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Evaluation of the Effect of High-intensity Laser Therapy in Knee Osteoarthritis

Primary Purpose

Knee Osteoarthritis, Laser Therapy, Muscle Strength

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
high-intensity laser therapy
sham high-intensity laser therapy
Sponsored by
Necmettin Erbakan University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis

Eligibility Criteria

45 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

1-40-70 years old 2-Diagnosis of knee OA according to ACR clinical and radiological diagnostic criteria 3-Kellgren Lawrence stage II or III 4-Knee pain for at least 6 months 5-Visual analog scale (VAS) score of at least 3 or more

Exclusion Criteria:

  1. History of surgery or traumatic injury
  2. Inflammatory arthritis
  3. History of cancer, bleeding diathesis and psychiatric disease
  4. Those who have a disease that limits their participation in exercises (severe chronic obstructive lung disease, severe heart failure, history of cerebrovascular events)
  5. Hip and ankle problems
  6. Participating in another physical therapy program in the last 3 months
  7. History of intra-articular injections in the last 6 months

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Sham Comparator

    Arm Label

    High-intensity laser therapy

    Sham high-intensity laser therapy

    Arm Description

    A total of 15 sessions of hotpack, TENS and exercise program will be applied to the patients for three weeks, 5 days a week, 1 session a day. The hotpack, which is used as a superficial heater, is applied to the knee area for 30 minutes, wrapped in two layers of towels. As analgesic current, conventional TENS is applied to the knee area for 30 minutes with 4 electrodes at 80 Hz frequency, 200 ms current duration. Flow intensity is adjusted according to the patient's tolerance, and the current intensity is increased as the patient's sense of current decreased in the following periods. HILT is applied in analgesic mode for 3 sessions every other day in the first week, and 6 sessions every other day in the biostimulant mode for the next two weeks, for a total of 9 sessions for three weeks.

    Hotpack, TENS and exercise program applications will be applied to the patients in the same way as in the HILT group, 5 days a week, 1 session a day, a total of 15 sessions for three weeks. HILT is administered as a placebo for three weeks, 3 sessions a week, every other day, for a total of 9 sessions.

    Outcomes

    Primary Outcome Measures

    Visual Analog Scale (VAS) Change from baseline in pain on the VAS at month 3
    Visual Analog Scale (VAS) is used to measure and monitor the intensity of pain. This is a 10 cm ruler that describes painlessness at one end and the most severe pain at the other. A patient scores his/her pain from 0 to 10.

    Secondary Outcome Measures

    Knee joint range of motion Change from baseline in knee joint on the measuring the range of motion at knee joint at month 3
    The range of motion of the patients, consisting of knee flexion and extension, is actively evaluated with a goniometer. In the measurement of the flexion angle, the patient is lying in the prone position and the extension angle is measured as the limitation of extension when the knee joint is at 0 degrees
    Femoral cartilage thickness Change from baseline in knee joint on the measuring the femoral cartilage thickness at month 3
    Femoral cartilage thickness is measured by the same physician by placing the probe axially in the suprapatellar region by ultrasonography while the patient is lying on his back and the knees are in maximum flexion. The distance between the thin hyperechoic line at the synovial cartilage interface and the sharp hyperechoic line at the cartilage-bone interface is defined as cartilage thickness
    SF-36 quality of life scale Change from baseline in physical and mental functions on SF-36 quality of life scale at month 3
    The SF-36 scale measures 8 dimensions of health and consists of 36 items; physical function (10 items), social function (2 items), role related to physical functions limitations (4 items), role limitations due to emotional problems (3 items), mental health (5 items), energy/fatigue (4 items), pain (2 items), and general perception of health (5 items). It is evaluated between 0 and 100 points; 0 represents poor health, 100 represents good health. There are two summary components, the physical component and the mental component
    Western OntarioMacMaster (WOMAC) Change from baseline in pain and physical functions on Western OntarioMacMaster scale at month 3
    It is widely used in studies with knee OA patients. The scale, each question of which is evaluated with a 5-point Likert scale, consists of 24 questions. It is filled by patients. There are pain, physical function and stiffness subscales. Pain subscale is evaluated with five items and is scored between 0-20. The hardness subscale has two items and is scored between 0-8. Function subscale consists of 17 items and is scored between 0-68. A high score indicates poor function, pain or stiffness.
    Isokinetic muscle strength measurement Change from baseline in knee joint on the measuring the isokinetic muscle strength at month 3
    Knee isokinetic muscle strength is measured with the Biodex System-3 isokinetic device . At 60° and 180° angular velocities, the range of motion was 90° flexion 0° extension, after three repetitions at each angular velocity; Measurements are made in a single set-five repetitions with 10 seconds of rest between repetitions

    Full Information

    First Posted
    August 18, 2022
    Last Updated
    September 27, 2022
    Sponsor
    Necmettin Erbakan University
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05510648
    Brief Title
    Evaluation of the Effect of High-intensity Laser Therapy in Knee Osteoarthritis
    Official Title
    The Effect of High-intensity Laser Therapy in Knee Osteoarthritis
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    September 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    September 25, 2022 (Anticipated)
    Primary Completion Date
    September 25, 2022 (Anticipated)
    Study Completion Date
    November 25, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Principal Investigator
    Name of the Sponsor
    Necmettin Erbakan University

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The aim of this study is to evaluate the effects of high intensity laser therapy (HILT) on range of motion, pain, quality of life, muscle strength and femoral cartilage thickness in patients with knee osteoarthritis.
    Detailed Description
    Patients who are admitted and diagnosed with knee osteoarthritis based on anamnesis, physical examination and imaging methods are included in the study.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Knee Osteoarthritis, Laser Therapy, Muscle Strength

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    Investigator
    Allocation
    Randomized
    Enrollment
    60 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    High-intensity laser therapy
    Arm Type
    Active Comparator
    Arm Description
    A total of 15 sessions of hotpack, TENS and exercise program will be applied to the patients for three weeks, 5 days a week, 1 session a day. The hotpack, which is used as a superficial heater, is applied to the knee area for 30 minutes, wrapped in two layers of towels. As analgesic current, conventional TENS is applied to the knee area for 30 minutes with 4 electrodes at 80 Hz frequency, 200 ms current duration. Flow intensity is adjusted according to the patient's tolerance, and the current intensity is increased as the patient's sense of current decreased in the following periods. HILT is applied in analgesic mode for 3 sessions every other day in the first week, and 6 sessions every other day in the biostimulant mode for the next two weeks, for a total of 9 sessions for three weeks.
    Arm Title
    Sham high-intensity laser therapy
    Arm Type
    Sham Comparator
    Arm Description
    Hotpack, TENS and exercise program applications will be applied to the patients in the same way as in the HILT group, 5 days a week, 1 session a day, a total of 15 sessions for three weeks. HILT is administered as a placebo for three weeks, 3 sessions a week, every other day, for a total of 9 sessions.
    Intervention Type
    Other
    Intervention Name(s)
    high-intensity laser therapy
    Intervention Description
    A total of 15 sessions of hotpack, TENS and exercise program will be applied to the patients for three weeks, 5 days a week, 1 session a day. The patients in the HILT group will be treated with a BTL 6000 brand device (Figure 5) for 3 sessions of high-intensity laser with a power of 10.0 w in the first week, energy density of 12 j/cm², every 25 cm² for 2 minutes in analgesic mode, and 5 sessions in the following 2 weeks. While 6 sessions of .0 w power, energy density of 120 j/cm², each 25 cm² for 10 minutes, will be applied in biostimulant mode for 6 sessions for three weeks, is applied in analgesic mode for 3 sessions every other day in the first week, and 6 sessions every other day in the biostimulant mode for the next two weeks, for a total of 9 sessions for three weeks.
    Intervention Type
    Other
    Intervention Name(s)
    sham high-intensity laser therapy
    Intervention Description
    Hotpack, TENS and exercise program applications will be applied to the patients in the same way as in the HILT group, 5 days a week, 1 session a day, a total of 15 sessions for three weeks. HILT is administered as a placebo for three weeks, 3 sessions a week, every other day, for a total of 9 sessions.
    Primary Outcome Measure Information:
    Title
    Visual Analog Scale (VAS) Change from baseline in pain on the VAS at month 3
    Description
    Visual Analog Scale (VAS) is used to measure and monitor the intensity of pain. This is a 10 cm ruler that describes painlessness at one end and the most severe pain at the other. A patient scores his/her pain from 0 to 10.
    Time Frame
    Baseline and month 3
    Secondary Outcome Measure Information:
    Title
    Knee joint range of motion Change from baseline in knee joint on the measuring the range of motion at knee joint at month 3
    Description
    The range of motion of the patients, consisting of knee flexion and extension, is actively evaluated with a goniometer. In the measurement of the flexion angle, the patient is lying in the prone position and the extension angle is measured as the limitation of extension when the knee joint is at 0 degrees
    Time Frame
    Baseline and month 3
    Title
    Femoral cartilage thickness Change from baseline in knee joint on the measuring the femoral cartilage thickness at month 3
    Description
    Femoral cartilage thickness is measured by the same physician by placing the probe axially in the suprapatellar region by ultrasonography while the patient is lying on his back and the knees are in maximum flexion. The distance between the thin hyperechoic line at the synovial cartilage interface and the sharp hyperechoic line at the cartilage-bone interface is defined as cartilage thickness
    Time Frame
    Baseline and month 3
    Title
    SF-36 quality of life scale Change from baseline in physical and mental functions on SF-36 quality of life scale at month 3
    Description
    The SF-36 scale measures 8 dimensions of health and consists of 36 items; physical function (10 items), social function (2 items), role related to physical functions limitations (4 items), role limitations due to emotional problems (3 items), mental health (5 items), energy/fatigue (4 items), pain (2 items), and general perception of health (5 items). It is evaluated between 0 and 100 points; 0 represents poor health, 100 represents good health. There are two summary components, the physical component and the mental component
    Time Frame
    Baseline and month 3
    Title
    Western OntarioMacMaster (WOMAC) Change from baseline in pain and physical functions on Western OntarioMacMaster scale at month 3
    Description
    It is widely used in studies with knee OA patients. The scale, each question of which is evaluated with a 5-point Likert scale, consists of 24 questions. It is filled by patients. There are pain, physical function and stiffness subscales. Pain subscale is evaluated with five items and is scored between 0-20. The hardness subscale has two items and is scored between 0-8. Function subscale consists of 17 items and is scored between 0-68. A high score indicates poor function, pain or stiffness.
    Time Frame
    Baseline and month 3
    Title
    Isokinetic muscle strength measurement Change from baseline in knee joint on the measuring the isokinetic muscle strength at month 3
    Description
    Knee isokinetic muscle strength is measured with the Biodex System-3 isokinetic device . At 60° and 180° angular velocities, the range of motion was 90° flexion 0° extension, after three repetitions at each angular velocity; Measurements are made in a single set-five repetitions with 10 seconds of rest between repetitions
    Time Frame
    Baseline and month 3

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    45 Years
    Maximum Age & Unit of Time
    70 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: 1-40-70 years old 2-Diagnosis of knee OA according to ACR clinical and radiological diagnostic criteria 3-Kellgren Lawrence stage II or III 4-Knee pain for at least 6 months 5-Visual analog scale (VAS) score of at least 3 or more Exclusion Criteria: History of surgery or traumatic injury Inflammatory arthritis History of cancer, bleeding diathesis and psychiatric disease Those who have a disease that limits their participation in exercises (severe chronic obstructive lung disease, severe heart failure, history of cerebrovascular events) Hip and ankle problems Participating in another physical therapy program in the last 3 months History of intra-articular injections in the last 6 months
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    BANU ORDAHAN
    Phone
    5058741256
    Email
    banuordahan@gmail.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    BANU ORDAHAN
    Organizational Affiliation
    Meram Medical School, Necmettin Erbakan University, Konya, Turkey
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Evaluation of the Effect of High-intensity Laser Therapy in Knee Osteoarthritis

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