Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial

Lizis, Paweł; Kobza, Wojciech; Mańko, Grzegorz

doi:10.3233/bmr-169781

Cited by 31 publications

(52 citation statements)

References 22 publications

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“…The sample size ranged from 18 to 160. All experimental groups received ESWT, while control groups received different treatments including placebo [22,23,25,26,28,30,34,48,49,51,52], medication [31,32,43,44,50], intra-articular injections [21,26,27,29,35,36,39,40], traditional Chinese medicine [38,41,42,45,2 BioMed Research International 46], ultrasound [22,24,47], surgery [33], and kinesiotherapy (KIN) [37].…”

Section: Statisticalmentioning

confidence: 99%

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Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

Chen

Liu

et al. 2020

BioMed Research International

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Background. Osteoarthritis is the most common musculoskeletal disease. Extracorporeal shockwave therapy had shown an effect on osteoarthritis in both some animal experiments and clinical studies, but there was no systematic review to confirm the value of shockwave therapy in the treatment of all types of osteoarthritis and compare it with other traditional therapies (especially traditional Chinese medicine). Method. PubMed, Medline, the Cochrane Central Register of Controlled Trials, Web of Science, Chinese National Knowledge Infrastructure, WANFANG database, and VIP database were searched up to December 10, 2019, to identify randomized controlled trials comparing shockwave therapy and other treatments for osteoarthritis. Visual analogue scale and the Western Ontario and McMaster Universities Osteoarthritis Index were extracted and analyzed by RevMan and STATA software as outcomes of pain reduction and functional improvement. Adverse reactions were recorded to evaluate the safety of shockwave therapy. Results. Shockwave therapy had significant improvement in both pain reduction and functional improvement compared with placebo, corticosteroid, hyaluronic acid, medication, and ultrasound (P < 0:05). In functional improvement, shockwave therapy showed statistical improvement compared with kinesiotherapy and moxibustion (P < 0:05) but not with acupotomy surgery (P = 0:24). A significant difference between shockwave therapy and platelet-rich plasma was observed in pain reduction (P < 0:05) but not in functional improvement (P = 0:89). Meanwhile, a statistical difference was found between shockwave therapy and fumigation in functional improvement (P < 0:05) but not in pain reduction (P = 0:26). Additionally, there was no statistically significant difference between shockwave therapy and manipulation in both pain reduction (P = 0:21) and functional improvement (P = 0:45). No serious adverse reaction occurred in all of studies. Conclusions. Extracorporeal shockwave therapy could be recommended in the treatment of osteoarthritis as a noninvasive therapy with safety and effectiveness, but the grade of recommendations needs to be discussed in a further study.

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Section: Statisticalmentioning

confidence: 99%

“…Only temporary pain, minor bruising, or transient soft tissue swelling was observed in nine studies [25,30,34,42,44,47,[50][51][52]. No adverse events were observed during the treatment in other six studies [27,29,[36][37][38]46], and the remaining studies did not mention it.…”

Section: Biomed Research Internationalmentioning

confidence: 99%

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

Chen

Liu

et al. 2020

BioMed Research International

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“…Another randomized controlled trial showed that ESWT can improve WOMAC and range of motion (ROM) better than kinesiotherapy (KIN) on knee OA [54]. Further, a retrospective study [49] showed that compared with laser therapy, patients underwent ESWT showed greater effect in symptoms relief with regard to WOMAC and Numeric Rating Scale (NRS) evaluation, while no adverse events occurred in both groups.…”

Section: Extracorporeal Shockwave Treatment For Osteoarthritismentioning

confidence: 99%

“…An in vitro study [ 53 ] explained that ESWT could increase the activity of chondrocytes through inducing the surface expression of major hyaluronan cell receptor CD44, which could allow the increase of Collagen type 2A/ Collagen type 1A (COL2A/COL1A) ratio when using HA, and this could enhance the cell susceptibility of chondrocytes to HA, favoring the repair of degenerated cartilage. Another randomized controlled trial showed that ESWT can improve WOMAC and range of motion (ROM) better than kinesiotherapy (KIN) on knee OA [ 54 ]. Further, a retrospective study [ 49 ] showed that compared with laser therapy, patients underwent ESWT showed greater effect in symptoms relief with regard to WOMAC and Numeric Rating Scale (NRS) evaluation, while no adverse events occurred in both groups.…”

Section: Extracorporeal Shockwave Treatment For Osteoarthritismentioning

confidence: 99%

Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism

Xie

et al. 2020

Bioscience Reports

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Osteoarthritis (OA), the most common degenerative joint disease, is characterized by the cardinal symptoms of chronic pain and restricted joint activity. The complicated pathological changes associated with OA and unclear mechanistic etiology have rendered existing non-surgical OA management options unsatisfactory. Increasing clinical and experimental evidence suggests that extracorporeal shockwave therapy (ESWT) is beneficial in OA treatment. ESWT is found to have modifying effects on cartilage and subchondral bone alterations in OA progression, as well as the clinical complaints of patients, including chronic pain and limited joint activities. However, the specific treatment strategy regarding the dosage and frequency of ESWT is still underdetermined. This review discusses the existing evidence regarding the therapeutic indications and possible mechanism of ESWT for OA treatment.

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“…Thus, while evidence supports combined interventions for thumb OA, we are unable to make specific recommendations regarding combined interventions for knee OA, or for other affected joints. With respect to adjunct interventions, we found evidence to support the use of tape for knee OA 21,55,57 , assistive devices for hand OA 59 , thumb splints for thumb OA 60 , manual therapy for knee OA 23,45,47,53 and neck OA 65 , acupuncture for knee OA 44 , and electrophysical agents for knee OA 19,22,48 (Tables III and IV), while conflicting evidence was found for transcranial direct current stimulation (tDCS) 30,37 (Table IV). Taken together with established clinical guidelines, our findings reinforce that these interventions should be adjuncts to accompany core recommended interventions for OA, rather than be used as standalone or key treatments 2,3,9e16 .…”

Section: Discussionmentioning

confidence: 99%

Osteoarthritis year in review 2018: rehabilitation and outcomes

Collins

Hart

Mills

2019

Osteoarthritis and Cartilage

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Objective: Conduct a systematic review of systematic reviews and randomised controlled trials (RCTs) from the past year evaluating rehabilitation for people with osteoarthritis, and provide narrative synthesis of findings focused on core recommended treatments for osteoarthritis (exercise, education, biomechanical interventions, weight loss). Design: A comprehensive search strategy was used to search PubMed, EMBASE and Cochrane databases (16 th May 2017 to 22 nd March 2018). Search terms included 'osteoarthritis', 'rehabilitation', 'systematic review', and 'randomised controlled trial'. Inclusion criteria were: (1) RCT, or systematic review of randomised clinical trials (RCTs); (2) human participants with osteoarthritis (any joint); (3) evaluation of rehabilitation intervention; and (4) at least one patient-reported measure. Methodological quality was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) tool (systematic reviews) and PEDro rating scale (RCTs). Narrative synthesis mapped findings to core recommendations from existing osteoarthritis clinical guidelines. Results: From 1994 records, 13 systematic reviews and 36 RCTs were included. 73% of these evaluated knee osteoarthritis (36 studies). The remaining studies evaluated hand osteoarthritis (6 studies), hip, hip/ knee and general osteoarthritis (each 2 studies), and neck osteoarthritis (1 study). Exercise was the most common intervention evaluated (31%). Updated recommendations for exercise prescription and preliminary guidance for psychological interventions are provided. Conclusion: Level 1 and 2 osteoarthritis rehabilitation literature continues to be dominated by knee osteoarthritis studies. Consistent with current clinical guidelines, exercise should be a core treatment for osteoarthritis, but future studies should ensure that exercise programs follow published dose guidelines. There is a clear need for research on rehabilitation for hip, hand, foot/ankle, shoulder and spine osteoarthritis.

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Extracorporeal shockwave therapy vs. kinesiotherapy for osteoarthritis of the knee: A pilot randomized controlled trial

Abstract: ESWT improves WOMAC and ROM better then KIN on the affected knee in patients with OA of the knee.

Cited by 31 publications

References 22 publications

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

Extracorporeal Shock Wave Therapy for the Treatment of Osteoarthritis: A Systematic Review and Meta-Analysis

Extracorporeal shockwave treatment in knee osteoarthritis: therapeutic effects and possible mechanism

Osteoarthritis year in review 2018: rehabilitation and outcomes

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