapy and transdermal forms containing a non-steroidal anti-inflammatory preparation and a chondroprotector with the use of magnetophoresis. For this purpose, we analyzed the samples exposed to the running magnetic field in an infrared spectrometer to elucidate the changes in the optical characteristics of the preparations of interest. The clinical effectiveness of the combined application of magnetophoresis was estimated in 83 patients presenting with knee osteoarthritis. The use of the infrared spectroscopic technique in the combination with the Fourier analysis made it possible to visualize the absence of coarse optical defects and structural changes in the test samples under the influence of the physical factors which provides the basis for their physiophoretic administration. The clinical studies conducted with the application of the combined physio-pharmacological treatment have demonstrated the feasibility and high effectiveness of this approach for the management of the patients presenting with articular pathology. The rehabilitative measures accelerated the earlier appearance of the pronounced analgesic effect and promoted the restoration of the joint function. Moreover, they reduced the drug load and improved the quality of life of the patients.