低强度脉冲超声治疗膝骨关节炎的疗效：一项随机对照试验的系统评价和荟萃分析。

Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.

机构信息

Graduate Students' Affairs Department, 66444Shenyang Sport University, Shen-yang, China.

Sports Training College, 66444Shenyang Sport University, Shen-yang, China.

出版信息

Clin Rehabil. 2022 Sep;36(9):1153-1169. doi: 10.1177/02692155221097035. Epub 2022 May 9.

OBJECTIVE

To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA).

DATA SOURCES

PubMed, Web of Science, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were used from inception to 18 March 2022.

REVIEW METHODS

Meta-analysis was performed to evaluate pain and function recovery between control and LIPUS groups. Standardized mean difference (SMD) or mean difference (MD) and 95% confidence interval (CI) were calculated, and data were combined using the fixed or random-effect model.

RESULTS

Thirteen studies involving 807 patients with KOA were included. Patients' outcomes treated by LIPUS were improved significantly, including Visual analog scale (VAS) score (MD = -0.95, 95% CI: -1.43 to -0.48， < 0.001), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score (MD = -4.35, 95% CI: -8.30 to -0.40, = 0.0309), Lysholm score (SMD = 1.59, 95% CI: 1.29 to 1.90, < 0.001), Lequesne index (MD = -1.33, 95% CI: -1.69 to -0.96, < 0.001), Range of motion (ROM) (MD = 2.43, 95% CI: 0.39 to 4.46, = 0.0197) and 50 meter walking time (SMD = 1.48, 95% CI: 0.46 to 2.49, = 0.0044). Subgroup analyses showed monotherapy of LIPUS produced a better effect on reducing VAS score ( = 0.0213), and the shorter therapeutic period (≤4 weeks) produced a more significant effect on raising the WOMAC score ( = 0.0083).

CONCLUSION

LIPUS was beneficial for pain relief and functional knee recovery and maybe as an alternative therapy in KOA rehabilitation.

目的

系统评价低强度脉冲超声（LIPUS）对膝骨关节炎（KOA）患者疼痛缓解和功能恢复的影响。

数据来源

从建库至 2022 年 3 月 18 日，检索PubMed、Web of Science、Cochrane 图书馆、物理治疗证据数据库（PEDro）和中国知网（CNKI）。

检索方法

采用 Meta 分析比较 LIPUS 组与对照组的疼痛和功能恢复情况。采用标准化均数差（SMD）或均数差（MD）及其 95%置信区间（CI）进行合并，采用固定或随机效应模型进行数据合并。

结果

共纳入 13 项研究，涉及 807 例 KOA 患者。LIPUS 治疗的患者结局明显改善，包括视觉模拟评分（VAS）（MD=-0.95，95%CI：-1.43 至-0.48， < 0.001）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）评分（MD=-4.35，95%CI：-8.30 至-0.40， = 0.0309）、Lysholm 评分（SMD=1.59，95%CI：1.29 至 1.90， < 0.001）、Lequesne 指数（MD=-1.33，95%CI：-1.69 至-0.96， < 0.001）、关节活动度（ROM）（MD=2.43，95%CI：0.39 至 4.46， = 0.0197）和 50 米步行时间（SMD=1.48，95%CI：0.46 至 2.49， = 0.0044）。亚组分析显示，LIPUS 单一疗法对降低 VAS 评分（ = 0.0213）效果更好，治疗周期较短（≤4 周）对提高 WOMAC 评分（ = 0.0083）效果更显著。