PENGARUH TERAPI REPETITIVE PERIPHERAL MAGNETIC STIMULATION TERHADAP NYERI DAN KEMAMPUAN FUNGSIONAL PADA OSTEOARTRITIS LUTUT
Abstract
Abstract
Background: Osteoarthritis (OA) is a chronic degenerative joint disorder having a significant economic impact on our health system worldwide. Osteoarthritis is known to be most frequent in the lower extremity, especially the knee joint, where pathological joint impact and shear forces as well as post traumatic risk factors cause early cartilage degeneration and joint aging.Repetitive Pheripheral Magnetic Stimulation is one of the latest magnetic theraphy that can reduce pain and tissue repair so as to increase the activities of daily life. Objective: To determine the effect of Repetitive Pheripheral Magnetic Stimulation on pain and functional ability in patients with knee Osteoarthritis. Materials and Methods: This was an experimental study with pre-test and post-test group design. Twenty-four(aged 45 – 65 years; n = 55.88), with diagnosed of knee Osteoarthritis based on American College of Rheumatology (clinical and radiological) criteria, with knee pain NPRS > 4, Kellgren – Lawrence criteria II – III were induced in the study. Research located in RSUP. Prof. R. D. Kandou , Manado; conducted from May – July 2019. Each Patient was given Repetitive Pheripheral Magnetic Stimulation (RPMS) using Super Inductive System (SIS) BTL 6000 with arthrosis chronic mode on pain area, each for 10 minutes. Theraphy is done six times in two weeks with the application of theraphy every 2 day. Pain assessment using NPRS and functional ability using WOMAC, assessed before and after RPMS theraphy. Results: Compared NPRS score before and after intervention were significantly improved (p<0,001) and Functional performance were significantly improved at the end of the 6 times intervention period (p<0,001).
Conclusions: Based on the result of this study, that was observed that RPMS theraphyis beneficial in reducing pain and improving functional performance in knee OA patients;Therefore RPMS theraphy can be used as a therapeutic method in patients with knee Osteoarthritis.
Keywords: Functional performance, Knee Osteoarthritis, Pain, RPMS Therapy.
Â
Abstrak
Latar belakang : Osteoarthritis (OA) adalah gangguan sendi degeneratif kronis yang memiliki dampak yang signifikan pada sistem kesehatan kita di seluruh dunia. Osteoarthritis diketahui paling sering terjadi pada ekstremitas bawah, terutama sendi lutut, dimana benturan sendi patologis dan gaya geser serta faktor resiko setelah trauma menyebabkan degenerasi tulang rawan dini dan penuaan sendi. Repetitive pheripheral magnetic stimulation merupakan salah satu terapi tebaru yang dapat mengurangi nyeri dan perbaikan jaringan sehingga dapat meningkatkan aktivitas kehidupan sehati hari. Tujuan : Untuk mengetahui efek Repetitive Pheripheral Magnetic Stimulation(RPMS) terhadap nyeri dan kemampuan fungsional pada pasien osteoartritis lutut. Material dan Metode : Penelitian eksperimental dengan desain kelompok pr - posttes. Dua puluh empat pasien (berusia 45 hingga 65 tahun; n = 53,88 tahun), dengan diagnosis osteoartritis lutut berdasarkan kriteria American College of Rheumatology (klinis dan radiologis), dengan nyeri lutut (NPRS >4), kriteria Kellgren-Lawrence II-III dilibatkan dalam penelitian ini. Penelitian berlokasi di RSUP Prof. R.D. Kandou, Manado; dilakukan dari May - July 2019. Setiap pasien diberi terapi RPMS (menggunakan SIS BTL-6000) dengan mode arthrosis kronik yang diaplikasikan pada daerah nyeri selama 10 menit. Terapi dilakukan 6 kali dalam 2 minggu. Penilaian nyeri menggunakan NPRS dan kemampuan fungsional menggunakan WOMAC, dinilai sebelum dan sesudah terapi RPMS. Hasil: Nyeri, terapi RPMS secara signifikan mengurangi tingkat nyeri pada NPRS, dinilai sebelum dan sesudah terapi (nilai rata-rata dari 5.0 menjadi 0,78). Kinerja fungsional (dievaluasi dengan WOMAC) meningkat secara signifikan setelah terapi RPMS (nilai rata-rata dari 61.32 menjadi 13.09). Kesimpulan : Berdasarkan hasil penelitian ini, diamati bahwa terapi RPMS bermanfaat dalam mengurangi rasa sakit dan meningkatkan kinerja fungsional pada pasien OA lutut; Oleh karena itu terapi RPMS dapat menjadi metode pilihan dalam pengobatan osteoarthritis.
Kata kunci : Osteoartritis Knee, Nyeri, Kinerja Fungsional, Terapi RPMSReferences
Hussain SM, Neilly DW. Baliga, S. Knee osteoarthritis : a review of management options. Scottish Medical Journal. 2016; 61(1): 7-16.
Delisa, J. Osteoarthritis. In : Delisa’s Physical Medicine & Rehabilitation Principles and Practice, 5th edition. Philadelphia : Lippincott williams & wilkins, 2010; 781-801 p.
Cucurullo SJ. Osteoarthritis. In : Physical Medicine and Rehabilitation Board Review, 3rd edition. New Jersey : Demos medical, 2015; 113-14 p.
Kemenkes RI. Riset kesehatan dasar - Riskesdas 2013. Badan penelitian dan pengembangan kesehatan kementerian kesehatan RI tahun 2013; 120-24 p.
Ayling S, Gessal J. Gambaran Faktor Risiko Penderita Osteoartritis Lutut di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado Periode Januari –Juni 2017. Manado : Universitas Samratulangi; 2017.
Data kunjungan pasien di Instalasi Rehabilitasi Medik Prof. Dr. R.D. Kandou Manado periode tahun 2015-2017.
Yusuf MA, Hossain MS. Updated Management of Osteoarthritis : A Review Article. Journal of Science Foundation. 2015; 11 : 49-53.
Bilfed MF, Lapegue F. Bone abnormalities of the knee : MRI features. M. Faruch Bilfeld. Elsevier Masson Journal. 2016; 97 : 779-88.
Kisner C. Osteoarthritis. In : Therapeutic exercise Foundation and Techniques. 6th edition. Philadelphia : Davis Company. 2012; 335-6 p.
Ashit S, Deodhar SD. Rheumatology Principles & Practice. Phildelphia. 2014: 72-3 p.
Blackwell A, Dunbar A. Pain in the knee. In : ABC Rheumatology, 4th edition. New York : Wiley Blackwell. 2010; 32-7 p.
Malemud JC. The Medical Therapy of Osteoarthritis :“Thinking Outside the Boxâ€. Journal of Osteoarthritis. 2016; 1(1) :1-2.
Schneider SA. Osteoarthritis. In : Board Review Series Pathology 2nd Edition. Chicago : Lippincott Williams & Wilkins. 2012; 375-90 p.
NICE. Osteoarthritis : care and management. Clinical guideline National Institute for Health and Care Excellence. Toronto. 2018; 9-15.
Ceuninck FD, Sabatini M. Cartilage and Osteoarthritis Volume 2. Structure and In Vivo Analysis. New Jersy : Humana Press Inc. 2014; 39-105 p.
Kurniawan L. Osteoartritis Genu. Dalam : Panduan Layanan Klinis Rehab Medik. Jakarta : Perdosri. 2012.
Deshpande S. History of rheumatology. Medical Journal Patil Univ. 2016 Sept 28; 7(2) : 119-22.
Dragana Zarkovic. RPMS as pain management solution in musculoskeletal and neurological disorder. International physical theraphy. 2016. P 672-75
Petioky J, Vana Z, Subert D. Repetitive pheripheral induction stimulation in musculoskeletal pain management. Journal of Phsycal theraphy science. Vol 4. P 195 -200.
Gordon G. Lenore B. American College of Rheumatology Guideline for the Prevention and Treatment of Glucocorticoid-Induced Osteoporosis. New York : Blackwell. 2017; 315-53 p.
Fitzgerald GK. Fritz JM. Exercise, manual therapy, and use of booster sessions in physical therapy for knee osteoarthritis: a multi-center, factorial randomized clinical trial. Osteoarthritis Research Society International. 2016; 24: 1340-49.
Robertson MC, Abbot HJ. Manual therapy, exercise therapy, or both, in addition to usual care, for osteoarthritis of the hip or knee. 2: economic evaluation alongside a randomized controlled trial. Osteoarthritis Research Society International. 2014; 21: 1504-13.
Brandt DK, Doherty M, Lohmander SL. Osteoarthritis, Second edition. Oxford : Oxford Medical Publications. 2013; 1-21 p.
Cameron MH. Physical properties In : Physical agents in rehabilitation from reserch to practice 2nd ed. California : Saundres. 2002; 383-87 p.
William E.P. Managing pain with thrapeutic modalities. In : Therapeutic Modalities for Sports Medicine and Athletic Training. New York : Mc Graw RPMSl. 2012; 1-30 p.
Petioky J. Vana Z. “Repetitive Pheripheral Inductive Stimulation in Musculoskeletal Pain Managementâ€. A pilot study. 2016.
Santoso B. Pain in Management of pain is probably one of the commonest and yet most difficult aspect of medical practice. Surabaya : Perdosri. 2009; 10-67 p.
Caliet R. Knee Pain and Disability 3th edition. Philadelphia. 2002; 1-59 p.
Ebrahimzadeh HM. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in Persian Speaking Patients with Knee Osteoarthritis. Arch Bone Joint Surg. 2014; 2(1): 57-62.
Konstantinidis AG, Aletras HV, et all. Comparative validation of the WOMAC osteoarthritis and Lequesne algofunctional indices in Greek patients with hip or knee osteoarthritis. Qual Life Res. 2014; 23: 539-48.
Bashir MS, Khade A, et all. A Comparative Study Between Different Pain Rating Scales In Patients Of Osteoarthritis. Indian J Physiol Pharmacol. 2015; 57(2) : 205–8.
Efthimious. J. Koulolas, MD. PhD. Pheripheral application of repetitive pulse magnetic stimulation on joint contracture for mobility restoration. Journal of Physical theraphy. 2016. P 519 – 24
BTL 6000. Super inductive system medical introduction. 2017
Super inductive system complete edition. 2017
BTL 6000. Super inductive system elite therapeutic encyclopedia. 2017
Hansen PA, Henrie AM, Deimel GW, Willick SE. Musculoskeletal disorder of the lower limb. In : Cifu DX. Braddom’s Physical Medicine and Rehabilitation. 5th ed. Elsevier Saunders;2016
Ashkavand Z, Malekinejad H, Vishwanath BS. The Pathophysiology of Osteoarthritis. Journal of Pharm Research. 2013 : 132 – 8.
Allen KD, Golightly YM. Epidemiology of Osteoarthtritis : state of evidence. Wolters Kluwer Health, Inc. 2015 : 1 – 8.
Yin AX, Wilkins AN, Philips EM. Osteoarthritis. In Frontera WR, Silver JK, Rizzo TD, editors. Essential Physical Medicine and Rehabilitation Musculoskeletal Disorder, Pain and Rehabilitation. 3rd ed. Elsevier Saunders;2015.
Rekomendasi IRA untuk diagnosis dan penatalaksaan Osteoartritis. 2014 : 1 – 42
Thomas H, Jeroen G, Corina N, Magdalena MG, Victor V. Aging and Osteoarthritis : An Inevitable Encounter. J of Aging Research. 2012 : 1 -7
Ziad MH, Jihad MA. The Clinical of Knee Osteoarthritis. In Jordan : A Hospital Based study. Inter J of med Science. 203;10(6);790 – 5
Zhang T, Jordan JM. Epidemiology of Osteoarthritis. Clin Geriatr Med. 2010;26(3):355 – 69
Angela A. Determinants of Physical Performance in people with knee osteoarthritis (MSc Thesis).McMaster University Hamilton, Ontario;2012
Cubukcu D, Sarsan A, Alkan H. Relationship between pain, function and Radiographic findings in Osteoarthritis of the knee : A cross sectional study. Arthritis;2012:1-5
