Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis

Abstract

SummaryObjectiveTo compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis.DesignSystematic review with network meta-analysis, to allow comparison of treatments within a coherent framework. Comprehensive searches were undertaken up to January 2013 to identify randomised controlled trials in patients with osteoarthritis of the knee, which reported pain.ResultsOf 156 eligible studies, 114 trials (covering 22 treatments and 9,709 patients) provided data suitable for analysis. Most trials studied short-term effects and many were classed as being of poor quality with high risk of bias, commonly associated with lack of blinding (which was sometimes impossible to achieve). End of treatment results showed that eight interventions: interferential therapy, acupuncture, TENS, pulsed electrical stimulation, balneotherapy, aerobic exercise, sham acupuncture, and muscle-strengthening exercise produced a statistically significant reduction in pain when compared with standard care. In a sensitivity analysis of satisfactory and good quality studies, most studies were of acupuncture (11 trials) or muscle-strengthening exercise (9 trials); both interventions were statistically significantly better than standard care, with acupuncture being statistically significantly better than muscle-strengthening exercise (standardised mean difference: 0.49, 95% credible interval 0.00–0.98).ConclusionsAs a summary of the current available research, the network meta-analysis results indicate that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. However, much of the evidence in this area of research is of poor quality, meaning there is uncertainty about the efficacy of many physical treatments.

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“…Consequently recent systematic reviews provide more reliable evidence when compared to reviews that were carried out in the late 1990s [1][2][3][4]. The current evidence indicates that acupuncture provides clinically relevant benefits when compared to usual care/ waiting list/ other physical interventions [4,5].…”

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“…Revisiones recientes que comparan los métodos físicos, rehabilitación, fisioterapia, TENS y ejercicio, concluyen que la acupuntura puede ser considerada como uno de los tratamientos físicos más eficaces para aliviar el dolor de osteoartritis de rodilla a corto plazo (14).…”

World Congress Integrative Medicine & Health 2017: part two

“…A Measurement Tool to Assess Systematic Reviews (AMSTAR) was used for quality assessment of the reviews [1][2]. Results 14 systematic reviews (6 conducted meta-analyses) satisfied our eligibility criteria with overall acceptable quality [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. Results published in the reviews rely partly on identical and to some extent on different studies.…”

“…Private practice "Astrocit", Vrsac, Serbia; 3 Private practice "Dr Jevdic", Vrsac, Serbia; 4 Special neuropsychiatric hospital "Dr S. Bakalovic", Vrsac, Serbia; 5 Health care Center "1. Oktobar", Plandiste, Serbia; 6 "Planet Zdravja", , Ljubljana, Slovenia; 7 Center for Integrative procedures and Supplements "Dr Dunjic", Belgrade, Serbia Correspondence: Dusan Vesovic BMC Complementary and Alternative Medicine 2017, 17(Suppl 1):P177 Objective The aim of this paper was to reveal whether the use of natural oils additionally to standard therapy may help regulation of cholesterol level (CHl) in diabetes mellitus type1 and type2 (DM1; DM2) patients.…”