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体外冲击波疗法、低强度激光疗法和脉冲电磁场疗法对膝骨关节炎的短期疗效比较:一项随机对照研究

Comparison of Short-Term Effects of Extracorporeal Shock Wave Therapy, Low-Level Laser Therapy and Pulsed Electromagnetic Field Therapy in Knee Osteoarthritis: A Randomized Controlled Study.

作者信息

Pasin Tugce, Dogruoz Karatekin Bilinc

机构信息

Department of Physical Medicine and Rehabilitation, Goztepe Prof Dr Suleyman Yalcin City Hospital, 34722 Istanbul, Turkey.

出版信息

J Clin Med. 2025 Jan 17;14(2):594. doi: 10.3390/jcm14020594.

DOI:10.3390/jcm14020594
PMID:39860600
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11766320/
Abstract

Knee osteoarthritis (OA) is the most prevalent form of osteoarthritis and a leading cause of chronic pain in adults. This study aimed to compare the short-term effects of extracorporeal shock wave therapy (ESWT), low-level laser therapy (LLLT), and pulsed electromagnetic field therapy (PEMF) on pain, function, and quality of life in patients with knee OA. A hundred and twenty patients with Kellgren-Lawrence grade 2-3 knee OA were randomized into four groups: ESWT (once a week for three sessions), LLLT (twice a week for eight sessions), PEMF (twice a week for eight sessions), and a control group with 30 patients in each group. All participants were instructed in a daily exercise program, including knee joint range of motion, stretching, and strengthening exercises (3 × 10 repetitions). Outcome measures, including the visual analog scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-36 (SF-36), and the Timed Up and Go (TUG) test, were assessed at baseline after treatment and at the third month. There were no significant differences between groups at baseline regarding VAS, WOMAC, SF-36, and TUG scores ( > 0.05). Significant improvements were observed in all parameters post-treatment for all groups ( < 0.001). However, the improvements in the PEMF group were significantly lower than in the ESWT and LLLT groups, particularly for VAS, WOMAC pain, and SF-36 physical function scores ( < 0.05). No significant differences were found between ESWT and LLLT ( > 0.05). In the short-term, ESWT, LLLT, and PEMF effectively reduce pain, improve physical function, and enhance quality of life in patients with knee OA, though PEMF showed less pronounced improvements.

摘要

膝骨关节炎(OA)是骨关节炎最常见的形式,也是成人慢性疼痛的主要原因。本研究旨在比较体外冲击波疗法(ESWT)、低强度激光疗法(LLLT)和脉冲电磁场疗法(PEMF)对膝骨关节炎患者疼痛、功能和生活质量的短期影响。120例Kellgren-Lawrence 2-3级膝骨关节炎患者被随机分为四组:ESWT组(每周一次,共三次)、LLLT组(每周两次,共八次)、PEMF组(每周两次,共八次),以及对照组,每组30例患者。所有参与者都接受了每日锻炼计划的指导,包括膝关节活动范围、伸展和强化锻炼(每组10次,共3组)。在治疗后基线期、治疗后及第三个月评估结果指标,包括视觉模拟量表(VAS)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、简短健康调查量表(SF-36)和计时起立行走测试(TUG)。在基线期,各组间VAS、WOMAC、SF-36和TUG评分无显著差异(P>0.05)。所有组治疗后所有参数均有显著改善(P<0.001)。然而,PEMF组的改善明显低于ESWT组和LLLT组,尤其是在VAS、WOMAC疼痛和SF-36身体功能评分方面(P<0.05)。ESWT组和LLLT组之间未发现显著差异(P>0.05)。短期内,ESWT、LLLT和PEMF均能有效减轻膝骨关节炎患者的疼痛、改善身体功能并提高生活质量,尽管PEMF的改善不太明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/a04e1c7bfbb9/jcm-14-00594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/6c0beb574bc3/jcm-14-00594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/dea9bfbe72b5/jcm-14-00594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/a04e1c7bfbb9/jcm-14-00594-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/6c0beb574bc3/jcm-14-00594-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/dea9bfbe72b5/jcm-14-00594-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3534/11766320/a04e1c7bfbb9/jcm-14-00594-g003.jpg

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