scholarly journals The Effect of Electroacupuncture on Dynamic Balance during Stair Climbing for Elderly Patients with Knee Osteoarthritis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Meijin Hou ◽  
Xiangbin Wang ◽  
Jiao Yu ◽  
Shengxing Fu ◽  
Fengjiao Yang ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Dynamic Balance ◽  
Stair Climbing ◽  
Initial Contact ◽  
Significant Difference ◽  
Stair Negotiation ◽  
Hip Kinematics ◽  
Risk Factors For Falls ◽  
Kinematics And Kinetics

Background. Poor balance is one of the risk factors for falls in patients with knee osteoarthritis (KOA), which is related to the symptoms. Electroacupuncture (EA) is one of the traditional Chinese conservative methods commonly used to improve the symptoms in patients with KOA. Objective. To assess whether EA increases the dynamic balance during stair negotiation among patients with KOA. Methods. A total of 40 KOA patients were assigned to two groups randomly (true electroacupuncture vs. mock electroacupuncture). Acupoints around the knee were selected in the true electroacupuncture (TEA) group with electrical stimulation (2 Hz). In the mock electroacupuncture (MEA) group, about 2 cm next to the above acupoints, the needles were inserted superficially without electrical stimulation. All the participants received 11 sessions of stimulation treatment in three weeks. The primary outcome was margin of stability (MOS). Secondary outcomes included hip kinematics and kinetics as well as pain. Results. There was no significant difference between the two groups for self-reported pain (p=0.585). During ascent, there was no difference between groups in MOS value in both directions, which was the anterior-posterior (A/P) direction and medial-lateral (M/L) direction at initial contact and toe-off as well as the midstance in the gait cycle, and no difference for the hip kinematics and kinetics between the groups was detected (p>0.05). For descent, at the toe-off event, the TEA group was more unstable as compared to the MEA group in the A/P direction (p=0.029) but not in the M/L direction, and the hip showed a larger internal rotator moment (p=0.049); at the midstance, the TEA group showed a lower abductor moment than the MEA group (p=0.003). Conclusions. Based on the assessment results from the chosen patients with KOA, the TEA did not demonstrate a significant effect in improving the dynamic balance during stair negotiation in comparison with the MEA. This finding does not support EA as a conservative treatment to improve the dynamic balance in such patients.

scholarly journals Hip Kinematics During a Stop-Jump Task in Patients With Chronic Ankle Instability

2011 ◽  
Vol 46 (5) ◽  
pp. 461-467 ◽  
Author(s):  
Cathleen N. Brown ◽  
Darin A. Padua ◽  
Stephen W. Marshall ◽  
Kevin M. Guskiewicz
Keyword(s):  
Ankle Sprain ◽  
Ankle Instability ◽  
Vertical Jump ◽  
Reaction Force ◽  
Chronic Ankle Instability ◽  
Maximum Speed ◽  
Initial Contact ◽  
Hip Kinematics ◽  
Hip Flexion ◽  
Kinematics And Kinetics

Context: Chronic ankle instability (CAI) commonly develops after lateral ankle sprain. Movement pattern differences at proximal joints may play a role in instability. Objective: To determine whether people with mechanical ankle instability (MAI) or functional ankle instability (FAI) exhibited different hip kinematics and kinetics during a stop-jump task compared with “copers.” Design: Cross-sectional study. Setting: Sports medicine research laboratory. Patients or Other Participants: Sixty-three recreational athletes, 21 (11 men, 10 women) per group, matched for sex, age, height, mass, and limb dominance. All participants reported a history of a moderate to severe ankle sprain. The participants with MAI and FAI reported 2 or more episodes of giving way at the ankle in the last year and decreased functional ability; copers did not. The MAI group demonstrated clinically positive anterior drawer and talar tilt tests, whereas the FAI group and copers did not. Intervention(s): Participants performed a maximum-speed approach run and a 2-legged stop jump followed by a maximum vertical jump. Main Outcome Measure(s): An electromagnetic tracking device synchronized with a force plate collected data during the stance phase of a 2-legged stop jump. Hip motion was measured from initial contact to takeoff into the vertical jump. Group differences in hip kinematics and kinetics were assessed. Results: The MAI group demonstrated greater hip flexion at initial contact and at maximum (P = .029 and P = .017, respectively) and greater hip external rotation at maximum (P = .035) than the coper group. The MAI group also demonstrated greater hip flexion displacement than both the FAI (P = .050) and coper groups (P = .006). No differences were noted between the FAI and coper groups in hip kinematic variables or among any of the groups in ground reaction force variables. Conclusions: The MAI group demonstrated different hip kinematics than the FAI and coper groups. Proximal joint motion may be affected by ankle joint function and laxity, and clinicians may need to assess proximal joints after repeated ankle sprains.

scholarly journals The Impact of Strengthening Exercise on Dynamic Balance in Patients with Knee Osteoarthritis

2021 ◽  
Vol 15 (10) ◽  
pp. 3429-3431
Author(s):  
Shenbaga Subramanian Sundaram ◽  
Makesh Babu Subramanian ◽  
Riziq Allah Mustafa Gaowgeh ◽  
Mikhled Falah Maayah ◽  
Ziyad Neamatallah ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Dynamic Balance ◽  
Mean Value ◽  
Control Group ◽  
P Value ◽  
Strengthening Exercise ◽  
Significant Difference ◽  
The Mean ◽  
The Impact ◽  
Experimental Group

Background: Knee osteoarthritis is characterised clinically by usage-related pain and/or functional limitation. OA that is associated with physical dysfunction and decline in health-related quality of life caused the main disability worldwide and is expected to increase due to aging and obesity rates and further load on the population and health system. The strengthening exercises that normally used is knee flexion and extensions, isometric quadriceps exercise, isometric hamstring exercise, and sit to stand to improve the balance. Objectives: is to find out the impact of Strengthening exercise on Balance in patients with knee Osteoarthritis Study Design: Quasi experimental study Methods: Fifty-six (n=56) of knee OA patients were involved in this study by judgemental sampling design. Researcher will first demonstrate and explain the Y-balance tools testing procedure based on Plisky and colleagues study. Participants are given to practice six trials before the formal testing, stated that SEBT have a significant learning effect and found that the reaching distances reached the longest distance after six trials and then will be constant. Results: Independent t-test shows significant difference in only anterior direction. In the experimental group the mean value is 69.83 with a SD of 11.62 while in the control group the mean value is 63.51 with a SD of 11.36; p-value of .045 and t-value of 2.056. In postero-lateral directions result shows there is no significant difference, experimental group the mean value is 91.10 with a SD of 9.74 while in control group mean value is 90.88 with SD value of 12.68; p-value of .947 and t-value of .067. Result of postero-medial shows no significant difference too, in experimental group the mean value of 95.16 with SD of 10.92 while in control group the mean value is 93.40 with SD of 8.20; p=value of .501 and t-value of .678. Conclusion: This study has proven strengthening exercise using YBT improved only anterior direction of YBT but no significant difference in postero-lateral and postero-medial direction. Key Words: Knee Osteoarthritis, Strengthening exercise, Dynamic Balance, Star excursion test

scholarly journals The effect of self-reported knee instability on plantar pressure and postural sways in women with knee osteoarthritis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Liana Chaharmahali ◽  
Farzaneh Gandomi ◽  
Ali Yalfani ◽  
Alireza Fazaeli
Keyword(s):  
Knee Osteoarthritis ◽  
Dynamic Balance ◽  
Self Report ◽  
Knee Instability ◽  
Foot Pressure ◽  
Balance Test ◽  
Cross Sectional ◽  
Significant Difference ◽  
Positive Correlations ◽  
Anterior Posterior

Abstract Background Giving way and knee instability are common problems in patients with knee osteoarthritis, disrupting the daily activities and balance of the affected individual. The present study aimed to evaluate the postural control status of women with knee osteoarthritis with and without self-report knee instability (KI). Methods This cross-sectional, single-blind study was conducted on 57 female patients with knee osteoarthritis. The patients were selected based on the inclusion and exclusion criteria and divided into two groups of with KI (n = 26) and without KI (n = 31). Fear of movement was assessed using the Tampa questionnaire, the degree of knee instability was measured based on the Fitzgard scale, the static and dynamic balance of the subjects were evaluated with open and closed eyes using a Biodex balance device, and foot pressure distribution situation was measured using a FDM-S-Zebris device. Results Mean comparison showed a significant difference between the subjects with and without KI in static balance only in anterior–posterior direction with open eyes (p = 0.01) and closed eyes (p = 0.0001). In the dynamic balance test, the subjects in both groups had significant differences in terms of all the indicators of anterior–posterior stability (p = 0.001), medial–lateral stability (p = 0.0001), and overall stability (p = 0.0001) with closed eyes. However, no significant difference was observed with open eyes (p > 0.05). Multiple regression also indicated significant positive correlations between pain intensity and disease duration with the degree of KI (p < 0.05). Conclusions According to the results, there were significant differences between the mean pain scores, static and dynamic balance, and the rate of fall between the women with knee osteoarthritis with and without the KI index. Therefore, patients with knee osteoarthritis, which also has an index of KI, are more susceptible to falls, and proper strategies are required to reduce the level of KI in these patients.

scholarly journals Unloader Knee Brace Increases Medial Compartment Joint Space During Gait In Knee Osteoarthritis Patients

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0011
Author(s):  
Kanto Nagai ◽  
Shumeng Yang ◽  
Freddie H. Fu ◽  
William Anderst
Keyword(s):  
Knee Osteoarthritis ◽  
Gait Cycle ◽  
Joint Space ◽  
Medial Compartment ◽  
Cycle Period ◽  
Initial Contact ◽  
Varus Knee ◽  
Knee Brace ◽  
Significant Difference ◽  
Unloader Brace

Objectives: Clinical outcome measures suggest the unloader brace provides small-to-moderate improvements in pain and function in varus knee osteoarthritis (OA) patients. However, controversy still exists as to whether the brace has the real effect of increasing tibiofemoral joint space in the medial compartment during functional activity. As a limitation, the previous studies did not report ground reaction forces (GRF) with and without the brace, which could be a confounding factor affecting joint space. Therefore, the purpose of the present study was to investigate the effect of an unloader brace on dynamic joint space in medial compartment in OA patients while simultaneously recording GRF during gait. The hypotheses were (1) dynamic joint space in the medial compartment would be greater with the unloader brace than without the brace during gait, and (2) GRF during gait would be smaller with the brace than without the brace. Methods: Ten varus knee OA patients were enrolled (Age: 52±8 years). After minimum 2-week daily use of the unloader brace, subjects walked (1.0 m/s) on an instrumented treadmill while biplane radiographs of the OA knees were acquired at 100 Hz. Tibiofemoral motion was determined from the biplane radiographs from initial contact to terminal stance phase (gait cycle: 0-40%) using a previously validated model-based tracking process. Dynamic joint space measurement in the medial compartment was performed using previously reported method. Briefly, the medial tibial plateau was divided into 9 sub-regions (Figure 1A) and the average minimum distance between femur and tibia subchondral bone was calculated in each region. The region with the smallest joint space over the three walking trials was selected for the analysis. GRF during gait were collected at 1000 Hz and normalized by each subject’s body weight. Output parameters were averaged over 10% intervals of the gait cycle. Two-way repeated measures ANOVA (gait cycle x brace condition) was used to explore differences in medial compartment dynamic joint space and GRF between the 2 conditions (unbraced and braced). Post-hoc paired t-tests identified the differences between the 2 conditions during the same gait cycle period. Significance level was set as P < 0.05. A subjective questionnaire for the brace usage was collected at the time of the test. Results: The dynamic joint space in the medial compartment was significantly greater with the unloader brace than without the brace during gait ( P = 0.004) (Table 1, Figure 1B). The average difference between the 2 conditions was 0.27 mm (95% confidential interval: 0.12-0.43). No significant difference was observed in terms of GRF between unbraced and braced conditions. The questionnaire showed participants felt reduced pain (4.1±0.7 out of 5 scale) and were comfortable (3.8±0.8 out of 5) when wearing the brace. Conclusion: The unloader knee brace induced a small but significant increase in medial dynamic joint space during gait. Furthermore, no differences in GRF during gait were found between unbraced and braced conditions, indicating that the increase of medial joint space with bracing was not due to decreased limb-loading during gait, but instead due to the brace use itself. These results suggest that the OA unloader brace may reduce medial compartment joint loading during dynamic loading activities. [Figure: see text][Table: see text]

scholarly journals Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Pain and the Function in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Aline Mizusaki Imoto ◽  
Stella Peccin ◽  
Kelson Nonato Gomes da Silva ◽  
Lucas Emmanuel Pedro de Paiva Teixeira ◽  
Marcelo Ismael Abrahão ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Rating Scale ◽  
Controlled Trial ◽  
Neuromuscular Electrical Stimulation ◽  
Functional Improvement ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Significant Difference

Objectives. To investigate the effect of 8 weeks of NMES + Ex (neuromuscular electrical stimulation combined with exercises) on pain and functional improvement in patients with knee osteoarthritis (OA) compared to exercise (Ex) alone.Design. Randomized controlled trial.Setting. A specialty outpatient clinic.Participants. Patients (N=100; women = 86, men = 14; age range, 50–75 years) with knee OA.Interventions. Participants were randomly assigned to NMES + Ex or Ex group.Outcome Measures. Numerical Rating Scale 0 to 10 (NRS) and the Timed Up and Go (TUG) test were the primary outcomes. The secondary outcomes used were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Results. Following the interventions, a statistically significant improvement in both groups was observed in all outcomes assessed. For the comparison between the groups, no statistically significant difference was found between the NMES + Ex and the Ex groups in NRS (P=0.52), TUG test (P=0.12), and aspects of WOMAC: pain (P=0.26), function (P=0.23), and stiffness (P=0.63).Conclusion. The addition of NMES to exercise did not improve the outcomes assessed in knee OA patients. This study was registered at the Australian Clinical Trials Registry (ACTRN012607000357459).

No difference in gait pattern between a short collum femoris-preserving and a conventional stem: 44 randomised total hip arthroplasty patients stem evaluated after 2 years

2020 ◽  
pp. 112070002096764
Author(s):  
Roland Zügner ◽  
Roy Tranberg ◽  
Johan Kärrholm ◽  
Goran Puretic ◽  
Maziar Mohaddes
Keyword(s):  
Gait Analysis ◽  
Study Groups ◽  
Gait Pattern ◽  
Camera Motion ◽  
Lateral Incision ◽  
Significant Difference ◽  
Flexion Extension ◽  
Hip Abduction ◽  
Hip Kinematics ◽  
Kinematics And Kinetics

Background: The uncemented collum femoris-preserving (CFP) stem offers preservation of the femoral neck and a more conservative soft tissue resection, which may facilitate a more normal walking pattern. We used gait analysis to evaluate if patients operated with a CFP stem showed more favourable hip kinematics and kinetics when compared with a group of patients operated with a conventional uncemented stem. Methods: 44 patients randomised to receive either a CFP or a Corail stem were studied and were operated using a direct lateral incision. Gait analysis was performed 2 years after the operation with a 12-camera motion capture system and 2 force plates. Hip kinematics and kinetics were analysed and 66 subjects served as controls. Results: None of the variables: speed, stride, cadence and stance showed any statistical significant difference between the 2 study groups. Neither did the hip kinematics and kinetics. Compared to controls, patients operated with the CFP stem showed an increased stance (62.5% vs. 61.1%, p < 0.006) and decreased hip abduction (−2.1° vs. −6.5°). Patients operated with the Corail stem showed decreased speed (1.18 vs. 1.23 m/second), and stride length (1.26 vs. 1.33 m), decreased hip extension (−7.5° vs. −12.8°) and range of hip flexion/extension (38° vs. 40.9°), as well as their hip adduction that was increased (6.3° vs. 4°), whereas their hip abduction was reduced (−2.8° vs. −6.5°), ( p < 0.004) compared to the controls. Conclusions: Use of a CFP stem did not significantly influence any of the gait parameters studied when compared to a standard stem, but still both stems studied were associated with gait deviations when compared to controls. Whether these differences could be attributed to the stem used, the underlying hip disease, or both is still unknown.

A Kinetic and Kinematic Analysis of the Effect of Stochastic Resonance Electrical Stimulation and Knee Sleeve During Gait in Osteoarthritis of the Knee

2014 ◽  
Vol 30 (1) ◽  
pp. 104-112 ◽  
Author(s):  
Amber Collins ◽  
Troy Blackburn ◽  
Chris Olcott ◽  
Joanne M. Jordan ◽  
Bing Yu ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Knee Osteoarthritis ◽  
Stochastic Resonance ◽  
Sagittal Plane ◽  
Knee Kinematics ◽  
Osteoarthritis Of The Knee ◽  
Initial Contact ◽  
Current Configuration ◽  
Knee Mechanics ◽  
Populations At Risk

Extended use of knee sleeves in populations at risk for knee osteoarthritis progression has shown functional and quality of life benefits; however, additional comprehensive kinematic and kinetic analyses are needed to determine possible physical mechanisms of these benefits which may be due to the sleeve’s ability to enhance knee proprioception. A novel means of extending these enhancements may be through stochastic resonance stimulation. Our goal was to determine whether the use of a knee sleeve alone or combined with stochastic resonance electrical stimulation improves knee mechanics in knee osteoarthritis. Gait kinetics and kinematics were assessed in subjects with medial knee osteoarthritis when presented with four conditions: control1, no electrical stimulation/sleeve, 75% threshold stimulation/sleeve, and control2. An increase in knee flexion angle throughout stance and a decrease in flexion moment occurring immediately after initial contact were seen in the stimulation/sleeve and sleeve alone conditions; however, these treatment conditions did not affect the knee adduction angle and internal knee abduction moment during weight acceptance. No differences were found between the sleeve alone and the stochastic resonance with sleeve conditions. A knee sleeve can improve sagittal-plane knee kinematics and kinetics, although adding the current configuration of stochastic resonance did not enhance these effects.

The Effect of Arm Position as a Comparison Between Gender During Single-Leg Landings

2013 ◽  
Author(s):  
Chi-Yin Tse ◽  
Ashkan Vaziri ◽  
Paul K. Canavan ◽  
Ruben Goebel ◽  
Hamid Nayeb-Hashemi
Keyword(s):  
Cruciate Ligament ◽  
Knee Kinematics ◽  
Initial Contact ◽  
Valgus Knee ◽  
Knee Valgus ◽  
Arm Position ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Kinetics Of ◽  
Kinematics And Kinetics

Increased knee valgus loading has been previously identified as a possible risk factor for non-contact anterior cruciate ligament (ACL) injury. Arm position during landing may affect the risk of injury by increasing the knee valgus load. The goal of this study was to examine the kinematics and kinetics of the knee joint during single-leg drop landings from platform heights that was subject specific. Ten subjects (5 female, 5 male) were selected to participate in this single-leg landing study. No significant difference in knee kinematics was noted between arm positions, or gender. Significant difference (p < 0.05) was noted in the varus/valgus knee angle at initial contact (VVIC) when comparing the 60% vertical max jump percentage (%VJMax) to the 80% VJMax and 100% VJMax.

Effect of Neuromuscular Electrical Stimulation on Swallowing Process in Stroke Patient with Neurogenic Dysphagia

1970 ◽  
Vol 1 (1) ◽  
pp. 44-53
Author(s):  
Ruth Ariyani ◽  
Widjajalaksmi ◽  
Luh K Wahyuni ◽  
Susyana Tamin ◽  
Saptawati Bardosono
Keyword(s):  
Electrical Stimulation ◽  
Voice Quality ◽  
Neuromuscular Electrical Stimulation ◽  
Neurogenic Dysphagia ◽  
Stroke Patients ◽  
Cough Reflex ◽  
Voluntary Cough ◽  
Pharyngeal Phase ◽  
Significant Difference ◽  
Quasi Experimental

Objective: The aim of this study to determine the therapeutic effect of Neuromuscular Electrical Stimulation (NMES) on pharyngeal phase of swallowing for stroke patients with neurogenic dysphagia,and to see the effect of NMES in reducing the incidence of standing secretion, residue, penetration and aspiration.Methods: It is a quasi-­experimental study design. 10 stroke patients with neurogenic dysphagia in Cipto Mangunkusumo hospital, Jakarta, 40-­80 years old with hemodynamically stable, cooperative and will be get NMES therapy for 4 weeks. Pre and Post treatment assessment caompared using a modified MASA test (The Mann Assessment of Swallowing Ability) and FEES examination (Flexible Endoscophic Evaluation of Swallowing). Analysis of change scores using Wilcoxon test.Results:The obtain average age of patients 59.80+9.705 years. Significant difference seen in the pharyngeal phase of swallowing increased score of gag reflex, velum elevation, cough reflex, voluntary cough, voice quality, pharynx response, pharyngeal constrictor contraction and vocal cord adduction (p<0.005).Also seen significant reduction in the incidence of standing secretion, residue and penetration (p<0.005), but not significantly in the incidence of aspiration (p=0083).Conclusions: NMES increased the pharyngeal phase of swallowing, reduced the incidence of standing secretion, residue and penetration of stroke patients with neurogenic dysphagia, but have not able to reduced aspiration.Keywords :Neuromuscular Electrical Stimulation (NEMS), neurogenic dysphagia, MASA test (The Mann Assessment of Swallow ing Ability), FEES examination (Flexible Endoscophic Evaluation of Swallowing), swallowing process.

scholarly journals FRI0382 EFFECTS OF GENICULAR NERVE BLOCK IN PATIENTS WITH KNEE OSTEOARTHRITIS WHO HAVE NEUROPATHIC OR NOCICEPTIVE PAIN

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 788.2-789
Author(s):  
B. Tas ◽  
P. Akpinar ◽  
I. Aktas ◽  
F. Unlu Ozkan ◽  
I. B. Kurucu
Keyword(s):  
Neuropathic Pain ◽  
Knee Osteoarthritis ◽  
Nerve Block ◽  
Intractable Pain ◽  
Ultrasound Guided ◽  
Lidocaine Group ◽  
Knee Oa ◽  
Significant Difference ◽  
Genicular Artery ◽  
Saline Solutions

Background:Genicular nerve block (GNB) is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA)(1). There is increasing support for the neuropathic component to the knee OA pain. Investigators proposed that targeting treatment to the underlying pain mechanism can improve pain management in knee OA (2). There is a debate on injectable solutions used in nerve blocks (3).Objectives:To investigate the analgesic and functional effects of USG-guided GNB in patients with chronic knee OA (with/without neuropathic pain) and to evaluate the efficacy of the anesthetic and non-anesthetic solutions used.Methods:Ninety patients with chronic knee OA between the ages of 50-80 were divided into two groups with and without neuropathic pain according to painDETECT questionnaire (4). The groups were randomized into three subgroups to either the lidocaine group (n=30) or dextrose group (n=29) or saline solutions (n=31). After the ultrasound-guided GNB, quadriceps isometric strengthening exercises and cryotherapy were recommended to the patients. Visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Lequesne-algofunctional Index were assessed at baseline and at 1 week, 1 and 3 months later after the procedure.Results:Statistically significant improvement was observed in all groups with or without neuropathic pain according to VAS values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). Statistically significant improvement was observed in all groups with neuropathic pain according to painDETECT values at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05). There was a statistically significant improvement in the groups without neuropathic pain which received dextrose and saline solutions, according to painDETECT values, but not in the group which received lidocain at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p>0.05). There was a statistically significant improvement in all groups with or without neuropathic pain according to WOMAC and Lequesne total scores at the 1stweek, 1stmonth and 3rdmonth compared to baseline (p<0.05).Conclusion:We conclude that in patients with chronic knee OA (with/without neuropathic pain), the use of GNB with USG is an analgesic method which provides short to medium term analgesia and functional recovery and has no serious side effects. The lack of significant difference between the anesthetic and non-anesthetic solutions used in the GNB suggests that this may be a central effect rather than a symptom of peripheral nerve dysfunction. It suggests that injection may have an indirect effect through nociceptive processing and changes in neuroplastic mechanisms in the brain. In addition, we can say that regular exercise program contributes to improved physical function with the decrease in pain.References:[1]Kim DH et al. Ultrasound-guided genicular nerve block for knee osteoarthritis: a double-blind, randomized controlled trial of local anesthetic alone or in combination with corticosteroid. Pain Physician 2018;21:41-51.[2]Thakur M et.al. Osteoarthritis pain: nociceptive or neuropathic?. Nat Rev Rheumatol 2014:10(6):374.[3]Lam SKH et al. Transition from deep regional blocks toward deep nerve hydrodissection in the upper body and torso: method description and results from a retrospective chart review. BioMed Research International Volume 2017;7920438.[4]Hochman JR et al. Neuropathic pain symptoms in a community knee OA cohort. Osteoarthritis Cartilage. 2011 Jun;19(6):647-54.Fig. 1:Ultrasound- guided identification of GNB target sites. Doppler mode. White arrows indicate genicular arteries.A.Superior medial genicular artery.B.Inferior medial genicular artery.C.Superior lateral genicular artery.Disclosure of Interests:None declared

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