Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials

doi:10.1177/0269215519846942

Paper

Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials

Published May 8, 2019 · Chun-De Liao, J. Tsauo, T. Liou

Clinical Rehabilitation

Q1 SJR score

24

Citations

2

Influential Citations

Full textSemantic Scholar

Abstract

Objective: This study determined the clinical efficacy of extracorporeal shockwave therapy and the predictors of its efficacy for knee osteoarthritis. Data Sources: Electronic databases and search engines, namely MEDLINE, PubMed, EMBASE, Cochrane Library Database, Physiotherapy Evidence Database (PEDro), China Academic Journals Full-text Database, and Google Scholar, were searched until 5 March 2019, for randomized controlled trials without restrictions on language and publication year. Review Methods: Eligible trials and extracted data were identified by two independent investigators. The included articles were subjected to a meta-analysis and risk of bias assessment. Outcomes of interest included treatment success rate, pain, and physical function outcomes. A meta-regression analysis was performed to determine the predictors of treatment outcomes following shockwave therapy. Results: We included 50 trials (4844 patients) with a median (range) PEDro score of 6 (5–9). Meta-analyses results revealed an overall significant effect favoring shockwave therapy on the treatment success rate (odds ratio 3.22, 95% confidence interval (CI) 2.21–4.69, P < 0.00001; heterogeneity (I2) = 62%), pain reduction (standardized mean difference (SMD) −2.02, 95% CI −2.38 to −1.67, P < 0.00001; I2 = 95%), and Western Ontario and McMaster Universities Osteoarthritis Index function outcome (SMD −2.71, 95% CI −3.50 to −1.92, P < 0.00001; I2 = 97%). Follow-up duration and energy flux density were independent significant predictors of shockwave efficacy. Conclusion: Shockwave therapy is beneficial for knee osteoarthritis. Shockwave dosage, particularly the energy level and intervention duration, may have different contributions to treatment efficacy.

Meta-Analysis

Rigorous Journal

Study Snapshot

Shockwave therapy is beneficial for knee osteoarthritis, with energy level and intervention duration playing different roles in treatment efficacy.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Clinical efficacy of extracorporeal shockwave therapy for knee osteoarthritis: a systematic review and meta-regression of randomized controlled trials

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References

Citations

Extracorporeal shock wave therapy versus dexamethasone iontophoresis as a treatment for symptomatic knee osteoarthritis

Extracorporeal shock wave therapy (ESWT) has a superior therapeutic effect in patients with symptomatic knee osteoarthritis compared to dexamethasone iontophoresis.

Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: An umbrella review 5-year update

Diet Therapy, Patient Education, and Resistance Training are strongly supported as core interventions for managing knee osteoarthritis, while other interventions have low evidence quality or inconclusive results.

Effectiveness of Extracorporeal Shock Wave Therapy in Treating Grade 1-2 Gonarthrosis: A Scientific Review

Extracorporeal shock wave therapy (ESWT) significantly improves pain reduction and knee joint function in patients with grades 1-2 gonarthrosis, making it a safe and preferred treatment option.

EVALUATION OF TREATMENT PARAMETERS FOR FOCUSED-EXTRACORPOREAL SHOCK WAVE THERAPY IN KNEE OSTEOARTHRITIS PATIENTS WITH BONE MARROW LESIONS: A PILOT STUDY

The highest dosage of focused-extracorporeal shock wave therapy improves pain and physical function in knee osteoarthritis patients with bone marrow lesions, but does not affect the underlying disease pathology.

Adjunctive electrophysical therapies used in addition to land-based exercise therapy for osteoarthritis of the hip or knee: A systematic review and meta-analysis

Laser therapy may provide short-term improvement in pain and physical function for hip or knee osteoarthritis, but other electrophysical therapies show no clinically significant effects.

The efficacy of extracorporeal shock wave therapy for knee osteoarthritis : an umbrella review

Extracorporeal shock wave therapy (ESWT) is an effective therapy for improving pain and function in patients with knee osteoarthritis.

A critical overview of systematic reviews and meta-analyses of extracorporeal shockwave therapy for knee osteoarthritis.

Extracorporeal shockwave therapy (ESWT) is a safe and effective non-pharmacological treatment for knee osteoarthritis, but the reliability of its results is affected by the generally low methodological and evidential quality of included studies.

Effect of extracorporeal shock wave therapy on pain and function in patients with knee osteoarthritis: a systematic review with meta-analysis and grade recommendations

Shockwave therapy may improve short-term function and long-term pain in patients with knee osteoarthritis compared to sham or kinesiotherapy.

How to report parameters and procedures for shockwave therapy in musculoskeletal disorders: A narrative review

This paper developed a consensus-based guideline on how to report shockwave therapy parameters for musculoskeletal conditions, enhancing reproducibility and interpretation of data in future studies.