Comparison of the Effectiveness of Pulsed and Continuous Diclofenac Phonophoresis in Treatment of Knee Osteoarthritis

[Purpose] The aim of this study was to compare the effectiveness of pulsed and continuous diclofenac gel phonophoresis with topical diclofenac gel treatment. [Methods] Eighty patients with knee osteoarthritis were randomly assigned to 4 groups. The first group received continuous diclofenac gel phonophoresis, the second group received pulsed diclofenac gel phonophoresis, the third group received diclofenac gel with sham ultrasound, and the fourth group received acoustic gel applied with sham ultrasound. Range of knee motion, VAS pain at rest and in activity, the WOMAC Index and 20 m walking time were evaluated before the treatment, at the end of treatment and 1 month after the treatment. [Results] Improvements were found in VAS pain at rest, VAS pain in activity, WOMAC pain and physical function scores in all of the groups up to 1 month after the therapy. Both modalities of phonophoresis were shown to improve VAS pain at rest, VAS pain in activity, WOMAC pain and physical function scores compared to the other treatments. There was no significant difference in the improvements between the pulsed phonophoresis group and the continuous phonophoresis group. [Conclusion] We showed that both continuous and pulsed ultrasound diclofenac gel phonophoresis is more effective for pain and functional status of patients with knee osteoarthritis than topical application of diclofenac gel, and that the effectiveness of pulsed phonophoresis and continuous phonophoresis is similar.