Chen Tzu-Yin, Chou Shih-Hsiang, Shih Chia-Lung
Department of Physical Therapy, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, 600, Taiwan.
Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
J Orthop. 2024 Feb 19;52:67-73. doi: 10.1016/j.jor.2024.02.021. eCollection 2024 Jun.
The aim of the research was to conduct a systematic review of dose-response meta-analysis, examining the correlation between the energy of extracorporeal shockwave therapy (ESWT) and clinical outcomes for patients with knee osteoarthritis (OA).
We conducted a systematic review of three online databases - PubMed, Embase, and Cochrane Library - to collect relevant articles from their inception to May 2023. We included the articles that investigated the efficacy of ESWT in treating knee OA and were designed using randomized controlled trials (RCTs). The main outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for primary outcomes and the Visual Analog Scale (VAS) for secondary outcomes. We conducted a dose-response meta-analysis to examine the correlation between the energy of ESWT and clinical outcomes.
Our study included a total of 7 RCTs (comprising 450 subjects) that met the inclusion criteria. We found a negative linear relationship between the doses of ESWT and WOMAC scores at the 1-week (p = 0.0398) and 4-week (p = 0.001) follow-up periods, but not at the 12-week follow-up period (p = 0.202). Furthermore, at the 4-week (p = 0.0477) and 12-week (p < 0.001) follow-up periods, a negative linear connection was found between the ESWT dose and VAS scores, but not at the 1-week follow-up period (p = 0.2268).
Our results demonstrate a dose-response connection between the energy of ESWT and clinical outcomes. This suggests that using higher energy levels of ESWT to treat knee OA could lead to greater improvement in clinical outcomes compared to using lower energy levels.
本研究旨在对剂量反应荟萃分析进行系统评价，探讨体外冲击波疗法（ESWT）的能量与膝骨关节炎（OA）患者临床结局之间的相关性。
我们对三个在线数据库——PubMed、Embase和Cochrane图书馆——进行了系统评价，以收集从其创建到2023年5月的相关文章。我们纳入了研究ESWT治疗膝OA疗效且采用随机对照试验（RCT）设计的文章。主要结局采用西安大略和麦克马斯特大学骨关节炎指数（WOMAC）进行测量作为主要结局，采用视觉模拟量表（VAS）进行测量作为次要结局。我们进行了剂量反应荟萃分析，以检验ESWT能量与临床结局之间的相关性。
我们的研究共纳入了7项符合纳入标准的RCT（包括450名受试者）。我们发现，在1周（p = 0.0398）和4周（p = 0.001）随访期，ESWT剂量与WOMAC评分之间存在负线性关系，但在12周随访期不存在（p = 0.202）。此外，在4周（p = 0.0477）和12周（p < 0.001）随访期，ESWT剂量与VAS评分之间存在负线性关系，但在1周随访期不存在（p = 0.2268）。
我们的结果表明ESWT能量与临床结局之间存在剂量反应关系。这表明，与使用较低能量水平相比，使用较高能量水平的ESWT治疗膝OA可能会导致临床结局有更大改善。
