Effects of transcutaneous electrical nerve stimulation (TENS) in people with knee osteoarthritis: A systematic review and meta-analysis

2021 ◽  
pp. 026921552110656
Author(s):  
Yu Wu ◽  
Feilong Zhu ◽  
Wei Chen ◽  
Ming Zhang
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Nerve Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Walking Ability ◽  
Medium Term ◽  
Randomized Controlled

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.

scholarly journals Proprioceptive Training for Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Yi Wang ◽  
Zugui Wu ◽  
Zehua Chen ◽  
Xiangling Ye ◽  
Guoqian Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Proprioceptive Training ◽  
Conventional Physiotherapy

Background: There is increased interest in proprioceptive training for knee osteoarthritis (KOA). However, little consensus supports the effectiveness of this intervention.Objective: This meta-analysis aimed to assess the effects of proprioceptive training on symptoms, function, and proprioception in people with KOA.Methods: The PubMed, Cochrane Library, Web of Science, and EMBASE databases were systematically searched from the inception dates to April 16, 2021 for relevant randomized controlled trials (RCTs). Data were pooled by calculating the standardized mean differences (SMDs) and 95% confidence intervals (CIs). A random-effects model was used for the analyses.Results: A total of 24 RCTs involving 1,275 participants were included in our analysis. This study indicated that compared to no intervention, proprioceptive training significantly improved pain, stiffness, physical function, joint position sense (JPS), muscle strength, mobility, and knee ROM (P &lt; 0.05) in people with KOA. When compared to other non-proprioceptive training, proprioceptive training provided better results in terms of JPS (SMD = −1.28, 95%CI: [−1.64, −0.92], I2 = 0%, P &lt; 0.00001) and mobility (timed walk over spongy surface) (SMD = −0.76, 95%CI: [−1.33, −0.18], I2 = 64%, P = 0.01), and other results are similar. When proprioceptive training plus other non-proprioceptive training compared to other non-proprioceptive training, the two groups showed similar outcomes, but there was a greater improvement for JPS (SMD = −1.54, 95%CI: [−2.74, −0.34], I2 = 79%, P = 0.01), physical function (SMD = −0.34, 95%CI: [−0.56, −0.12], I2 = 0%, P = 0.003), and knee ROM (P &lt; 0.05) in the proprioceptive training plus other non-proprioceptive training group. When proprioceptive training plus conventional physiotherapy compared against conventional physiotherapy, the two groups demonstrated similar outcomes, but there was a significant improvement for JPS (SMD = −0.95, 95%CI: [−1.73, −0.18], I2 = 78%, P = 0.02) in the proprioceptive training plus conventional physiotherapy group.Conclusions: Proprioceptive training is safe and effective in treating KOA. There is some evidence that proprioceptive training combined with general non-proprioceptive training or conventional physiotherapy appears to be more effective and should be considered as part of the rehabilitation program. However, given that the majority of current studies investigated the short-term effect of these proprioceptive training programs, more large-scale and well-designed studies with long-term follow up are needed to determine the long-term effects of these proprioceptive training regimes in KOA.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#recordDetails, PROSPERO, identifier: CRD42021240587.

Safety and Effectiveness of Long-Term Exercise Interventions in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2020 ◽  
Vol 50 (6) ◽  
pp. 1095-1106 ◽  
Author(s):  
Antonio García-Hermoso ◽  
Robinson Ramirez-Vélez ◽  
Mikel L. Sáez de Asteasu ◽  
Nicolás Martínez-Velilla ◽  
Fabricio Zambom-Ferraresi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Randomized Controlled

scholarly journals Neuromodulation techniques for acute and preventive migraine treatment: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xavier Moisset ◽  
Bruno Pereira ◽  
Daniel Ciampi de Andrade ◽  
Denys Fontaine ◽  
Michel Lantéri-Minet ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Nerve Stimulation ◽  
Acute Treatment ◽  
Meta Analysis ◽  
Preventive Treatment ◽  
Migraine Treatment ◽  
Controlled Trials ◽  
Electrical Nerve Stimulation ◽  
Randomized Controlled

Abstract Background Several neuromodulation methods exists for migraine treatment. The aim of the present study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) focusing on migraine treatment using neurostimulation methods. Methods We searched Medline and Embase up to July 1, 2020 for RCTs reporting acute or preventive treatment of migraine with either non-invasive or invasive neurostimulation methods. Two researchers independently assessed the eligibility of the retrieved studies and extracted data. Outcomes for the quantitative synthesis were 2 h pain free for acute treatment and headache days per month for preventive treatment. We performed subgroup analyses by treatment (stimulation method and site of application). Estimates were pooled using random-effects meta-analysis. Results Thirty-eight articles were included in the qualitative analysis (7 acute, 31 preventive) and 34 in the quantitative evaluation (6 acute, 28 preventive). Remote electrical neuromodulation (REN) was effective for acute treatment. Data were insufficient to draw conclusions for any other techniques (single studies). Invasive occipital nerve stimulation (ONS) was effective for migraine prevention, with a large effect size but considerable heterogeneity, whereas supra-orbital transcutaneous electrical nerve stimulation (TENS), percutaneous electrical nerve stimulation (PENS), and high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor cortex (M1) were effective, with small to medium effect sizes. Vagus-nerve stimulation, left prefrontal cortex rTMS, and cathodal transcranial direct current stimulation (tDCS) over the M1 had no significant effect and heterogeneity was high. Conclusion Several neuromodulation methods are of potential interest for migraine management, but the quality of the evidence is very poor. Future large and well-conducted studies are needed and could improve on the present results.

Effectiveness of high-intensity laser therapy in the management of patients with knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 33 (6) ◽  
pp. 875-884
Author(s):  
Hyun Jin Song ◽  
Hyun-Ju Seo ◽  
Donghwi Kim
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Randomized Controlled Trials ◽  
High Intensity ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
High Intensity Laser ◽  
And Function ◽  
Intensity Laser

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.

Sign in / Sign up

Export Citation Format

Share Document