Cod Liver Oil Phonophoresis as a Non-Invasive Intervention for Chronic Knee Osteoarthritis
Abstract
Objective: Osteoarthritis is a degenerative joint disorder affecting millions of older people worldwide. Conventional treatments include the use of oral NSAIDs, which can cause potential complications like stomach ulcers, gastrointestinal bleeding, and other digestive problems. Identifying an alternative natural anti-inflammatory drug, such as cod liver oil, which can be delivered transdermally by phonophoresis, reducing the potential complications of oral drug administration, was the primary requirement of the study.
Material and Methods: This cross-sectional study included 60 participants selected from Saveetha Medical College and Hospital and other rehabilitation centers, based on defined inclusion and exclusion criteria. They were divided into two groups: one received cod liver oil phonophoresis and the other conventional ultrasound. Treatment spanned five days per week over four weeks, with each session lasting 8 minutes. Baseline and week 4 assessments included pain intensity (Numerical Pain Rating Scale) and functional capacity (Six-minute walk test). Data were analysed using paired and independent t-tests with significance set at p-value<0.005.
Results: Both groups demonstrated statistically significant reductions in pain intensity and functional limitation scores. However, the phonophoresis group showed greater reductions in NPRS scores (mean decrease 3.83 vs. 2.40; p-value<0.001) and superior gains in 6MWT distance (mean increase 21.97 m vs. 10.62 m; p-vaue<0.001) compared to the ultrasound group. Increased knee flexion ROM and patient satisfaction scores also favored the phonophoresis group.
Conclusion: Cod liver oil phonophoresis is an effective, non-invasive intervention for reducing pain and functional limitations in chronic knee osteoarthritis. Its natural composition and safety profile make it a promising alternative or adjunct to traditional pharmacological treatments.
Keywords
Full Text:
PDFReferences
Geng R, Li J, Yu C, Zhang C, Chen F, Chen J, et al. Knee osteoarthritis: Current status and research progress in treatment. Exp Ther Med 2023;26:1-1.
Peanpadungrat P. Efficacy and safety of fish oil in treatment of knee osteoarthritis. J Med Assoc Thai 2015;98(Suppl 3):S110-4.
Gelber AC. Knee osteoarthritis. Ann Intern Med 2024;177:ITC129-44.
Fransen M, Bridgett L, March L, Hoy D, Penserga E, Brooks P. The epidemiology of osteoarthritis in Asia. Int J Rheum Dis 2011;14:113-21.
Venkatachalam J, Natesan M, Eswaran M, Johnson AK, Bharath V, Singh Z. Prevalence of osteoarthritis of knee joint among adult population in a rural area of Kanchipuram District, Tamil Nadu. Indian J Public Health 2018;62:117-22.
Vincent KR, Conrad BP, Fregly BJ, Vincent HK. The pathophysiology of osteoarthritis: a mechanical perspective on the knee joint. PM&R 2012;4:S3-9.
Martin-Vega FJ, Lucena-Anton D, Galán-Mercant A, Perez-Cabezas V, Luque-Moreno C, Vinolo-Gil MJ, et al. Phonophoresis through nonsteroidal anti-inflammatory drugs for knee osteoarthritis treatment: systematic review and meta-analysis. Biomedicines 2022;10:3254.
Lee YH, Bae SC, Song GG. Omega-3 Polyunsaturated Fatty Acids and the Treatment of Rheumatoid Arthritis: A Meta-analysis. Arch Med Res 2012;43:356–62.
Deng W, Yi Z, Yin E, Lu R, You H, Yuan X. Effect of omega-3 polyunsaturated fatty acids supplementation for patients with osteoarthritis: a meta-analysis. J Orthop Surg Res 2023;18:381.
Marathe D, Vasudeva Sampriya Bhuvanashree, Mehta CH, Ashwini T, Nayak UY. Low-frequency sonophoresis: a promising strategy for enhanced transdermal delivery. Adv Pharmacol Pharm Sci 2024;2024.
Gaikwad SS, Zanje AL, Somwanshi JD. Advancements in transdermal drug delivery: A comprehensive review of physical penetration enhancement techniques. Int J Pharm X 2024;652:123856–6.
Bhardwaj A, Patra RC, Potale Y, Kumar M, Khera K, Sanju BS, et al. Phonophoresis in physiotherapy: mechanisms, applications, and emerging trends for enhanced drug delivery and therapeutic efficacy. InBIO Web of Conferences. EDP Sciences 2024;86:01031.
Martin-Vega FJ, Lucena-Anton D, Galán-Mercant A, Perez-Cabezas V, Luque-Moreno C, Vinolo-Gil MJ, et al. Phonophoresis through nonsteroidal anti-inflammatory drugs for knee osteoarthritis treatment: Systematic review and meta-analysis. Biomedicines 2022;10:3254.
Durmus D, Alayli G, Goktepe AS, Taskaynatan MA, Bilgici A, Kuru O. Is phonophoresis effective in the treatment of chronic low back pain? A single-blind randomized controlled trial. Intern J Rheumatol 2013;33:1737-44.
Cordingley DM, Cornish SM. Omega-3 fatty acids for the management of osteoarthritis: A narrative review. Nutrients 2022;14:3362.
Iannitti T, McDermott MF, Laurino C, Malagoli A, Palmieri B. Corticosteroid transdermal delivery significantly improves arthritis pain and functional disability. Drug Deliv Transl Res 2017;7:156-61.
Li J, Tian X, Wang K, Jia Y, Ma F. Transdermal delivery of celecoxib and α-linolenic acid from microemulsion-incorporated dissolving microneedles for enhanced osteoarthritis therapy. J Drug Target 2023;31:206-16.
Coskun Benlidayi I, Gokcen N, Basaran S. Comparative short-term effectiveness of ibuprofen gel and cream phonophoresis in patients with knee osteoarthritis. Int J Rheumatol 2018;38:1927–32.
Hill CL, March LM, Aitken D, Lester SE, Battersby R, Hynes K, et al. Fish oil in knee osteoarthritis: a randomised clinical trial of low dose versus high dose. Ann Rheum Dis 2016;75:23-9.
MacFarlane LA, Cook NR, Kim E, Lee IM, Iversen MD, Gordon D, et al. The effects of vitamin D and marine omega-3 fatty acid supplementation on chronic knee pain in older US adults: results from a randomized trial. Arthritis Rheumatol 2020;72:1836-44.
Hong JW, Noh JH, Kim DJ. The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged≥50 years: The 2010–2013 Korea National Health and Nutrition Examination Survey. PLoS One 2020;15:e0230613.
Modarresi S, Lukacs MJ, Ghodrati M, Salim S, MacDermid JC, Walton DM. A systematic review and synthesis of psychometric properties of the numeric pain rating scale and the visual analog scale for use in people with neck pain. Clin J Pain 2021;38.
Refbacks
- There are currently no refbacks.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.