Comparative short-term effectiveness of ibuprofen gel and cream phonophoresis in patients with knee osteoarthritis
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The objective of the present study was to compare the effectiveness of gel and cream ibuprofen phonophoresis in patients with knee osteoarthritis. A single-blinded, randomized, comparative design was applied. Patients diagnosed with knee osteoarthritis according to the American College of Rheumatology criteria were included in the study. After obtaining written informed consent, patients were randomized into ibuprofen gel and cream phonophoresis groups. Each patient was treated five sessions per week for 2 weeks (ten sessions). Main outcome measures were 100 mm visual analogue scale (VAS) for pain and the disease-specific questionnaire; Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Sixty-one knee osteoarthritis patients with a mean age of 57.9 ± 9.7 years were included in the study. Baseline VAS and WOMAC scores were similar between gel (n = 30) and cream (n = 31) phonophoresis groups (p > 0.05 for both). Following the treatment, both groups showed improvement compared to baseline measures including VAS pain and WOMAC scores. In the gel phonophoresis group, the improvement in VAS score was higher than that observed in the cream phonophoresis group (p < 0.001). Similarly, the improvement in WOMAC total score was also higher in the gel phonophoresis group (p < 0.001). Ibuprofen phonophoresis is clinically effective in patients with knee osteoarthritis. Phonophoresis using the gel form of ibuprofen is associated with more clinical improvement than that using the cream form of the same molecule.
KeywordsIbuprofen Knee osteoarthritis Osteoarthritis Phonophoresis
We thank physiotherapist Safine Havuc for her valuable contribution to the treatment sessions of phonophoresis.
ICB: contributed to the conception and design of the study; collection, analysis, and interpretation of data; drafting and revising the article; approval of the final version. NG: contributed to the acquisition of data; drafting the article and approval of the final version. SB: contributed to the design of the study; drafting the article and approval of the final version.
The study was funded by the Research Fund of Cukurova University (Project number: TF2014BAP11), which had no involvement in the design, execution, or reporting of the study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Ethical consent was obtained from the Local Ethics Committee of Cukurova University (Date: 23-June-2015, number: 42/8) and approved by the Turkish Ministry of Health.
Animal/human rights statement
All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 4.Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J et al, American College of Rheumatology (2012) American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken) 64:465–474CrossRefGoogle Scholar
- 5.Boonhong J, Suntornpiyapan P, Piriyajarukul A (2018) Ultrasound combined transcutaneous electrical nerve stimulation (UltraTENS) versus phonophoresis of piroxicam (PhP) in symptomatic knee osteoarthritis: a randomized double-blind, controlled trial. J Back Musculoskelet Rehabil. https://doi.org/10.3233/BMR-150492 PubMedCrossRefGoogle Scholar
- 12.Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K et al (1986) Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum 29:1039–1049CrossRefPubMedGoogle Scholar
- 14.Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMedGoogle Scholar
- 16.Bellamy N (2003) WOMAC Osteoarthritis Index user guide VI, Queensland, AustraliaGoogle Scholar
- 28.Watson T, Young SR (2008) Therapeutic ultrasound. In: Watson T (ed) Electrotherapy: evidence-based practice, 12th edn. Chruchill Livingstone-Elsevier, Edinburgh, pp 179–200Google Scholar