Effect of radiofrequency ablation of genicular nerves on the isokinetic muscle strength of knee joint in patients with osteoarthritis knee: A randomized double-blind sham controlled clinical trial.

BACKGROUND: This randomised controlled trial evaluated the effect of radiofrequency ablation (RFA) of genicular nerve on muscle strength in osteoarthritis knee patients with chronic pain. METHODOLOGY: Fifty-four patients with chronic knee osteoarthritis, experiencing significant pain (VNRS > 50) and moderate to severe disease (KL grade ≥ 2) were enrolled. Group 1 received RFA of genicular nerves of the affected knee while Group 2 received a sham procedure. The primary outcome was change in knee muscle strength evaluated using isokinetic peak torque(IPT) using IsoforceTM isokinetic dynamometer at 3 months. Secondary outcomes included changes in pain scores, function, perceived effect of the treatment and compliance to physiotherapy. RESULTS: At 3 months, significant difference was observed between IPT of flexor muscle at 60 and 180 degrees between the treatment and the Sham control (p-value = 0.01). No significant difference was observed in the extensor muscle strength. Within-group analysis revealed a significant increase in the IPT values for both extension and flexion at 60 and 180 degrees/sec evident across various time intervals. Group1 consistently reported lower VNRS scores at all time points. WOMAC scores of both groups were significantly different at all timepoints, with higher scores indicating reduced functionality in Group2. The GPE and compliance to physiotherapy were higher in Group1 patients at all times of follow up albeit decreasing trend in later periods. CONCLUSION: Application of RFA to genicular nerves in chronic OA knee patients resulted in better pain relief, improved functionality and increased muscle strength at extension and flexion at 3 months follow-up.

A single group trial (before - after) on impact of physiotherapeutic intervention package on relief from low back pain of pregnant women.

Introduction: More than half of the women have low back pain (LBP) at some point during pregnancy; the intensity of back pain increases as the pregnancy progresses. Such changes increase their risk for musculoskeletal disorders and fall injuries. Aim and Objective: Our study's objective was to estimate the prevalence of LBP in antenatal and postnatal cases of pregnancy in PGIMER, Chandigarh and to ascertain impact of a training intervention on incidence and severity of LBP in the study subjects. Methodology: A single group trial (before and after) on impact of physiotherapeutic intervention package on relief from LBP in pregnant women in between 20 and 35 years of age group were selected. The study duration was one year. The numeric pain rating scale was taken for measuring pain intensity at different levels. Where 0 indicates no pain, 1-3 indicates mild pain (which may be nagging, annoying, and interfering little with activities of daily livings (ADLs)), 4-6 indicates moderate pain (interferes significant with ADLs), and 7-10 indicates severe pain (Disabling, unable to perform ADLs). As per available time, it was decided to include at least 30 subjects in the study. Results: Initially 45 patients were enrolled. Of those, 30 patients were suffering from backache, that is, 67% of the total and 33% did not have any backache. There were no backaches reported in the first trimester, five cases were in the second trimester, and 18 cases were in the third trimester. Of 30 patients, 11 were less than 25 years of age and remaining 19 patients were in the age group of 26-35 years.

Postural deviation in pregnancy: A significant debilitating balance problem which can be rectified by physiotherapeutic intervention.

Objective: The purpose of this study was to evaluate the effect of physiotherapeutic intervention to improve the deviated balance of pregnant women. Method: A total of 174 subjects were included in the study out of which 62 had postural deviation. They were divided into three groups, two intervention groups and one control group. The target population consisted of women in the antenatal stage, randomly selected from Obstetrics and Gynecology OPD, PGIMER, Chandigarh. The study was conducted over a period of 3 years (2014-2017). They were advised exercises, postural correction, regular walking, and hot water fomentation. Six follow-ups were taken into consideration throughout the pregnancy and postnatal stage. Result: The impact of the intervention package on both ante-natal and postnatal women with balance problems showed significant improvement. Conclusion: Postural deviations, pain, heaviness in the lower limb, incontinence, breathlessness, etc., are common complaints during and after pregnancy. The problem starts early in pregnancy and increased over time and may persist throughout life if treatment does not start early in the pregnancy. This intervention can be practiced in primary care setting after giving proper training to the health care workers by experienced physiotherapists.

Impact of two intervention packages on the health and fitness of ante - and post-natal women attending in a teaching hospital.

INTRODUCTION: Pregnancy brings about many changes in mothers' body which continue even after the baby is born. After a vaginal delivery, taking good care of the mother is an essential part of postpartum care and to maintain overall fitness. OBJECTIVE: The purpose of this research was to evaluate the effect of a physiotherapeutic intervention to improve the maternity fitness of Indian women. METHODOLOGY: It was a three-group RCT (randomized controlled trial). The target population consisted of women in ante and postnatal stage, 50 participants (58 were included in the end) in each group, randomly selected from Obstetrics and Gynecology OPD of a tertiary care hospital in North India. The study was carried out in the department of PRM (Physiotherapy). A total of 174 participants was included in the study and was divided into three groups, two intervention groups, and one control group. The target population consisted of women in ante and postnatal stage, randomly selected from ANC (Antenatal clinic) and PNC (Post-natal clinic). The study was conducted over a period of 4 years (2014-2018). They were advised to do exercise, postural correction, regular walking, and electrotherapy modalities and six follow-ups throughout their pregnancy. Outcome measures like (Visual Analogue Scale = VAS): Low and upper back pain relief (n = 158), Leg cramps (n = 41), Coccyx pain (n = 36), Sacro-iliac joint pain (n = 26) was considered. RESULTS: The impact of the intervention package on both ante-natal and post-natal women with fitness-related health problems showed significant improvement. CONCLUSION: Pain, leg cramp and heaviness in the lower limb, coccyx pain, etc., during pregnancy are common complaints that start early in pregnancy and may persist throughout life if treatment does not start early in the pregnancy.