A Randomized single blind placebo controlled trial in management of cases of Knee Osteoarthritis by Individualized Homoeopathic medicine with aid of “Boenninghausen’s Characteristics & Repertory” by C.M. Boger.

Abstract

Background: Knee osteoarthritis (OA) is the most common musculoskeletal disease which affects ability for sitting on the chair, standing, walking and climbing stairs and various other daily living activities of individual. Cyrus Maxwell Boger introduced the concept of pathological general, time modalities and tissue affinity in his repertory “Boenninghausen’s Characteristics and Repertory which is used in the study for selection of individualised homoeopathic medicines for management of knee osteoarthritis.

Aim

To assess the effectiveness of individualised homoeopathic medicine with the aid of

Boenninghausen’s Characteristics and Repertory by C.M. Boger in management of knee OA.

Objectives

• To assess the extent of improvement in patient receiving Indivisualised Homoeopathic medicines with physiotherapy by comparing pre and post treatment scores of Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS questionnaire as an outcome assessment scale within the group
• To assess the extent of improvement in patient receiving placebo with physiotherapy by comparing pre and post treatment scores of Knee Outcome Survey Activities of Daily Living Scale (KOS-ADLS) questionnaire as an outcome assessment scale within the group.

Methodology: It was 9 months Interventional, Single blind, Randomized placebo controlled study. Which was conducted on 65 patients diagnosed with knee osteoarthritis using with KOS-ADLS Score diagnosed criteria at Out Patient Department (O.P.D) of Dr. Girendra Pal Homoeopathic Hospital, Research centre collegiate Hospital of Dr. M. P. K. Homoeopathic Medical College, Hospital and Research Centre, Homoeopathy University, Saipura, Sanganer, Jaipur, Rajasthan.  KOS-ADLS Score was used for pre and post treatment evaluation. Paired t test and independent test used for statistical analysis and the indivisualized homeopathic medicine given after repertoring from Boenninghausen’s Characteristics and Repertory.

Result: 65 Patients completed  the study, 5 Patients considered in drop out(n=35-5=30) as per the inclusion and exclusion criteria, the study suggests that female patients were more prone to knee OA, of age group 35-45 years, among more in reported middle class socioeconomic status people and House wives were found to be the most affected group. Most of the patients found in urban population. Most commonly affected joint were B/L knee joints. Most patients found their daily activity was mostly affected in first motion with marked stiffness. Most frequently observed grade in x-ray are ‘GRADE-II. Most commonly prescribed medicines after repertorization were Rhus toxicodenron and Bryonia alba. The calculation of statistical analysis paired t test individualized Homoeopathic medicine with Physiotherapy, showed significant effect (difference of mean= -26.829 t(35) =-11.577, P<0.001 where negative mean difference indicate the higher value of the post scores which signifies greater improvement. Placebo and Physiotherapy, difference of mean= -2.333, t (30) =-4.215, P > .001 where negative mean difference indicate the higher value of the post scores which signifies greater improvement. Levene’s Test indicated that there is significant (P<.001) increase in Symptomatic domain of KOS-ADLS score in cases of knee osteoarthritis with Individualized Homoeopathic medicine with Physiotherapy (M= 55.7, S.D. = 11.238) than Placebo with Physiotherapy (M=31.93, S.D.= 5.471), t(65)= 11.107, P<.001

Conclusion: The findings of this study Out of the 35 cases of knee osteoarthritis in Group A (Individualized Homoeopathy medicine and Physiotherapy) 51.428% (n-18) showed mild improvement; 20% (n-7) showed moderate improvement and non-significant improvement; 2.857% (n-1) showed marked improvement; showed 5.7% (n-2) no improvement (status quo). Out of 30 cases of knee osteoarthritis in Group B (Placebo and Physiotherapy 76.666% (n-23) showed non-significant improvement; 20% (n-7) were aggravated; 16.666% (n-5). Hence, proved the significant utility of Individualised Homoeopathic medicine selected from Boenninghausen’s Characteristics & Repertory by C.M. Boger showed improvement in KOSADLS Score in patients suffering from knee osteoarthritis.