Number: 09-04
Physiotherapy 2007;93(S1):S635
Wednesday 6 June 14:00
VCEC Exhibit Hall B & C

PHONOPHORESIS WITH DICLOFENAC GEL IN THE TREATMENT OF ANKLE SPRAINS. Mendonca C1-3, Torres R2; 1Centro De Saúde Do Nordeste (S. Miguel-Portugal). 2Escola Superior Tecnologias Da Saúde Do Porto (Porto-Portugal). 3Fitness Absoluto – Policlinica Do Nordeste (S. Miguel-Portugal)

PURPOSE: The ankle sprains represents one of the most frequent muscular-skeletal injuries in the physical therapy practice, specially at the acute stage, after the injury.The most common therapeutic modalities used to eliminate the pain and the inflammatory process in the acute stage are the administration of non-steroid Anti-inflammatory drugs and the Ultrasound therapy. Even though the use of these type of drugs often brings some side effects related to it’s oral administration. The Transdermic administration of this drug in gel form brings some actual controversy about it’s deep penetration and therapeutic index. RELEVANCE: Being the Ultra-sound one of the therapeutic modalities more commonly used in this type of injury, even though, with enourmous controversy found in the scientific literature on the ideal mode of it’s application. The controversy also existing in the transdermic administration of topics and is effectiveness. Literature expresses positive effects on the use of Ultra-sound energy to facilitate the penetration of drugs trough the skin, this study uses the therapeutic effect of two diferent modalities used in Physiotherapy to clearify it’s effectiveness. DESCRIPTION: This study used a sample of 30 subjects divided in two groups. In one group was administrated ultra-sound with it’s normal conductive gel, and the other group was used Phonophoresis with Voltaren Emulgel(regtm) (Sodium Diclofenac gel). Both groups with a frequency of 1 MHZ, 1W/Cm2 of intensity in continuous mode of application, during 10 minutes for daily sessions.The pain levels with the joint assessed in pasive movement were measured according to the Visual Analogic Scale and Numeric Pain Rate, in six different moments with four treatment sessions intervals. The software S.P.S.S. version 10.1, was used for the data analysis. EVALUATION: All procedures during the program were completed with normality, with the subjects finishing the treatment with full recovery on the last assessment test. Subjects of the sample also respected all the requests from the program, showing at all time good motivation. Subjects from the group of the Phonophoresis required fewer days in the program than the subjects of the other group. No incidents during the program occurred related to adverse effects of the aplication of the treatment. CONCLUSIONS: At the level of significance of α = 0.05, the analysis of the results, concluded that the application of Phonophoresis (1MHZ;1W/Cm2) with Voltaren Emulgel (regtm) in the inflammatory stage of the tissue repair of the capsular-ligament structure of the ankle, is statistically more effective than the application of the regular Ultra-sound, in the same conditions. It’s also more effective in the reduction of the days that the patient shows injury and pain (t = −2.732; p = 0.011), and in the reduction of the number of treatment sessions to reach total absence of pain (t = −3.402; p = 0.002). IMPLICATIONS: This differences in the reduction of pain is more noticeable at the biginning of the first 4 sessions of treatment. Both treatments showed a Therapeutic Index very high, showing good results in relieving pain with total absence of adverse effects. The scales of assessing the pain demonstrated being very liable and easy to use. KEYWORDS: Phonophoresis; Diclofenac; Ultrasound. FUNDING ACKNOWLEDGEMENTS: This work was funding by Escola Superior De Tecnologias Da Saúde Do Porto (ESTSP); Centro De Saúde Do Nordeste and Fitness Absoluto Lda. CONTACT: