5% Ibuprofen Iontophoresis Compared with Transcutaneous Electrical Nerve Stimulation in the Management of Knee Osteoarthritis: A Feasibility Study

Abstract

Objective: The study compared the inclusions of 5% ibuprofen iontophoresis and Trans- cutaneous Electrical Nerve stimulation (TENS) in the management of osteoarthritis (OA) of the knee joint. Subjects and Methods: Patients diagnosed with knee OA and referred for physiotherapy at a tertiary health facility in Accra, Ghana participated in the study. They were alternately assigned into either TENS or iontophoresis groups. Patients in TENS Group received conventional TENS mode while those in iontophoresis group were treated with 5% ibuprofen iontophoresis using galvanic electrical current. Both protocols were performed twice weekly for six weeks in addition to their prescribed therapeutic exercises. 15-minute walking time, Numerical Rating Scale and Goniometer were used as the main outcome measures to determine subjects’ walking speed, pain and active range of motion (AROM) respectively. Treatment evaluation was performed at baseline, week 3 and week 6 by an independent assessor. Comparisons of variables within and between groups were tested using Friedman’s mean rank and Mann-Whitney U tests respectively at p < 0.05. Results: Participants in both groups were not significantly different in age (p = 0.460), height (p = 0.548) and weight (p = 0.810). Significant improvements were recorded for walking speed (p = 0.001), pain (p = 0.001) and AROM (p = 0.001) of the subjects within groups. However, between group comparison of the treatment variables showed no significant differences (p > 0.05) for all the outcome measures. Conclusion: 5% ibuprofen iontophoresis and TENS add equal therapeutic value in the management of knee OA. Consideration of both modalities as adjuncts to therapeutic exercises is therefore worthwhile for managing the condition.