Effectiveness of isometric exercises on level of pain among osteoarthritis patients in selected villages at Virudhunagar

The Research Project“A study to assess the effectiveness of Isometric exercises on level of pain among osteoarthritis patients in selected villages at Virudhunagar”. It is conducted as partial fulfillment of the requirement for the Degree of Master of science in nursing at Sri.K.Ramachandran Naidu College of Nursing, Thirunelveli under the Tamil Nadu Dr. M.G.R Medical University, Chennai during the year August 2016. OBJECTIVES: To assess the pre and post-test level of pain among patients with osteoarthritis in experimental group and control group. To compare the pre-test and post-test level of pain among osteoarthritis patients in experimental group and control group. To compare the effectiveness of isometric exercise on level of pain among osteoarthritis patients in experimental group and control group. To associate the pre-test level of pain among patients with osteoarthritis in experimental group and control group with their selected demographic variables. (Age, Sex, Body mass index, Marital Status, Education, Occupation, Dietary pattern, Duration of illness and Duration of treatment). HYPOTHESES: All hypotheses are tested at 0.05 levels : H1: Mean post-test level of pain among osteoarthritis patients in experimental group will be significantly lower than the mean pre-test level of pain in experimental group. H2: Mean post-test level of pain among osteoarthritis patients in control group will be significantly lower than the mean pre-test level of pain in control group. H3: Mean post-test level of pain among osteoarthritis patients in experimental group will be significantly lower than the mean post-test level of pain in control group. H4: There will be a significant association between the pre-test level of pain among Patients with osteoarthritis in experimental and control group with their selected demographics variables. (Age, Sex, Body mass index, Marital Status, Education, Occupation, Dietary pattern, Duration of illness and Duration of treatment) The study was based on the CIPP (Context, Input, Process, Product Model). The quantitative approach was used for this study. The study was conducted in Zaminkollankondan and Avarampatti village in Virudhunagar. The design adopted for this study was Quasi experimental Pre-test and Post-test control group design to assess the effectiveness of Isometric exercises on level of pain among osteoarthritis patients. Non probability purposive sampling technique was used to select 30 samples for experimental group from zaminkollankondan village and the same method was used to select 30 samples for control group from avarampatti. The data collection tool used for the study was modified Lequence observational checklist for osteoarthritis to identify the severity of osteoarthritis. The content validity of the tool was obtained from four nursing experts and one medical experts in the field of medical and surgical nursing. The reliability of the tool(r=0.9) was established by test and retest method by using Karl Pearson’s correlation coefficient.The tool was accepted as reliable by the clinical experts. Pilot study was conducted to find out the feasibility and the data analysis was done. Data collection was done by using the modified Lequence observational checklist to identifying the severity of osteoarthritis and pre and post-test level of pain was measured by Numerical pain intensity rating scale for experimental and control group. The data obtained were analyzed both in terms of descriptive and inferential statistics. FINDINGS: Majority of patients 10 (33.3%) were between the age group of 30 - 40years in experimental group. Where as in control group majority of patients 11(37%) were in the age group of 41-50 years. With respect to sex classification, majority of patients 15 (50%) were female and 15 (50%) were male in the experimental group, whereas in control group majority of patients 16(53.3%) were female. With regard to Body Mass Index (BMI), majority of the patients 16(53%) were belongs to Overweight, whereas in control group, majority of patients 11 (37%) were belongs to normal weight and Overweight category. With regard to marital status, majority of patients 17(57%) were belongs to married in experimental group, where as in control group majority of patients 22(73%) were in unmarried group. Based on the educational status, majority of patients 12(40%) were belongs to no formal education in experimental group where as in control group majority of patients 13(44%) were completed primary education. With respect to occupation majority of patients 16(53%) were belongs to sedentary worker in experimental group and control group also majority of patients 13(44%) were in sedentary worker. With regard to dietary habits classification, majority of patients 21 (70%) were belongs vegetarianin the experimental group, whereas in control group majority of patients 26(87%) were non vegetarian. With regard to duration of illness,majority of patients 12(40%) were in more than 1 year to 2 years of illness, whereas in control group also the majority of patients were in 14(46%) were in more than 1 year to 2 years of illness. With regard to duration of treatment, majority of patients 16(53%) were in more than 1 year to 2 years of treatment, whereas in control group also the majority of patients were in 16(54%) were in the category of 6months -1year of treatment. With regard to the pre and post-test level of pain among experimental group, it was found that the pre-test mean was 6.17, standard deviation 2.07 and mean difference was 2.97 and post-test level of mean value was 3.2 standard deviation 2.35 and it was found that the mean difference was 2.97 and the t value was 7.77 indicating that the table value is highly than calculated value.It was found that there is significant reduction in post-test level of pain in the experimental group than the pre-test level of pain at p<0.05 level. With regard to the pre and post-test level of pain among control group, it was found that the pre-test 4.06 with standard deviation of 2.40 and the post-test mean value was 5.93 standard deviation 2.63.The mean difference was -1.87 and calculated ‘t’ value was 2.87 which showed that there was no significant reduction in post-test level of pain than the pre-test test level of pain among osteoarthritis patients in control group at p < 0.05 levels. Hence hypothesis was rejected. With regard to the post-test level of pain among experimental group it was found that the mean value is 3.2 and the standard deviation is 2.35, where as in control group mean value is 5.93 and standard deviation is 2.63 and the ‘t’ value was 7.01, it shows that there is significant reduction in post-test level of pain in experimental group than post-test level of pain in control group at p<0.05 level. RECOMMENDATIONS: Similar study can be conducted with large samples for better generalisation. An explorative study can be done at various settings like in hospitals or in orthoclinics to identify factors influencing osteoarthritis among elderly people. A similar study can be conducted to find out the effectiveness of other therapies like yoga and muscle relaxation technique. A comparative study can be done between aerobic exercise and isometric exercise for osteoarthritis. A study can be conducted to evaluate the knowledge and attitude of nurses regarding isometric exercises for osteoarthritis. As a nurse working in hospital as well as in community has a vital role to provide effective nursing care for the patients. The nurses are need to develop their knowledge and skills in management of osteoarthritis by assessing the pain and providing care to the osteoarthritis patients, and to use wide variety of interventions in order to reduce pain in such patients. CONCLUSION: From the result of the study, it was concluded that, rendering Isometric exercises to the osteoarthritis patient was effectivess in reduction of knee pain. Therefore the investigator felt that the importance of isometric exercise for osteoarthritis patient used to reduce the level of pain

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