جستجوی مقالات مرتبط با کلیدواژه « درد زانو » در نشریات گروه « پزشکی »

The effectiveness of stabilizing core muscles of the trunk and pelvis has been studied more in osteoarthritis (OA) of the hip and less in knee. Performing these exercises while standing, removes the limitation of performing them in different environments. The current study examines the effectiveness of standing core exercises on pain and performance of patients with knee OA, who have no strenuous activity and often have sedentary jobs. On the one hand, by reducing the social restrictions of doing these exercises and on the other hand, by reducing the occupational interfering factors that cause knee arthrosis, we have tried to get a purer and more accurate conclusion from these therapeutic exercises.

This is a randomized, controlled trial. Patients with knee osteoarthritis were invited to enter the study and if they met the criteria and received the consent, they were randomly divided into two groups. The control group, which only received the program of performing conventional exercises of knee OA, and the intervention group, which received the program of standing core exercises in addition to conventional exercises. The primary outcome of this study was visual analytic score (VAS) of pain and the secondary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne and 6-minute walking test (6WMT) at 6 and 12 weeks.

In this study, 38 patients completed the study per-protocol. The baseline characteristics and outcome measurements did not differ significantly before the intervention. Within-group analysis showed that there is a significant difference in VAS, WOMAC pain, discomfort and maximum distance of Lequesne and 6MWT indices in both groups (P<0.05). Also, within-group analysis showed that there was a significant difference in WOMAC physical performance and Lequesne daily activity only in the intervention group (P<0.05). The results of the between-group analysis showed a significant difference between the two groups in all outcomes in 12 weeks (P<0.0001), and in the VAS and Lequesne index, a significant difference can be seen between the two groups even in 6 weeks (P<0.005). The effect size on the primary outcome of VAS is 0.68 in the core exercise group compared to the control group.

The results of this study show that standing core exercises, after 12 weeks, causes a significant reduction of pain, improvement of function and activity in patients with knee osteoarthritis compared to conventional exercises, and its positive effect on pain or discomfort, ‘maximum distance walked’, and ‘activities of daily living’ after 6 weeks, also observed. Although previous studies showed the positive effect of core exercise on the pain index and activity of knee osteoarthritis patients, the results of this study showed that even standing core exercises may be effective.

Knee osteoarthritis is an important cause of pain and disability in the community. The present study investigated the risk factors for primary osteoarthritis of the knee in patients with knee pain and their relationship with knee osteoarthritis.

87 patients were included in the study and were matched in terms of age. Cases consisted of female patients less than 50 years of age with knee pain and the control group was selected from patients under 50 years of age with knee pain and no radiographic findings of osteoarthritis.

This study showed that the rate of osteoarthritis of the knee was significantly related to body mass index (p=0.001). The relationship between knee osteoarthritis and ESR was not significant, but an increase in CRP with a p-value of 0.01 was associated with a risk of approximately a 3.5-fold increase in knee osteoarthritis. With increasing education, the rate of knee osteoarthritis decreased (p=0.022). The Increased circadian outpatient activity was significantly associated with increased knee osteoarthritis (p=0.032). In performed assessments on osteoarthritis of the knee, there was no statistically significant relationship between the type of bathroom used, the use of stairs, and residential houses.

Knee osteoarthritis has a relationship with body mass index, Education level, CRP index, and circadian activity level. it is recommended to lose weight in people with abnormal body mass index, exercise, and improve their lifestyle to reduce the incidence of knee osteoarthritis and disability.

Proximal femoral fracture is one of the most common fractures, especially among elderly people. Skin and skeletal traction are usually used to reduce the pain in the patients before surgery. In this study we investigated the effects of skin traction and use of pillow under knee before surgery on pain relief in the patients with proximal femoral fracture.

This study included patients with proximal femoral fractures referring to Ayatollah Kashani Hospital in Shahrekord in 2016. Patients were randomly assigned to skin traction and under knee pillow groups. Demographic data including gender, age, body mass index and other information such as type of fracture, time interval between the accident and referring to the hospital, the amount of sedatives taken, the time interval between admission and surgery, type of device used for surgical fixation and pain assessment by VAS were obtained after interview with the participants and recorded in a questionnaire.

The traction group included 19 men and 19 women with a mean age of 74.81 ± 13.10 years and the under knee pillow group consisted of 15 male and 20 female participants with a mean age of 73.08 ± 13.11 years. The mean pain scores did not show any significant differences at the first visit (traction group 7.31±2.08; pillow group 6.94±2.54) and also on every separate day of the study up to the fifth day of hospitalization in the traction (2.40±2.07) and pillow groups (2±0) (P>0.05).

Considering the complications of skin transaction such as skin ulcers and its subsequent cost of treatment, in this study we found that use of pillow under knee was associated with a reduction in pain similar to the traction method and had fewer complications.

Osteoarthritis is one of the most important causes of disability among the elderly, causing pain, knee stiffness, decreasing the quality of life of the elderly, and increasing their dependence. One of the non-causative nursing interventions eliminates the symptoms of pain and thus promotes comfort and health. The aim of this study was to investigate the effect of broccoli on the reduction of joints pain in elderly patients with knee osteoarthritis in Zabol elderly homes in 1396.
This randomized clinical trial was conducted on 40 elderly people with knee osteoarthritis (two groups of 20 controls and broccoli controls for 4 weeks) at the age of 96 years old in Zabol city. A standardized questionnaire was used to assess the data and then the data were analyzed using paired t-test and Chi-squash test in 18spss software.
The sampling method was simple random sampling, so elderly patients with knee osteoarthritis were placed in one of the control and control groups by referring to the elderly home in Zabol. The data collection tools were: 1-Demographic questionnaire 2-questionnaire. Broccoli was packed in 10gr packs as a powder and placed in the elderly with a daily meal (preferably lunch) for 4 weeks.
The two groups did not differ significantly in pain intensity before intervention. Comparison after intervention showed a significant difference in mean of performance (p Considering the effectiveness of the intervention, the use of broccoli on the severity of knee pain in elderly patients with osteoarthritis based on the results of this study, is suggested as a low cost, safe and easy intervention in the elderly with knee osteoarthritis.

Concurrent pain in the knee joint and its-related muscles is expectable in patients with sacroiliac dysfunction. However، the association between the severity of knee pain and the level of sacroiliac dysfunction is still unclear. The present study aimed to determine the association between the severity of sacroiliac dysfunction and the severity of pain due to involvement of knee compartment. One hundred consecutive patients who visited an orthopedic clinic with the primary complaint of knee pain were recruited. According to specific diagnostic tests، 50 had sacroiliac dysfunction and 50 had no history of sacroiliac dysfunction. The severity of knee pain was determined using the Anterior Knee Pain Scale (AKPS). T-tests were then performed to compare the two groups in terms of AKPS scores. The mean AKPS score was 33. 2 ± 12. 1 in patients with sacroiliac dysfunction and 62. 6 ± 18. 6 in those without sacroiliac dysfunction (p < 0. 001). Moreover، anterior knee pain was more frequent in the first group (56% vs. 10%; p < 0. 001). There is a significant association between the severity of anterior knee pain and severity of sacroiliac dysfunction. This association may be due to involvement of knee extensor muscles following the progression of sacroiliac dysfunction.

Oliban oil is frequently used in daily rheumatologic practice in Traditional Iranian Medicine، but its benefit، remains to be evaluated. Using of Oliban oil offers an alternative to oral treatment and Topical NSAID therapy، with the potential for a reduced knee pain and outcomes. Up to now، there is no research about of Oliban oil effects in knee pain. The objective of this trial was to assess the efficacy and safety of topical Oliban oil in relieving the symptoms of knee pain (vajaol-rakbe). We identified 183 men and women with knee pain that adapted to The American College of Rheumatology clinical criteria for the classification of osteoarthritis and inclusion criteria. The participants were randomly assigned classified into three groups to apply topical treatment their painful knee for 6 weeks: Oliban oil as intervention group، sesame oil as control group and diclofenac gel as usual and positive control group. The degree of knee pain was quantified by visual analogue scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS) Pain. Safety was evaluated with Criteria for Adverse Events (CTCAE) (v4. 2010). Efficacy: In K. O. O. S pain score، The intervention group showed an improvement in the pain and symptoms compared with the control group (P = 0. 04) but Activities of Daily Living (ADL)، Sport and Recreation (Sport/Rec) and Knee-related Quality of Life (QOL) don’t improvement significantly. The V. A. S. scores were significantly better for the patients who applied the the Oliban oil and topical diclofenac gel than for those who applied the sesame oil (p = 0. 02). Furthermore، The intervention group showed an improvement in the pain compared with the diclofenac group (P = 0. 03). Safety: safety assessments showed that topical Oliban oil caused skin pruritus in 1/48 (o. o2%). this controlled drug trial demonstrates the potential efficacy and safety of topical Oliban oil in symptomatic treatment of knee pain and with only minor local skin pruritus.

Knee pain is one of common cause that patients refer to orthopedic clinics and has several reasons. One group is reversible and other is irreversible. Excessive Q-angle composes of 10% causes of knee pain reasons and is recovered (90%) by physical therapy. This study was conducted for evaluation of correlation of knee pain with excessive Q-angle and comparing both sexes and ages groups.

100 patients (50 men and 50 women) in a simple convenience study were enrolled in this research. Q-angle and pain scale (VSA) were measured and then Q-angle deviation in both sexes and ages groups analyzed using ANOVA, t-test. Spearman test with SPSS17 software.

The correlation between severity of knee pain and Q-angle in general population and in both sex was significant using of Spearman’s test. There was no significant correlation between different ages and Q-angle. There was significant relationship between Q-angle in men and women (P<0.05). 10% of men, 18% of women and 14% of general population refered to orthopedic clinic had Q-angle greater than normal range.

Higher level of Q-angle in females might be related to anatomical differences and high level of estrogen, multiparity, malnutrition, genetical differences and exceesive activity, in females.

Knee pain is a common complaint after intramedullary nailing of tibia. Several entry sites have been described, but the optimal site remains a topic of debate. The aim of this study was to compare two surgical approaches, transpatellar and medial parapatellar tendon in tibial intramedullary nailing for treatment of tibial fractures. In a randomized clinical trial, 50 patients with fracture of tibial shaft were recruited during a 16-month period in Tabriz Shohada Hospital. Intramedullary nailing was employed as the surgical technique in all patients through two different approaches; transpatellar (group T) and medial parapatellar tendon (group M). Patients were randomly assigned to each group (25 patients in each group). Pain was assessed by visual analogue scale (VAS), as well as range of motion (ROM) 2 weeks and 1, 3 and 6 months after operation. There were 23 males and 2 females with a mean age of 28.68±5.76 years in group T and 21 males and 4 females with a mean age of 28.80±5.82 years in group M (P=0.667 and 0.942, respectively). The mean score of pain (VAS) was significantly higher in group T three and 6 months after operation comparing with that in group M (P=0.013 and 0.009, respectively). Range of motion as well as length of skin incision and nail out of anterior tibial cortex was not significantly different between the two groups. Based on our results, both approaches are safe; however, the transpatellar approach might be along with more pain for the patients. Therefore, the medial parapatellar tendon approach is recommended in this regard.

Knee osteoarthritis (OA) is one of the common disabling conditions in human. Joint mobilization is a passive rhythmic accessory movement therapy that is used in the treatment of OA. In this study, the effect of grade one mobilization, on pain reduction of knee OA has been investigated. This study was an unidirectional blind clinical trial with random sampling from patients admitted to sarcheshme physiotherapy clinic in 2007. Thirty participants were divided into 3 groups randomly: group 1: Mobilization + Exercise therapy, group 2: Exercise therapy and group 3: Mobilization. Ultrasound with the intensity below 0.2 W/Cm2 was used for all groups as placebo. The treatment was done in 10 sessions during 3 weeks. Outcome was measured using was WOMAC questionnaire form (Likert Type). Measurements were done before and after treatment and one week after final treatment session. Friedman, Wilcoxon and Kruskal-Wallis tests were used for data analysis included. Comparison of pain between before and after treatment showed significant differences in group 1 (P=0.01) and group 3 (P=0.04) but was not significant in group 2 (P=0.135). The difference of pain at follow up visit was significant only in group 1 in comparison to before treatment (P=0.007). Pain reduction between before and after treatment (P=0.504) and before treatment and follow up session (P=0.18), showed no significant differences, between 3 groups. This study showed that grade 1 mobilization can decrease the pain of knee OA. If exercise therapy is used combined with mobilization, the effect of treatment will continue at least for about one week.

Bacground and Foot orthoses are a common intervention for patients with patellofemoral pain syndrome but, limited information is available in the effects of foot orthoses on knee pain and function of athletes with patellofemoral pain syndrome. The aim of our study was to determinate the effects of foot orthoses on reducing pain and increasing function of athletes with patellofemoral pain syndrome who demonstrated excessive foot pronation. 418 female athletes between 15 – 35 years old in running, soccer, volleyball, fencing and mountain climbing were examinated. Among these athletes 25 subjects with patellofemoral pain syndrome had excessive foot pronation. The severity of pain was measured by VAS (visual analog scale) and their function were measured by KOOS (knee injury and osteoarthritis outcome score). Full length firm foot orthoses were given to athletes which at least 8 hours during the day was used. After 2 weeks: pain by VAS and function by KOOS were evaluated. After 6 weeks these variables were measured again. The results of analysis of variance in repeated measures indicated a statistically significant improvement in pain by VAS after 2 weeks (p value=0.001) and after 6 weeks (p value=0.001). Improvement of function on KOOS were statistically significant at 5 subscales: reduction of symptoms after 2 weeks was not prominent but after 6 weeks was significant (p value=0.001) and reduction of pain after 2 weeks (p value=0.001), reduction of pain after 6 weeks (p value=0.001) and improvement of ADL after 2 weeks (p value=0.004) and after 6 weeks (p value = 0.001) and improvement of sport activities after 2 weeks (p value=0.012) and after 6 weeks (p value=0.001) and improvement in QOL after 6 weeks (p value=0.001). Our results confirmed a significant improvement in reducing pain and increasing function of female athletes with patellofemoral pain syndrome and excessive foot pronation after foot orthoses.

Knee pain is one of the most common musculoskeletal complaints. Musculoskeletal injuries resulted of overuse, reduce the efficiency of training among recruits underwent basic military instruction. The aim of this study was to determine the effect of basic military training on knee pain and muscular flexibility of lower limbs. 100 soldiers (having no complaint of knee pain) from military training center of Birjand (0-4) were studied. Physical examination of knee and passive range of motion of lower limbs were assessed before and immediately after a 3-month priod of basic military training. All musculoskeletal complaints and injuries were documented prospectively during the study. Data was analyzed with SPSS11.5. Wilcoxon and ANOVA were used to compare mean values and significancy level was considered at p<0.05. During the study, 20 soldiers (20%) complained of knee pain. Frequency of positive sherug test increased (p<0.05) but no significant changes in the results of other tests were seen. At the end of the training, flexibility of all tested muscles was improved: Hamestrings (7.91 ± 0.57%), Gasterosuleus (25.72 ± 2%), Thigh adductors (32.66 ± 2.52%) and Quadriceps (7.81 ± 0.79%). Pattelofemoral syndrome was the most common finding in new cases of knee pain during the military training period. Due to high incidence of muscle shortness, an appropriate stretching exercise is recommended both to improve flexibility and prevent injuries.

Considering the increasing prevalence of knee joint pain and its complications and lack of adequate information about its causes this study was carried out to evaluate the incidence of knee joint osteoarthritis and its risk factors in patients referring to out patient departments of Kashan in 2004. One thousand patients with knee joint pain enrolled to this cross sectional descriptive study. Knee joint X-ray was obtained from patients with signs and symptoms of osteoarthritis and those complying the criteria of American Society of Rheumatology (ACR), were selected and their demographic data including age, sex, weight, body mass index (BMI), history of trauma to knee, and smoking were recorded and analyzed with Chi square, and Fisher Exact tests. Three hundred and fifty patients (35%) had knee joint arthritis. From 350 patients 43 (12.3%) were male, and 307(87.7%) female. The most common age range of involvement in both males and females was 50-59. The most common BMI range was 30-40 Kg/m². Thirty seven (10.5%) of patients had history of severe trauma to knee joint. This study showed that the most important risk factor for knee joint osteoarthritis in adult is heavy weight. Previous injuries to the knee joint and occupational factors are other important factors.

The goal of the study was to investigate the major factors influencing knee osteoarthritis and to estimate its prevalence. This article is the outcome of an Ex Post Facto study on the files of 176 patients complaining of knee pain who referred to orthopedic clinics in Tehran within the period of 10 months from 1998 November to 1999 August. The selection of the files was implemented randomly. The prevalence of osteoarthritis in "only left knee" cases turned out to be 22.9%, in "only right knee" cases 39.4%, and in "both knees" cases 37.6%. The gender variable showed a significant effect on the prevalence of this condition (p<0.002) so that the prevalence in males is higher than that in females although the prevalence is higher in urban than in rural areas, this difference is not significant indicating that location does not influence this condition (p<1471). Other results showed that there is a significant positive go-togetherness between age and the prevalence of the condition (p<0.00l). There is also a significant positive correlation between occupations demanding physical labor and the prevalence of the condition. From factors aggravating pain in both "only right knee and both knees" cases, the highest effect belongs to sitting with entirely bent knees, and the lowest has to do with short distance walking, whereas in the case of "only left knee" cases long distance walking has the highest and rest the lowest effect on pain increase in all the three groups. Full rest leads to 40% decrease in pain, while sitting on a chair has the lowest effect on the relief of the pain, but in "only left knee" cases extending the lower extremities in sitting has the lowest effect on pain relief. Physical factors including apparent joint deformity in standing position, knee range of motion and meniscus laceration have a significant effects on this condition. Furthermore factors noticed through radiological observations such as joint atrophy, sub-cartilaginous bone sclerosis, cyst formation, osteophyte formation and biomechanical abnormality in the knee, all have significant effects on knee osteoarthritis. Factors including height, weight, knee trauma, knee infection record, using chairs, pharmaceutical treatment, health system type, doing exercises, and treatment non-pharmaceutical also have an impact on this condition.