【論文摘要】The Effects of Extracorporeal Shockwave Therapy on Pain and Physical Performance in Particiapants With Knee Osteoarthritis: A Systematic Review and Meta-Analysis

【論文摘要】體外震波療法對膝關節骨性關節炎患者疼痛和身體活動表現之效果：系統性回顧與統合分析

武皇秋香(Vu Hoang Thu Huong) ； 陳治中(Chih-Chung Chen) ； 劉文瑜(Wen-Yu Liu) ； 賴郁臻(Yu-Jhen Lai) ； 蔡佳玲(Jia-Ling Tsai)

《物理治療》 47卷4期 (2022/12) Pp. 295-295

https://doi.org/10.6215/FJPT.202212.O23

摘要

Background and Purpose: The effects of extracorporeal shockwave therapy (ESWT) in the particaptnts with knee osteoarthritis (KOA) were unclear on physical performance although its effects on pain had been investiagted. This study aims to explore the effects of ESWT on pain relief and physical performance on KOA. Methods: The studies with the randomized controlled design to investigate the effects of ESWT on KOA were systematically searched using inclusion and exclusion criteria through seven electronic databases including PubMed etc. between 1990 and Dec 2021. To summarize those data, visual analog scale (VAS) or pain scores were determined for measure of pain intensity. Range of knee motion, or the scores of physical activities including Lequesne index (LI), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were determined for measure of physical performances. The effect of post-treatment period was defined as a score difference between sham/placebo and ESWT group in one week after the end of ESWT period. The effect of following period was defined as the aforementioned difference in 1 to 5 months after post-treatment period. Data analysis was performed using RevMan 5.4.1 software. A significant level was set at p ＜ 0.01. Results: Seven studies (n = 438) reoprting the ESWT effects on mild-to-moderate severity (Grades I to III Kellgren-Lawrence) of KOA were qualified for meta-analysis. Comapred to sham or placebo, the ESWT group had a signifiacnt decrease of VAS rest score (-0.90 [-1.67 ~ -0.12] as mean difference [95% confidence interval]) and pain score WOMAC (-2.49 [-3.76 ~ -1.22]), and a significant improvement of physical performance with a decrease of the scores of WOMAC activities (-8.18 [-12.39 ~ -3.97]), LI (-3.47 [-5.26 ~ -1.68]), and KOOS (-5.87 [-10.00 ~ -1.73]) in the post-treatment period. There were also a significant decrease of WOMAC pain score (-2.83 [-3.53 ~ -2.12]) and a significant decrease of the scores of WOMAC activities (-9.47 [-11.28 ~ -7.65]) and LI (-4.12 [-5.89 ~ -2.34]) in the following period. Conclusions: The ESWT was effective in relieving pains and improving physical activities in the participants with mild-tomoderate KOA at post-treatment or following period. Clinical Relevance: There are the effects of ESWT on pain relief and the improvement of physical performance in the population with KOA.