Post-Operative Management of Metal Implanted Elbow Stiffness with Pulsed Short-Wave Diathermy (SWD) and Joint Mobilization
Background: Stiffness of the elbow after trauma is a well-recognized disabling condition that interferes with daily activities. Restoration of joint motion in the post-traumatic stiff elbow remains difficult and poses a challenge for surgeons. Diathermy is a superb warming modality to be used in deep tissues. Mobilization preceded through warmness frequently produces larger mobility gains. Objective: To determine the effect of short-wave diathermy in pain management, elbow range of motion and disability after elbow surgery. Study Design: Randomized clinical trial (RCT). Settings: Allied hospital, District Headquarter (DHQ) Hospital, Madinah teaching hospital Faisalabad (MTH) Pakistan. Duration: The study duration was July to November 2018. Methods: A study was conducted on 30 patients that meet inclusion criteria further divided these 30 patients in two groups group A and group B. Intervention: The group A receives Mobilization with PSWD on cubital fossa with for 20 minutes and after that crushed ice applied for 30 min. Group B receives only mobilization and ice application for the same time. Outcome measure: Data was assessed through the numeric pain rating scale ROM with goniometer and function with Liverpool score of elbows. Results: Repeated measures ANOVA was applied to analyze within group variation for pain and ROM. Pre and post comparison of Liverpool scores was made using paired sample t-test. The mean age of group A and group B was 31.60±12.488, 31.666±11.926 respectively. The test results show that there was no statistical difference of elbow flexion and extension ROM in starting but at the last session difference became statistically significant (p-value= <0.05). Significant difference occur in means of pre and post elbow Liverpool score (p-value <0.05). Conclusion: Pulsed shortwave diathermy with mobilization was more effective for the treatment of post-surgical elbow pain, stiffness and reduced disability as compared to mobilization alone.