Therapeutic massage for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 19 (5) ◽  
pp. 354-363
Author(s):  
Xing Hua ◽  
Shen Jia-yun ◽  
Gong Li ◽  
Yao Fei ◽  
Li Jian-hua ◽  
...  
2020 ◽  
Vol 33 (6) ◽  
pp. 875-884
Author(s):  
Hyun Jin Song ◽  
Hyun-Ju Seo ◽  
Donghwi Kim

OBJECTIVES: High-intensity laser therapy (HILT) has recently been used to control pain and symptom improvement in knee osteoarthritis. We performed a systematic review and meta-analysis of randomized controlled trials to assess the effectiveness of HILT in patients with knee osteoarthritis. METHODS: We conducted a search of articles in the MEDLINE, EMBASE, Cochrane CENTRAL, and Web of Science databases up to March 2020 for randomized controlled trials investigating HILT intervention, placebo, or active intervention as comparator groups for alleviating pain in knee osteoarthritis. Two independent reviewers evaluated the methodological quality and extracted pain and functional outcomes using a pre-specified form. A meta-analysis was performed using an inverse-variance random effect model. Heterogeneity was assessed using Higgins I2 with p-values. RESULTS: Six randomized controlled trials (RCTs) were included in this meta-analysis. For VAS pain, 334 patients from four studies showed that HILT significantly decreased pain compared to the control (MD, -1.18; 95% CI, -1.68 to -0.69). HILT significantly improved WOMAC stiffness (SMD -1.00; 95% CI -1.32, -0.68) and function (SMD, -5.36; 95% CI -7.39 to -3.34) compared to the control. CONCLUSION: The effectiveness of HILT on pain, stiffness, and function in patients with knee osteoarthritis is promising. However, due to the limited number of studies, further randomized controlled trials with large, well-designed samples are needed.


Cartilage ◽  
2019 ◽  
pp. 194760351988878
Author(s):  
Larry E. Miller ◽  
Samir Bhattacharyya ◽  
William R. Parrish ◽  
Michael Fredericson ◽  
Brad Bisson ◽  
...  

Objective The objective of this systematic review and meta-analysis was to report the safety of intra-articular hyaluronic acid (IAHA) in patients with symptomatic knee osteoarthritis (OA). Methods We identified randomized controlled trials reporting the safety of IAHA versus IA saline in adults with symptomatic knee OA. Main safety outcomes were adverse events (AEs), local AEs, serious adverse events (SAEs), study withdrawals, and AE-related study withdrawals. Results A total of 35 randomized controlled trials with 38 group comparisons comprising 8,078 unique patients (IAHA: 4,295, IA saline: 3,783) were included in the meta-analysis. Comparing IAHA with IA saline over a median of 6 months follow-up, there were no differences in the risk of AEs (42.4% vs. 39.7%, risk ratio [RR] = 1.01, 95% CI = 0.96-1.07, P = 0.61), SAEs (1.8% vs. 1.2%, RR = 1.44, 95% CI = 0.91-2.26, P=0.12), study withdrawals (12.3% vs. 12.7%, RR = 0.99, 95% CI = 0.87-1.12, P = 0.83), or AE-related study withdrawals (2.7% vs. 2.1%, RR = 1.37, 95% CI = 0.97-1.93, P = 0.08). Local AEs, all of which were nonserious, were more common with IAHA vs. IA saline (14.5% vs. 11.7%, RR = 1.21, 95% CI = 1.07-1.36, P = 0.003) and typically resolved within days. Conclusion IAHA was shown to be safe for use in patients with symptomatic knee OA. Compared with IA saline, IAHA is associated with an increased risk of nonserious, transient local reactions. There was no evidence to suggest any additional safety risks of IAHA.


2021 ◽  
pp. 026921552110656
Author(s):  
Yu Wu ◽  
Feilong Zhu ◽  
Wei Chen ◽  
Ming Zhang

Objective To evaluate the effects of Transcutaneous Electric Nerve Stimulation (TENS) on pain, function, walking ability and stiffness in people with Knee osteoarthritis (KOA). Design Systematic review and meta-analysis of randomized controlled trials. Methods We searched MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), clinicaltrials.gov and Web of Science (last search November 2021) for randomized controlled trials. The Cochrane Risk of Bias Tool was used for the included studies, and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) was used to interpret the certainty of results. Standardized Mean Differences (SMDs) and 95% confidence interval (CI) were calculated for meta-analysis. Results Twenty-nine studies were found (1398 people, age range 54-85, 74% are female) and fourteen were included in this review. Intervention duration was divided as short term (immediately after intervention), medium term (<four weeks) and long term (≥ four weeks). Active TENS showed greater improvement in Visual Analogue Scale (VAS) than sham TENS.Combining TENS with other interventions produced superior outcomes compared with other interventions for VAS in all the terms. In the meanwhile, TENS combined with other interventions was superior to other interventions for the pain subgroup of Western Ontario and McMaster Universities Arthritis Index in the medium term and long term. TENS combined with other interventions was superior to other interventions for function in the medium term and long term. Conclusion TENS could significantly relieve pain, decrease dysfunction and improve walking ability in people with KOA, but it is not effective for stiffness.


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