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Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 61 www.mmcjopt.org
“THE EFFECT OF INTERFERENTIAL CURRENT THERAPY ON
ABDOMINAL OBESITY IN FEMALE INDIVIDUALS WITH
POLYCYSTIC OVARIAN SYNDROME: A RANDOMIZED
CONTROLLED TRIAL’’
Kinjal Doshi (B.P.Th) 1 Amit V. Nagrale (M.P.Th, PhD scholar) 2
1Intern, Maharashtra Institute of Physiotherapy, MIMSR Medical College, Latur
2Professor, College of Physiotherapy, Wanless Hospital, Miraj Medical Centre, Miraj.
Address all correspondence and requests for
permission: Kinjal Doshi
+919029296066
Copyright: 2019 Miraj Medical Centre’s Juornal of Physiotherapy
ABSTRACT:
BACKGROUND AND PURPOSE: The
changes in lifestyle that incorporate an
increase of physical activity and limited
caloric intake have been beneficial in
reducing abdominal obesity. The
purpose of the study was to find out the
effectiveness of IFCT on waist
circumference of female subjects with
PCOS induced obesity. METHOD:
Total of 56 female subjects with PCOS
induced abdominal obesity were
selected. Those patients satisfying the
inclusion criteria with age group of 15-
30 years were included for the study.
They were randomly designated into
two groups: group A (experimental
group) and group B (control group) with
28 subjects in each group. Group A was
treated with interferential current
therapy, Pilates exercises and Group B
was treated with Pilates exercises only.
The subjects in both the groups had
received allocated treatment for 3 times
a week for 6 weeks. In both the groups
the data was collected pre-treatment
and post treatment using waist
circumference, waist hip ratio, Beck
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 62 www.mmcjopt.org
Depression Inventory. RESULT:
Statistical analysis is done by using
Graph Pad Prism 8.0.2.263 software
and level of significance was set at 95%
CI. The experimental groups showed
decrease in central obesity after the
intervention (pre- post analysis- p-value
<0.0001). However, in between group
comparison showed significant
difference post intervention (p-value
0.7797) CONCLUSION: The use of
IFCT and Pilates exercises were more
effective in reducing the waist
circumference, waist- hip ratio and
depression level.
KEYWORDS: Females, PCOS, central obesity, waist circumference, waist- hip ratio,
Beck Depression Inventory.
INTRODUCTION:
Polycystic ovarian syndrome
(PCOS) induced obesity is an
endocrine and metabolic
heterogeneous disorder, with a likely
genetic origin, which occurs due to an
increase in the number of fat cells
resulting in excessive accumulation of
fat tissue in the body. (1)(2)Obesity
along with PCOS prevalence is as high
as 80% in the modern society with
PCOS affecting approximately 7% of
women population. (2)(3) PCOS has
28.3% higher prevalence in obese
women as compared to lean women.
(5)
It is also associated with raising
prevalence of cardiovascular risk
factors including hypertension. (12)It
has the ability to cause psychological
and social depression in women further
leading to an increased risk of
cardiovascular diseases, diabetes and
hyperlipidaemia. (2)
Park YH et al (2017) they stated
that there is significant reduction in
waist circumference (p<0.05) and
visceral fat length (p<0.05) in the
experimental group as compared to the
controlled group. Hence, they
concluded that the use of interferential
current therapy on abdominal obesity
yields a significant reduction in the
waist circumference and visceral fat
length.
The effect of electrical
stimulation by conducting the
experiment on four groups out of which
the first group was the control group,
the second group was treated with IFT,
the third group was treated with hot
water application and IFT and the fourth
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 63 www.mmcjopt.org
group was given aerobic exercises on
treadmill or brisk walking. The results
proved that maximum fat reduction was
seen in second and third group. Hence,
it was concluded that body fat
percentage was less after the
treatment.
Some of the studied compared
the combined effect of current therapy
and active exercise therapy on
abdominal obesity in young subjects
who are obese. The results revealed
that there was reduction in waist
circumference and body fat
percentage. Hence, they suggested
that current therapy is beneficial in
reducing obesity, however, it should be
used along with active exercises.
Sharma P et al (2011): They
mentioned the effect of electrical
stimulation by conducting the
experiment on four groups out of which
the first group was the control group,
the second group was treated with IFT,
the third group was treated with hot
water application and IFT and the fourth
group was given aerobic exercises on
treadmill or brisk walking. The results
proved that maximum fat reduction was
seen in second and third group. Hence,
it was concluded that body fat
percentage was less after the
treatment.
Although there are various
options which are being employed in
the reduction of abdominal obesity,
ranging from dietary therapy, exercise
therapy, drug therapy, electrical
stimulation, etc. but till date no optimal
regimen exists for this disabling
affliction. (2)Recently, interferential
current therapy(IFCT), has been
suggested as a non-invasive method to
address this global and alarming issue
among the female population. (2)Due to
the electrical property of IFCT in terms
of higher frequency and less resistance
to the tissue, the feasibility of this
therapy is considered as significant and
beneficial to the PCOS induced obese
population. (2)
Hence, the purpose of the study
was to find out the effectiveness of
IFCT on waist circumference of female
subjects with PCOS induced obesity.
(2)
MATERIALS & METHODOLOGY:
This study was conducted on
undergraduate students of MIMSR
campus, latur, Maharashtra, India,
between August 2018 and February
2019.
Total of 56 female subjects with
PCOS induced abdominal obesity were
selected. Those patients satisfying the
inclusion criteria with age group of 15-
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 64 www.mmcjopt.org
30 years and PCOS induced obese
women defined as: BMI ≥25 kg/m2were
included for the study. Exclusion criteria
were subject any Hormonal
medications, Medication for diabetes,
oral contraceptives, renal dysfunction,
hypertension, hyperlipidaemia,
Pregnant uterus. They were randomly
designated into two groups: group A
(experimental group) and group B
(control group) with 28 subjects in each
group.
PROCEDURE:
After obtaining clearance from the
ethical committee, subjects were
selected based on the inclusion and
exclusion criteria by Convenient
Sampling method. Total of 56 female
subjects with PCOS induced abdominal
obesity were selected. Sample size was
calculated using common prevalence
formula based on prevalence of PCOD
in Maharashtra. Those patients
satisfying the inclusion criteria with age
group of 15-30 years were included for
the study. They were randomly
designated using blocked
randomization methods into two
groups: group A (experimental group)
and group B (control group) with 28
subjects in each group.Group A was
treated with interferential current
therapy intensity as tolerated by subject
to procure observation contraction,
frequency 400 Hz, 4 pole vector method
was applying for 20-30 min. Pilates
exercises for 30 min and Group B was
treated with Pilates exercises are single
leg stretch, double leg stretch, single
straight leg stretch, and mat hundred.
The subjects in both the groups had
received allocated treatment for 3 times
a week for 6 weeks. In both the groups
the data was collected pre-treatment
and post treatment using waist
circumference measure at the level of
the belly button, and circle the whole
way around the body and back to the
starting point, the waist-hip ratio (WHR)
is the dimensionless ratio of the
circumference of the waist to that of the
hips, Beck Depression Inventory is a
21-question multiple-choice self-report
inventory, one of the most widely used
psychometric tests for measuring the
severity of depression. All outcome
measures were recorded by
independent observer pre and post
treatment. Figure1
STATISTICAL ANALYSIS
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 65 www.mmcjopt.org
Statistical analysis is done by using
Graph Pad Prism 8.0.2.263 software
and level of significance was set at 95%
CI. The experimental groups showed
decrease in central obesity after the
intervention (pre- post analysis- p-value
<0.0001). However, in between group
comparison showed significant
difference post intervention (p-value
0.7797).
Descriptive statistics using mean
and standard deviation was carried for
the variables. The Paired „t‟ Test was
used within the same group (pre and
post intervention) analysis and
Unpaired „t‟ Test was used for between
group analysis. We used intention to
treat analysis.
RESULT
The Paired „t‟ Test was used within the same group (pre and post intervention)
analysis and Unpaired „t‟ Test was used for between group analyses.
GROUP A: Comparison of Pre and Post Waist circumference, Waist Hip Ratio
and Beck Depression Inventory
Outcome
measurements
Pre Exercise
Mean ±SD
Post Exercise
Mean±SD
T-value P value
WC 102.000±7.800 96.519±8.127 25.9116 <0.0001
WHR 0.887±0.023 0.850±0.022 26.439 <0.0001
BDI 15.392±7.15 14.038±5.28 3.728 0.0010
Table 1 showed pre and post
values of waist circumference. The
mean waist circumference in Group A
before the treatment was 102, while
after the treatment, it reduced to
96.519. Pre and post values of waist-
hip ratio. The mean waist- hip ratio in
Group A before the treatment was
0.887, while after the treatment, it
reduced to 0.850. Pre and post values
of Beck Depression Inventory. The
mean Beck Depression Inventory in
Group A before the treatment was
15.39, while after the treatment, it
reduced to 14.04.
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 66 www.mmcjopt.org
GROUP A: Comparison of Pre and Post Waist circumference, Waist Hip Ratio
and Beck Depression Inventory
Graph 1showed there was a significant reduction in waist circumference at p <
0.0001 (t=25.9116). waist- hip ratio at p < 0.0001 (t=26.4396), reduction in Beck
Depression Inventory at p = 0.0010 (t=3.7282).
GROUP B: Comparison of Pre and Post Waist circumference, Waist Hip Ratio
and Beck Depression Inventory
Outcome
measurements
Pre Exercise
Mean ±SD
Post Exercise
Mean±SD
T-value P value
WC 98.571±6.602 95.964±6.324 21.936 <0.0001
WHR 0.878±0.022 0.867±0.026 7.129 <0.0001
Table 4 showed pre and post
values of waist circumference. The
mean waist circumference in Group B
before the treatment was 98.571, while
after the treatment, it reduced to
95.964. Table 5 showed pre and post
values of waist- hip ratio. The mean
waist- hip ratio in Group B before the
treatment was 0.878, while after the
treatment, it reduced to 0.867. Table 6
showed pre and post values of Beck
Depression Inventory. The mean Beck
Depression Inventory in Group B before
the treatment was 10.64, while after the
treatment, it reduced to 10.04.
96.519
0.8508 14.038
95.964
0.8671 10.0350
20
40
60
80
100
120
WC WHR BDI
Axi
s Ti
tle
Axis Title
GROUP A: Comparison of Pre and Post
Series1 Series2
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 67 www.mmcjopt.org
GROUP B: Comparison of Pre and Post Waist circumference, Waist Hip Ratio
and Beck Depression Inventory
There was a significant reduction in waist circumference at p < 0.0001
(t=21.9366), waist- hip ratio at p < 0.0001 (t=7.1291) and Beck Depression Inventory
at p =0.0294 (t=2.3000). The findings are depicted in Graph 2.
COMPARISON OF GROUP A AND GROUP B Pre and Post Waist circumference,
Waist Hip Ratio and Beck Depression Inventory
Outcome
measurements
Pre Exercise
Mean ±SD
Post Exercise
Mean±SD
T-value P value
WC 96.519±8.127 95.964±6.324 0.2812 0.7797
WHR 0.8508±0.0228 0.8671±0.0261 2.4360 0.0183
BDI 14.038±5.28 10.035±6.23 2.5373 0.0142
Table 3 showed post values of
waist circumference, waist- hip ratioand
Beck Depression Inventory in Group A
and Group B. The mean values of waist
circumference in Group A after the
treatment was 96.519, while in Group B
after the treatment were 95.964.The
mean values of waist- hip ratio in Group
A after the treatment was 0.8508, while
in Group B after the treatment were
0.8670. The mean values of Beck
Depression Inventory in Group A after
the treatment was 14.038, while in
WC WHR BDI
Axi
s Ti
tle
Axis Title
GROUP B: Comparison of Pre and Post
Series1
Series2
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 68 www.mmcjopt.org
Group B after the treatment were
10.035.
COMPARISON OF GROUP A AND GROUP B Pre and Post Waist circumference,
Waist Hip Ratio and Beck Depression Inventory
There was a significant
reduction in waist circumference at p
=0.7797 (t=0.2812). waist- hip ratio at p
= 0.0183 (t=2.4360). at p = 0.0142
(t=2.5373). The findings are depicted in
Graph 3.
A small size treatment effect
favoring IFCT and Pilates exercises for
waist circumference, waist hip ratio and
back depression inventory was found
with an effect size of 0.07, 0.6 and 0.06
respectively.
DISCUSSION
Polycystic ovary syndrome
(PCOS) is an endocrine and metabolic
heterogeneous disorder, with a likely
genetic origin, influenced by
environmental factors such as nutrition
and physical activity. PCOS is also
associated with overweight or obesity
(Azziz, et al., 2004), mainly abdominal
adiposity (Moran et al., 1999). Food
habits and lifestyle are also factors in
the presentation and the development
of PCOS.
Obesity affects approximately
60-80% of PCOS patients. Obesity is a
nutritional disorder in which there is an
excess accumulation of fat tissue in the
body caused by an increase in fat cells
and abnormal differentiation due to
energy imbalances. The lack of
physical activity and excessive energy
96.519
0.8508 14.038
95.964
0.8671 10.035
WC WHR BDI
COMPARISON OF GROUP A AND GROUP B
Series1 Series2
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 69 www.mmcjopt.org
intake is increasing the risk of
complications. The changes in lifestyle
that incorporate an increase of physical
activity and limited caloric intake have
been beneficial in reducing abdominal
obesity. However, as the application of
exercise programs due to busy daily
lives becomes difficult, obesity
management using electrotherapy has
begun to attract attention.
The present study was aimed to
determine the effectiveness of IFCT
(Interferential Current therapy) and
Pilates exercise in comparison with
Pilates exercise on waist circumference
of female subjects with PCOS induced
obesity.The present study showed that
there is significant reduction in waist
circumference and waist hip ratio in
PCOS induced obese women after
execution of IFCT and Pilates exercise.
The findings of the present study
are in accordance with the previous
study conducted by Sharma P, Lehri A,
Verma SK (2011), where the patients
who participated in the intervention
observed nearly 2-3% decrease in body
fat in Group II (IFCT), Group III (IFCT +
hot water application) and Group IV
(aerobic exercises). The authors
showed that the Group III intervention
observed relatively greater reduction
than the other interventions namely the
aerobic or the IFCT.
The present study also revealed
similar results that the interventional
group with IFCT and Pilates exercises
showed a significantly greater reduction
in abdominal obesity and waist hip ratio
and even slight reduction in the level of
depression as compared to the control
group only with Pilates exercises.
IFCT for management of obesity
in PCOS induced women is a non-
invasive method. Interferential current
therapy can stimulate internal tissues
effectively, with less irritation to the skin
compared to low-frequency currents,
higher the frequency, lesser the
capacitance resistance i.e., the current
can easily pass through the skin. The
current initially breaks the fatty capsule
that covers the muscle, improves blood
supply to the muscles, and then it helps
it to gain the lost tone to return to its
original size. This return to size and
tone gives the abdominal muscle the
strength to crumble the fatty capsule
from the inside, through their
contractions. IFCT has the ability to
stimulate (a) large number of muscle
fibres for greater muscular work (b)
parasympathetic nerve fiber for causing
increased blood flow in the region and
(c) deeper tissues at the stimulated
Miraj Medical Centre’s Journal of Physiotherapy 2019 VOL 1 ISSUE 1 70 www.mmcjopt.org
sites. Limitation of this study are smaller
sample size, short duration of
intervention and no diet plan was
included in this study.
CONCLUSION:
The use of IFCT and Pilates
exercises were more effective in
reducing the waist circumference,
waist- hip ratio and depression levels. A
significant higher proportion of females
experienced 6 cm of reduction in
abdominal obesity which is more
important for a good health. Further
research should be contacted on large
sample using latest technology of body
fat measurement.
Acknowledgements
We appreciate the work of Dr. Satish
Wadde, Professor, Dept of Community
Medicine, MIMSR Medical College,
latur, for his statistical contribution
during analysis of the data.
Source of support
None
Financial disclosure
It was non-funded study
Conflict of interest
The authors declare that have no
conflict of interest
Ethics Approval
This study was approved from
Institutional Ethics Committee, MIMSR
Medical College, Latur
Author’s contributions
Kinjal Doshi and Amit V. Nagrale were
involved in formation of literature
search, methodology, and drafting the
manuscript.
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