Efficacy Comparison of Five Different Acupuncture Methods on Pain, Stiffness, and Function in Osteoarthritis of the Knee: A Network Meta-Analysis

The principal objective of this present study was to compare the effects of different acupuncture methods on pain, stiffness, and physical function for osteoarthritis of the knee by the pairwise and network meta-analysis (NMA). A network meta-analysis of randomized controlled trials (RCTs) was searched from three English databases and one Chinese database until January 2018. A pairwise meta-analysis was performed with a random effects model. Then we carried out the NMA within a Bayesian framework. Mean difference (MD) and its 95% confidence interval (CI) were calculated by R 3.4.1, Stata 14.0, and RevMan 5.3 software to assess the relief of pain, the effectiveness for stiffness, and physical function recovery. Node-splitting method was used to calculate the inconsistency. Rank probabilities were assessed and clustered by the surface under the cumulative ranking curve (SUCRA). 16 trials mostly researched short-term effectiveness and showed that fire needle and electro-acupuncture were statistically significant to decrease WOMAC pain and physical function scores when compared with other treatments, but there was no significant difference in stiffness calculations. Our NMA demonstrated that acupuncture with heat pain or electrical stimulation might be suggested as the better choices in all acupuncture methods to osteoarthritis of the knee.

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Development and Feasibility of the Early Rehabilitation Program on Postoperative Enhanced Recovery Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

10.21203/rs.3.rs-115850/v1 ◽

2020 ◽

Author(s):

Funa Yang ◽

Lijuan Li ◽

Yanzhi Mi ◽

Limin Zou ◽

Xiaofei Chu ◽

...

Keyword(s):

Hospital Stay ◽

Physical Function ◽

Enhanced Recovery ◽

Rehabilitation Program ◽

Postoperative Hospital Stay ◽

Early Rehabilitation ◽

Control Group ◽

Function Recovery ◽

Significant Difference ◽

Physical Function Recovery

Abstract Background: Perioperative rehabilitation management is essential to enhanced recovery after surgery. Few reports, however, focused on quantitative, detailed early activity plans for patients after esophagectomy. Aim: The purpose of this research was to estimate the effect of the Early Rehabilitation Program (ERP) on the recovery of bowel function and physical function for patients undergoing esophagectomy. Method: In this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selected from June 2019 to February 2020 and assigned to the intervention group (IG) or the control group(CG) randomly. The participants in IG received an ERP strategy during the perioperative period, and the CG received routine care. The recovery of bowel and physical function, readiness for hospital discharge (RHD) and postoperative hospital stay were evaluated on the day of discharge. Results: 215 cases were enrolled and randomized to the CG (n=108) or IG (n=107). There was no significant difference between the two groups in terms of demographic and clinical characteristics and baseline physical function. After the ERP intervention, the IG group presented a significantly shorter time to first flatus (P<0.001) and to first bowel movement postoperative (P=0.024), and a better physical function recovery (P＜0.001), compared with the CG group. The analysis also showed that participants in the IG have higher scores of RHD and shorter length of postoperative stay than the CG (P＜0.05). Conclusion: The findings suggest that the ERP can improve bowel and physical function recovery, ameliorate patients' RHD, and shorten postoperative hospital stay for patients undergoing MIE.Trial registration：ClinicalTrials.gov Identifier: NCT01998230

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Effectiveness of the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) Based on ERAS in Improving the Physical Function Recovery for Patients Following Minimally Invasive Esophagectomy: A Prospective Randomized Controlled Trial

10.21203/rs.3.rs-460781/v1 ◽

2021 ◽

Author(s):

Funa Yang ◽

Lijuan Li ◽

Yanzhi Mi ◽

Limin Zou ◽

Xiaofei Chu ◽

...

Keyword(s):

Minimally Invasive ◽

Physical Function ◽

Minimally Invasive Esophagectomy ◽

Intervention Group ◽

Rehabilitation Program ◽

Invasive Esophagectomy ◽

Function Recovery ◽

Significant Difference ◽

Comprehensive Rehabilitation ◽

Physical Function Recovery

Abstract BackgroundPerioperative rehabilitation management is essential to enhanced recovery after surgery (ERAS). Few reports, however, focused on quantitative, detailed early activity plans for patients after minimally invasive esophagectomy (MIE). The purpose of this research was to estimate the Tailored, Early Comprehensive Rehabilitation Program (t-ECRP) based on ERAS inthe recovery of bowel function andphysical functionfor patients undergoingMIE. MethodsIn this single-blind, 2-arm, parallel-group, randomized pilot clinical trial, patients were selectedfrom June 2019 to February 2020 and assigned to the intervention group (IG) or the controlgroup(CG)randomly.The participants inIGreceived at-ECRPstrategy during theperioperative period, and the CG received routine care. The recovery of bowel andphysical function, readiness for hospital discharge (RHD) and postoperative hospital stay evaluated on the day of discharge. Results215 cases were enrolled and randomized to theIG (n=107)orCG (n=108). There was no significant difference between the two groups in terms of demographic and clinicalcharacteristics and baseline physical function.After the t-ECRP intervention,the IG group presented a significantly shorter time tofirst flatus(P<0.001) and to first bowel movement postoperative (P=0.024),and a better physical function recovery (P＜0.001), compared with theCG group.The analysis also showed thatparticipants in the IG have higherscores of RHD and shorter length of postoperative stay than the CG (P＜0.05).Conclusions The findings suggest that the t-ECRP can improve bowel andphysical functionrecovery,amelioratepatients'RHD, and shorten postoperative hospital stayfor patients undergoing MIE.Trial registrationClinicalTrials.gov (Identifier: NCT01998230)

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Effectiveness and feasibility of acupuncture for knee osteoarthritis: a pilot randomized controlled trial

Clinical Rehabilitation ◽

10.1177/0269215518790632 ◽

2018 ◽

Vol 32 (12) ◽

pp. 1666-1675 ◽

Cited By ~ 10

Author(s):

Lu-Lu Lin ◽

Yong-Ting Li ◽

Jian-Feng Tu ◽

Jing-Wen Yang ◽

Ning Sun ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Response Rate ◽

Controlled Trial ◽

Womac Pain ◽

Chinese Acupuncture ◽

Randomized Controlled ◽

Acupuncture Intervention ◽

Significant Difference ◽

And Function ◽

Pilot Randomized Controlled Trial

Objective: To evaluate the effectiveness of acupuncture for pain relief and function improvement in patients with knee osteoarthritis and to determine the feasibility of an eight-week acupuncture intervention. Design: Pilot randomized controlled trial. Setting: Three teaching hospitals in China. Subjects: Patients with knee osteoarthritis (Kellgren grade II or III). Interventions: Patients were randomly assigned to an eight-week (three sessions per week) intervention of either traditional Chinese acupuncture or sham acupuncture. Main measures: The primary outcome was response rate—the proportion of patients achieving score ⩾36% decrease in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function at week 8 compared with baseline. Secondary outcomes included pain, function and quality of life. Results: Of 42 patients randomized, 36 (85.7%) completed the study. There was no significant difference in response rate between the traditional Chinese acupuncture and control groups: 61.9% (13 of 21) versus 42.9% (9 of 21) achieved score ⩾36% decrease in WOMAC pain and function at week 8 ( P = 0.217). The sum of WOMAC pain and function scores at week 8 was 11.6 (9.1) in the traditional Chinese acupuncture group compared with 16.3 (10.9) in the control group ( P = 0.183). There was no significant difference between groups. Three adverse events were recorded and were classified as mild. Conclusion: It showed that three sessions per week acupuncture intervention of knee osteoarthritis was feasible and safe. No difference was observed between groups due to small sample size. Larger (sample size ⩾ 296) randomized controlled trials of this intervention appear justified.

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Sustainability of effects of land-based exercise on pain and physical function for osteoarthritis of the knee: systematic review and meta-analysis

Osteoarthritis and Cartilage ◽

10.1016/j.joca.2014.02.724 ◽

2014 ◽

Vol 22 ◽

pp. S388 ◽

Cited By ~ 1

Author(s):

A.R. Harmer ◽

S. McConnell ◽

M. Simic ◽

M. van der Esch ◽

K.L. Bennell ◽

...

Keyword(s):

Systematic Review ◽

Physical Function ◽

Meta Analysis ◽

Osteoarthritis Of The Knee

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The Effectiveness of Acupuncture for Osteoarthritis of the Knee – a Systematic Review

Acupuncture in Medicine ◽

10.1136/aim.24.suppl.40 ◽

2006 ◽

Vol 24 (1_suppl) ◽

pp. 40-48 ◽

Cited By ~ 12

Author(s):

Adrian White ◽

Nadine Foster ◽

Mike Cummings ◽

Panos Barlas

Keyword(s):

Systematic Review ◽

Acupuncture Treatment ◽

Meta Analysis ◽

Internal Validity ◽

Sham Acupuncture ◽

Sensitivity Analyses ◽

Osteoarthritis Of The Knee ◽

Reduction Of Pain ◽

Randomised Controlled ◽

And Function

Objective To determine the effectiveness of acupuncture treatment for pain and function of patients with osteoarthritis of the knee. Methods A systematic review of randomised controlled trials was performed, including a meta-analysis which combined the results of trials that used adequate acupuncture treatment and used WOMAC scores to measure the effect. The internal validity (quality) and heterogeneity of studies were taken into account. Results Thirteen studies were available, of which eight, involving 2362 patients, could be combined. For both reduction of pain and improvement of function, acupuncture was significantly superior to sham acupuncture (P<0.05 for all comparisons) in both the short term and the long term. Compared with no additional intervention (usual care), acupuncture was again significantly superior for pain and function. The treatment effects were maintained after taking account of quality and heterogeneity in sensitivity analyses. Conclusion Acupuncture is an effective treatment for osteoarthritis of the knee. Its overall effect size is 0.8, and it can be considered instead of non-steroidal anti-inflammatory drugs for patients whose symptoms are not controlled by education, exercise, weight loss if appropriate and simple analgesics. Further research is necessary into the most efficient way of delivering acupuncture, and its longer term benefits.

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Electroacupuncture for Gastrointestinal Function Recovery after Gynecological Surgery: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/8329366 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Xiang Gao ◽

Yuzhuo Zhang ◽

Yizhe Zhang ◽

YuTzu Ku ◽

Yi Guo

Keyword(s):

Large Scale ◽

Ph Value ◽

Meta Analysis ◽

Control Group ◽

Controlled Trials ◽

Gastrointestinal Function ◽

Cochrane Central Register ◽

Gynecological Surgery ◽

Function Recovery ◽

Significant Difference

Background. Evidence for the efficacy and safety of electroacupuncture (EA) on gastrointestinal function recovery after gynecological surgery is unclear. Objective. This meta-analysis aimed to evaluate the effects of EA on recovery of postoperative gastrointestinal function for patients receiving gynecological surgery. Data sources: PubMed, Cochrane Central Register of Controlled Trials (CINAHL), Embase, China National Knowledge Infrastructure (CNKI), Weipu (CQVIP), and Wanfang databases were systematically searched from the inception dates to May 30, 2020, for relevant randomized controlled trials (RCTs). Study selection: RCTs that evaluated EA for postoperative gastrointestinal function directly related to gynecological surgery in adults aged 18 years or over. Data extraction and synthesis: paired reviewer independently extracted the data and assessed study quality. Standardized mean differences (SMD) were calculated as the effect measure from a random effects model. Main outcomes and measures: time to first flatus (TFF), time to bowel sounds recovery (TBS), and time to first defecation (TFD) were recorded as primary outcomes; postoperative nausea and vomiting (PONV), motilin (MTL), gastrin (GAS), pH value of gastric mucosa (pHi), gastric mucosal partial pressure of carbon dioxide (PgCO2), vasoactive intestinal peptide (VIP), and adverse event were reported as secondary outcomes. Results. We included eighteen RCTs (1117 participants). Our findings suggested that compared to the control group (CG), electroacupuncture group (EG) showed significant effects on TFF (SMD = −0.98, 95% CI: [−1.28, −0.68], P < 0.00001 , I2 = 69%), TBS (SMD = −0.98, 95% CI: [−1.84, −0.12], P = 0.03 , I2 = 92%), and TFD (SMD = −1.23, 95% CI: [−1.59, −0.88], P < 0.0001 , I2 = 0%). Moreover, the incidence of PONV at postoperative 6 h (OR = 0.42, 95% CI: [0.27, 0.64], P < 0.0001 , I2 = 0%) and 24 h (OR = 0.46, 95% CI: [0.32, 0.68], P < 0.0001 , I2 = 0%) was lower in the EG than that in the CG, whereas no significant difference in ratio of PONV at postoperative 48 h (OR = 0.55, 95% CI: [0.20, 1.51], P = 0.25 , I2 = 0%) was detected between the two groups. Meanwhile, there was a significant effect in favor of EA on the level of MTL at postoperative 6 h (SMD = −0.93, 95% CI: [−1.36, −0.61], P < 0.0001 , I2 = 21%), while no significant effect was observed at postoperative 24 h (SMD = −0.43, 95% CI: [−0.89, 0.02], P = 0.06 , I2 = 69%) in the EG when compared to the CG. Additionally, a large significant effect on decreasing PgCO2 was found in the EG in comparison to the CG, but no significant effect in favor of EA on GAS, VIP, or pHi was observed. It was reported that there was one participant with pain at the needling sites and bruising, and three participants withdrew because they were not intolerant to EA. Conclusions. EA could be a promising strategy for the prevention and treatment of gastrointestinal dysfunction after gynecological surgery, including shortening TFF and TFD, TBS, regulating MTL, and decreasing the ratio of PONV within postoperative 24h. The effects on MTL and PONV varied with different intervention points, and EA used at 30 min prior to surgery might be recommended. However, the evidence quality ranged from low to very low, and large-scale and high-quality RCTs were warranted.

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The effect of balneotherapy on pain relief, stiffness, and physical function in patients with osteoarthritis of the knee: a meta-analysis

Clinical Rheumatology ◽

10.1007/s10067-017-3592-y ◽

2017 ◽

Vol 36 (8) ◽

pp. 1839-1847 ◽

Cited By ~ 12

Author(s):

Hiromi Matsumoto ◽

Hiroshi Hagino ◽

Kunihiko Hayashi ◽

Yuki Ideno ◽

Takashi Wada ◽

...

Keyword(s):

Pain Relief ◽

Physical Function ◽

Meta Analysis ◽

Osteoarthritis Of The Knee

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Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01919-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Jia Zhu Tang ◽

Ming Jun Nie ◽

Jian Zhong Zhao ◽

Guang Cheng Zhang ◽

Qing Zhang ◽

...

Keyword(s):

Hyaluronic Acid ◽

Adverse Events ◽

Knee Osteoarthritis ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Womac Pain ◽

Significant Difference ◽

Vas Scores ◽

Eq Vas

Abstract Background This study aimed to evaluate the clinical efficacy of platelet-rich plasma (PRP) injection compared with hyaluronic acid (HA) injection for patients undergoing knee osteoarthritis. Methods We systematically searched electronic databases including PubMed, Embase, Web of Science, and the Cochrane Library on January 23, 2020 to identify relevant studies issued in English languages. The outcomes evaluating the efficacy of knee osteoarthritis (KOA) treatment were Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores (WOMAC pain, function, stiffness, and total scores) at 1, 3, 6, and 12 months; International Knee Documentation Committee (IKDC) scores, Lequesne Index score, Visual Analog Scale (VAS) scores, EQ-VAS scores, and KOOS scores. The pooled data were analyzed by Stata 12.0. Results A total of 20 RCTs were enrolled in the present meta-analysis. The pooled results demonstrated that platelet-rich plasma (PRP) injection reduced pain more effectively than hyaluronic acid (HA) injection at 6-month and 12-month follow-up evaluated by WOMAC pain scores and VAS scores. EQ-VAS in the patients treated with PRP injection was lower than that in patients with HA injection at 12 months. Moreover, the patients with PRP injection had a better function recovery than those with HA injection at 1-month, 3-month, 6-month, and 12-month follow-up, as evaluated by WOMAC function scores. WOMAC total scores showed significant difference at 6-month and 12-month follow-up. The IKDC scores indicated PRP injection was significantly more effective than HA injection at 3 months and 6 months. However, the Lequesne Index scores, KOOS scores, and adverse events did not show any significant difference between groups. Conclusion Intra-articular PRP injection appeared to be more efficacious than HA injection for the treatment of KOA in terms of short-term functional recovery. Moreover, PRP injection was superior to HA injection in terms of long-term pain relief and function improvement. In addition, PRP injection did not increase the risk of adverse events compared to HA injection.

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The Effects of Morus alba and Acacia catechu on Quality of Life and Overall Function in Adults with Osteoarthritis of the Knee

Journal of Nutrition and Metabolism ◽

10.1155/2017/4893104 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 6

Author(s):

Douglas S. Kalman ◽

Susan J. Hewlings

Keyword(s):

Cartilage Damage ◽

Type Ii Collagen ◽

Cartilage Degradation ◽

Morus Alba ◽

Osteoarthritis Of The Knee ◽

Significant Difference ◽

Womac Questionnaire ◽

Acacia Catechu ◽

Double Blinded ◽

And Function

The purpose of this study was to determine the effects of UP1306 on discomfort and function in adults with osteoarthritis of the knee. In a randomized, double-blinded, placebo-controlled, parallel design, 135 subjects received UP1306, a standardized, proprietary extract of Morus alba and Acacia catechu, glucosamine chondroitin, or placebo for 12 weeks. Discomfort, stiffness, and activities of daily living measured by the WOMAC questionnaire and VAS (pain/discomfort) were improved within all groups. Range of motion and distance walked were improved. There were no changes in TNFα levels for any of the products. There was a significant difference in urinary C-telopeptides of type II collagen (CTX-II), a marker of cartilage degradation between UP1306, and placebo after 12 weeks (p=0.029). All efficacy measurements were improved from baseline to most time-points for UP1306, the comparator, and placebo without a significant association between the products. There was a significant difference between the changes of uCTX-II for UP1306 and placebo after 12 weeks. Early intervention with UP1306 aimed at reducing bone and cartilage degradation through reported inhibition of catabolic proinflammatory pathways may help to prevent joint cartilage damage. This study is registered with Clinical Trial ID ISRCTN15418623.

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