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[Effectiveness of various methods of cryotherapy in patients with osteoarthritis]
1Central Production and Commercial Department for the Service of the Diplomatic Corps under the Ministry of Foreign Affairs of the Russian Federation (Medical Center), Moscow, Russia.
Abstract:
Aim of this study - the comparative effectiveness of cryotherapy (CT) with ice 0 °C, CT with ice 0 °C + SMC (cryo-SMC), air cryotherapy (ACT) -30 °C, hyperbaric gas cryotherapy (HC) CO2 -78 °C.
Material And Methods:
We examined 150 patients with II - IV stage osteoarthritis of the knee and hip joints, movement pain of more than 40 mm on a VAS and Leken index more than 9. 120 of these patients received a course of CT of various temperatures and cryo-SMC for 2 weeks: 1st group (n=30) - CT of ice 0 °C; 2nd group (n=30) - cryo-SMC; 3rd group (n=30) - ACT; 4th group (n=30) - HC. The 5th group (control) included patients (n=30) who received only non-steroidal anti-inflammatory drugs (NSAIDs). We assessed dynamics of rest and movement pain according to VAS, the WOMAC index, the effectiveness according to the OMERACT-OARSI criterion and the need for NSAIDs. Effectiveness of treatment was evaluated by the patient and the doctor.
Results:
OMERACT-OARSI analysis demonstrated a high percentage of CT response. A statistically significant decrease in rest and movement pain intensity was registered in all patients of the groups: ice 0 °C, cryo-SMC, ACT, HC and control groups. The pain decreased by 82-83% in the groups 1-4, and by 70% in the control group. There were no differences in the effectiveness of treatment between groups 1, 3, and 4 and the cryo-SMC group; effectiveness of treatment was statistically significant (p<0.01) between groups 1-4 and the control group. A statistically significant decrease in the total WOMAC index, as well as in «pain» and «stiffness» VAS subscales (p<0.01) in the absence of intergroup differences in the 1st, 3rd, 4th groups and the cryo-SMC (p>0.05) group and a statistically significant difference between the 1st-4th groups and the control group (p<0.01). According to the «function» subscale of the WOMAC index, a statistically significant difference between all groups was not found (p>0.05).
Conclusion:
Results of this study according to the OMERACT-OARSI effectiveness evaluation criteria indicate the comparability of CT as a treatment method with NSAID therapy in terms of the effect on improving the patient's functional capabilities and greater CT efficiency in relieving pain and stiffness in the joints.
