5% Ibuprofen Iontophoresis Compared with Transcutaneous Electrical Nerve Stimulation in the Management of Knee Osteoarthritis: A Feasibility Study


Objective: The study compared the inclusions of 5% ibuprofen iontophoresis and Transcutaneous Electrical Nerve stimulation (TENS) in the management of osteoarthritis (OA) of the knee joint. Subjects and Methods: Patients diagnosed with knee OA and referred for physiotherapy at a tertiary health facility in Accra, Ghana participated in the study. They were alternately assigned into either TENS or iontophoresis groups. Patients in TENS Group received conventional TENS mode while those in iontophoresis group were treated with 5% ibuprofen iontophoresis using galvanic electrical current. Both protocols were performed twice weekly for six weeks in addition to their prescribed therapeutic exercises. 15-minute walking time, Numerical Rating Scale and Goniometer were used as the main outcome measures to determine subjects’ walking speed, pain and active range of motion (AROM) respectively. Treatment evaluation was performed at baseline, week 3 and week 6 by an independent assessor. Comparisons of variables within and between groups were tested using Friedman’s mean rank and Mann-Whitney U tests respectively at p < 0.05. Results: Participants in both groups were not significantly different in age (p = 0.460), height (p = 0.548) and weight (p = 0.810). Significant improvements were recorded for walking speed (p = 0.001), pain (p = 0.001) and AROM (p = 0.001) of thesubjects within groups. However, between group comparison of the treatment variables showed no significant differences (p > 0.05) for all the outcome measures. Conclusion: 5% ibuprofen iontophoresis and TENS add equal therapeutic value in the management of knee OA. Consideration of both modalities as adjuncts to therapeutic exercises is therefore worthwhile for managing the condition.

Share and Cite:

Bello, A. and Kuwornu, S. (2014) 5% Ibuprofen Iontophoresis Compared with Transcutaneous Electrical Nerve Stimulation in the Management of Knee Osteoarthritis: A Feasibility Study. Open Journal of Therapy and Rehabilitation, 2, 166-172. doi: 10.4236/ojtr.2014.24022.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Veenhof, C. (2007) The Effectiveness of Behavioural Graded Activity in Osteoarthritis. Dutch Journal of Physical Therapy, 117, 118-119.
[2] Owusu-Ansah, B., Wiredu, E.K. and Hamzat, T.K. (2007) Comparative Efficacy of Transcutaneous Electrical Nerve Stimulation and Hotpack in the Management of Knee Joint Osteoarthritis. Ghana Journal of Allied Health Sciences, 1, 24-29.
[3] Vogels, E.M.H.M., Hendriks, H.J.M., vaa Baar, M.E., Dekker, J., HopmanRock, M. and Oostendorp, R.A. (2001) Clinical Practice Guidelines for Physical Therapy in Patients with Osteoarthritis of the Hip or Knee. KNGF—Guide- lines for Physical Therapy in Patients with Osteoarthritis of the Hip or Knee.
[4] Fransen, M., McConell, S. and Bell, M. (2003) Exercise for Osteoarthritis of the Hip or Knee. Cochrane Database Systematic Review, 3, Article ID: CD004286.
[5] Vance, C.G., Rakel, B.A., Blodgett, N.P., DeSantana, M.J., Amendola, A., Zimmerman, M.B., et al. (2012) Effectiveness of Transcutaneous Electrical Nerve Stimulation on Pain, Pain Sensitivity and Function in People with Knee Osteoarthritis: A Randomized Controlled Trial. Physical Therapy, 92, 898-910.
[6] Rutjes, A.W., Nüesch, E. and Sterchi, R. (2009) Transcutaneous Electrostimulation for Osteoarthritis of the Knee. Cochrane Database Systematic Review, 4, Article ID: CD002823.
[7] Bello, A.I., Crankson, S. and Adegoke, B.O.A. (2014) Comparative Treatment Outcomes of Pre and Post-Exercise Tens Application on Knee Osteoarthritis: A Preliminary Report. Rehabilitation Process and Outcome, 3, 1-5. http://dx.doi.org/10.4137/RPO.S13794
[8] Aiyejusunle, C.B., Kola-Korolo, T.A. and Ajiboye, O.A. (2007) Comparison of the Effects of TENS and Sodium Salicylate Iontophoresis in the Management of Osteoarthritis of the Knee. Nigerian Quarterly Journal of Hospital Medicine, 17, 30-34. http://dx.doi.org/10.4314/nqjhm.v17i1.12539
[9] Kivitz, A., Fairfax, M., Sheldon, E.A., Jone, B.A., Gammaitoni, A.R. and Gould, E.M. (2008) Comparison of the Effectiveness and Tolerability of Lidocaine Patch 5% versus Celecoxib for Osteoarthritis-Related Knee Pain: Post Hoc Analysis of a 12 Week, Prospective, Randomized, Active-Controlled, Open-Label, Parallel-Group Trial in Adults. Clinical Therapeutics, 30, 2366-2377.
[10] Paker, N., Kesiktas, N. and Soy, D. (2006) Comparison of Therapeutic Efficacy of TENS versus Intra-Articular Hyaluronic Acid Injection in Patients with Knee Osteoarthritis. Advances in Therapy, 23, 342-353. http://www.ncbi.nlm.nih.gov/pubmed/16751166. cited 08/07/08
[11] Itoh, K., Hirota, S., Katsumi, Y., Ochi, H. and Kitakoji, H. (2008) A Pilot Study on Using Acupuncture and Transcutaneous Electrical Nerve Stimulation to Treat Knee Osteoarthritis. Chinese Medicine, 3, 2. http://www.ncbi.nlm.nih.gov/pubmed/18312661. cited 08/07/08
[12] Costello, C.T. and Jeske, AH. (1995) Iontophoresis: Applications in Transdermal Medication Delivery. Physical Therapy, 75, 554-563.
[13] Sarzi-Puttini, P., Cimmino, M.A., Scarpa, R. and Caporali, R. (2005) Osteoarthritis: An Overview of the Disease and Its Treatment Strategies. Seminars in Arthritis and Rheumatism, 35, 1-10.
[14] Cameron, M.H. (2003) Physical Agents in Rehabilitation from Research to Practice. Saunders. St. Louis, Missouri, 227-230.
[15] Cummings, J. (1987) Iontophoresis in Clinical Electrotherapy (Nelson R.M.) Norwalk. Appleton & Lange, East Norwalk, 231-241.
[16] Balint, G. and Szebenyi, B. (1997) 9 Non-Pharmacological Therapies in Osteoarthritis. Bailliere’s Clinical Rheuma- tology, 11, 1757-1761.
[17] Xiaoying, H., Anigbogu, A., Singh, P. and Xiong, G. (2001) Pharmacokinetic and Local Disposition of [14C] Sodium Diclofenac Following Iontophoresis and Systemic Administration in Rabbits. Journal of Pharmaceutical Sciences, 90, 1269-1276. http://dx.doi.org/10.1002/jps.1079
[18] Allen, L.V. (2007) Compounding for Geriatric and Arthritis Patients. Secundum Artem, 9.
[19] Low, J. and Reed, A. (2004) Electrotherapy Explained: Principles and Practice. 2nd Edition, Butterworth-Heinemann, Oxford.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.