miraj medical center’s journal of physiotherapy - abdominal...

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

[email protected]

+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

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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



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-



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



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.



GROUP A: Comparison of Pre and Post Waist circumference, Waist Hip Ratio


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


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



GROUP B: Comparison of Pre and Post Waist circumference, Waist Hip Ratio


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



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



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



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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