Effect of iontophoretically delivered dexamethasone on muscle performance in a rheumatoid arthritic joint. A case study - Chiropractic Treatment

Effect of iontophoretically delivered dexamethasone on muscle performance in a rheumatoid arthritic joint. A case study
8 Dec 2005
Scott M. Hasson, EdD, PT 1 *, Susan E. English, PT 2, Jerry C. Daniels, MD, PhD 3, Miles Reich, MS, PT 4
1Department of Physical Therapy, The University of Texas Medical Branch, Galveston, TX
2Department of Physical Therapy, The University of Texas Medical Branch, Galveston, TX
3Department of Internal Medicine, The University of Texas Medical Branch, Galveston, TX
4Department of Physical Therapy, The University of Texas Medical Branch, Galveston, TX
Arthritis Care & Research

Abstract
Dexamethasone is a corticosteroid that has been used to decrease inflammation and pain in inflammed 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-blind 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.

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