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ABSTRACT: Introduction & Objective: Osteoarthritis is the most common joint disease of humans. Acupuncture is one of the treatments for osteoarthritis. This study aimed to compare lbuprofen with acupuncture in the pain reduction in knee osteoarthritis. Materials & Methods: This is a clinical trial which was performed in Shiraz Medical School Clinics in 2007. Forty six patients with chronic pain due to the knee osteoarthritis were recruited using strict inclusion and exclusion criteria. All the patients were randomly divided into two groups (A and B) who received lbuprofen (1200 mg/day) or acupuncture (2 sessions per week) for 2 weeks, respectively. Evaluating measuring tools were pain intensity (based on VAS), ROM (based on degree) and morning stiffness of the knee joint. Collected data were analyzed by Chi-Square test, using SPSS software. Results: Pain intensity at baseline, after the course of treatment and 3 weeks after the treatment in group A was 7.29 ± 0.61, 4.20±0.93 and 5.20± 1.32 cm, respectively while these figures for group B were 7.35±0.82, 3.43±0.96 and 4.93±1.32 cm, respectively (p<0.005). Also knee ROM degree in group A was 21.54±7.46, 13.08±5.60 and 15.38±3.2 and for group B was 20.36±7.19, 12.40±5.78 and 10.36±5.30, respectively (p=0.003). Knee morning stiffness improved more in group B. Conclusion: Result of this study showed that both modalities significantly reduced the pain in patients with knee osteoarthritis and improved ROM while morning stiffness improved more in group B.

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ABSTRACT: Introduction & Objective: One of the most common disorders of the knee joint in adult is patellofemoral pain syndrome. Sometimes it becomes chronic and causes activity limitation. This study aimed to compare the efficacy of exercise therapy with Transcutaneous Electrical Nerve Stimulation on improvement of pain intensity, knee function, muscle atrophy and range of knee flexion. Materials & Methods: This double-blind, randomized clinical trial was carried out in Zahedan Razmejo-Moghadam Physiotherapy Clinic, in 2007. Thirty-two patients with patellofemoral pain syndrome were recruited through simple non-probability sampling. Subjects were randomly assigned to one of the equal groups, exercise therapy (including hip, knee, and leg muscles strengthening and stretching exercises) or electrical stimulation group. Before and after intervention, we assessed pain through Visual Analog Scale (VAS) (ordinal), function (ordinal) with Knee Injury and Osteoarthritis Outcome Score (KOOS), thigh circumference with tape measure (centimeter) and range of knee flexion with goniometer (degree). A 10 session treatment program, three sessions per week and one hour per session was performed for both groups. Independent t-test or Mann-Whitney U and paired t-test or Wilcoxon were used for comparison between the pretreatment and post treatment results between groups and within groups, in SPSS software, respectively. Results: The mean total score of knee function increased from 100.53±19.25 to 130.87±18.25 in the electrical stimulation group and from 107.67±22.69 to 131.47±15.11 in the exercise therapy group (p=0.001). The mean score of knee function subscales including symptoms, pain, functional limitation, recreational activity, and life style improved in both groups (p<0.05). The pain score and range of knee flexion improved in both groups (p<0.05). After treatment, range of knee flexion significantly increased in the exercise group compared with the electrical stimulation one (p=0.008). Conclusion: Both of the exercise therapy and transcutaneous electrical nerve stimulation are effective in treatment of patellofemoral pain syndrome. However, exercise therapy is more effective increasing in the range of knee flexion.

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Abstract Background & aim: Pain and limited range of motion (ROM) are the crucial subsequent results of joint hemorrhages in patients suffering from hemophilia. Different training protocols designed to treat these patients are of great importance. The purpose of this study was to compare the effects of drought and water therapy on pain and range of motion of the knee in hemophilia patients. Methods: In this present clinical-trial study, 40 patients with hemophilia type A were randomly divided into three groups: exercise therapy on land, hydrotherapy, and control groups. The first two groups attended their special exercises on three days within 4 weeks, but the control group were only subjected to their daily life activities. Experimental pain, flexion and knee extension were measured using a visual analogue scale (VAS) and standard Goniometer at the beginning and after the intervention. Data were analyzed by ANOVA and Scheffe’s test (P<0.05). . Results: Both experimental groups exhibited significant reduction of pain along with improved knee flexion and extension compared with the control group (P<0.001). Pain reduction in subjects treated in water treatment was significantly higher than exercise group in drought (P<0.001), but no significant changes was seen in flexion and knee extension of the two exercise groups (P>0.05). Conclusion: The use of therapeutic exercise in water with regular exercise rehabilitation for patients with hemophilia can be helpful to reduce pain and improve range of motion in hemophilia patients. The effect of exercise therapy on pain reduction is more effective compared to traditional pain therapy. Key words: Hydrotherapy, Exercise Therapy, Hemophilia, Knee Range of Motion

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Background & aim: Throughout the world, half of the people over 70 years of age suffer from knee osteoarthritis and detection of the factors associated with this disease is important. The present study was conducted to examine the association of knee joint anatomic parameters with osteoarthritis occurrence. Methods: In the present observational-comparative study, ninety-four patients with joint osteoarthritis as case group and 106 healthy individuals as control group were enrolled from Orthopedic Clinic of Shahrekord Hospital into the study for comparison. Anatomical parameters such as tibial plateau tilt, Cam effect, and tibial plateau coverage by femoral condyles were calculated by using radiographic findings and compared between two groups. The data were analyzed by SPSS software 16 using chi-square and Pearson correlation Results: Tibial plateau tilt values in patients with osteoarthritis of knee (11.9±3.4°) was significantly higher than the control group (10.2±1.9 °) (p<0.001). Cam effect in patients with osteoarthritis (1.8 ± 0.1) was higher than control group (1.7± 0.1) (p< 0.001). Index of tibial plateau articular surface occupied by condyles of femur in patients with osteoarthritis were 2/3±9/51% and 1/2±1/50% in the control group respectively (p<001/0).Tibial plateau coverage was identified in patients with osteoarthritis equal to 51.9 ± 3.2% and in the control group 50.1±2.1%. These parameters were not associated with each other, as well as age and gender (p>0.05). Conclusion: Anatomic parameters under study could be used to predict osteoarthritis occurrence in healthy individuals.