Abstract 8

Arthritis Care and Research, 1:177-181, 1988.

Effect of Iontopheretically Delivered Dexamethasone on Muscle Performance in a Rheumatoid Arthritic Joint

Scott M. Hasson, EdD, PT, Susan English, PT,
Jerry C. Daniels, MD, PhD, and Miles Reich, MS, PT
Departments of Physical Therapy and Internal Medicine
The University of Texas Medical Branch, Galveston, Texas

Dexamethasone is a corticosteroid that has been used to decrease inflammation and pain in inflamed joints. The method of delivery has conventionally been through joint injection. The subject (female, age 36) in this investigation, has a 2-year history of rheumatoid arthritis in the wrists, knees, ankles, and feet. The joints treated in this study were the knees, and a double bilnd procedure was utilized to determine the experimental (E) (dexamethasone and lidocaine) left; versus the control (C) (lidocaine only) right. Treatment consisted of iontophoresis onto the knee joint; and then repeated on the other knee joint, three times a week over an 8-week period. Prior to the initial treatment session baseline data were collected for peak torque (knee extension [KE] at high omnikinetic resistance (PT); KE angular velocity at low resistance (AV); and total KE work at low resistance (20 repetitions). The subject was subsequently reassessed at 2 weeks, 4 weeks, 6 weeks and 8 weeks. The results (E vs C, percentage change from baseline to 8 weeks): PT (20.8% vs. -6.7%); AV (22.3% vs. 13.4%); and TW (54.0% vs. 17.2%). The results indicate that delivery of dexamethasone via electrical current may be effective in improving muscle / joint performance in a patient with rheumatoid arthritis.

?The results of our study indicate that delivery of dexamethasone via iontophoresis may be effective in improving muscle and joint performance and functional status in a rheumatoid arthritic joint.

?It is important to note that improvements in muscle/joint function occurred even though the subject had decreased her prednisone dose (by 5.0mg/day) immediately prior to initiation of the investigation; this may explain why a decrease in peak torque was observed with the control limb.
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