Effects of radial extracorporeal shock wave therapy on clinical variables and isokinetic performance in patients with knee osteoarthritis: a prospective, randomized, single-blind and controlled trial

Abstract

Objective This study aims to compare the efficacy of r-ESWT treatment with sham-ESWT on pain, walking speed, physical function, and isokinetic muscle strength in knee osteoarthritis. Methods The study included 104 patients (mean age 61.0 ± 6.2 years; range 50 to 70 years) who were admitted to our outpatient clinic with newly diagnosed with knee osteoarthritis. Patients were randomly assigned to two groups. Both groups received transcutaneous electrical nerve stimulation for 30 minutes, hot pack for 40 minutes, and home-based exercise program of around the knee strengthening for 30 minutes in a day for three weeks (5 days in a week). Also, one group was treated with r-ESWT, while the other group was treated with sham-ESWT. For r-ESWT, patients received 2000 pulses of shockwave at 2.0 to 3.0 bar weekly for three weeks. All patients were evaluated with visual analog scale (VAS), active knee range of motion (ROM), 20metre walk test, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Lequesne's disability index, and isokinetic muscle performance before treatment, at the end of treatment, at one month and three months after treatment. Results When groups were compared, group 1 scores were significantly better than the group 2 in all outcome parameters except WOMAC-stiffness at the end of treatment, at one month and three month follow-up (all p < 0.05). The VAS-resting, VASmovement, knee ROM, 20-m walk test, WOMAC, and Lequesne's disability scores and peak torque values of knee extension improved in both groups with the highest improvement in the r-ESWT group. A comparison of difference of the two group scores showed statistically significant superior improvement in group 1 in all parameters at both one month and three months. Conclusion Our findings revealed that r-ESWT combined with conventional electrotherapy is an effective treatment for improving pain and physical function in knee osteoarthritis to control symptoms up to three months. Clinical trials ID NCT04243135

Comparative Effectiveness of Focused Extracorporeal versus Radial Extracorporeal Shockwave Therapy for Knee Osteoarthritis—Randomized Controlled Study

“…Uysal et al compared the efficacy of r-ESWT treatment with sham-ESWT for knee OA. They found r-ESWT to be more effective than sham-ESWT at improving pain, walking speed, physical function, and isokinetic muscle strength [ 23 ]. Investigating the effectiveness of f-ESWT in patients with knee OA, Lee et al found that f-ESWT in combination with physical therapy was superior to physical therapy alone in reducing pain and improving the functional status of knee OA patients [ 38 ].…”

“…These differences may lead to different therapeutic effects between f-ESWT and r-ESWT [ 21 , 22 ]. Although shockwave therapy is not currently approved by the International Society for Medical Shockwave Treatment (ISMST) for treating OA, recent studies suggested that f-ESWT or r-ESWT could be effective at reducing pain and improving the functional status of knee OA patients [ 21 , 22 , 23 , 24 ]. To our knowledge, no prior studies have directly compared the effects of f-ESWT and r-ESWT in knee OA patients.…”

Application of extracorporeal shock wave therapy in nervous system diseases: A review

“…Thus, patients do not need to spend much time or money on ESWT. Because of these beneficial characteristics, ESWT has been a therapeutic option for the treatment of many musculoskeletal diseases ( 6 , 7 ), including plantar fasciitis ( 8 – 10 ), calcific shoulder tendinopathy ( 11 ), tennis elbow ( 12 ), trigger finger ( 13 ), knee osteoarthritis ( 14 ), and bone non-union ( 15 – 17 ). ESWT has also been utilized to treat wounds ( 18 – 21 ), urological diseases ( 22 – 24 ), and male erectile rejuvenation ( 25 ).…”

Comparison of Extracorporeal Shockwave Therapy with Non-Steroid Anti-Inflammatory Drugs and Intra-Articular Hyaluronic Acid Injection for Early Osteoarthritis of the Knees

“…Dr. Zhong compared the treatment of ESWT with placebo on knee OA, and the VAS, WOMAC, Lequesne index are superior in the ESWT group [ 32 ]. Dr. Uysal also reported the radial ESWT has statistically significant superior improvement than sham ESWT in all parameters, including VAS score, knee ROM, 20-m walk test, and Lequesne’s disability scores [ 33 ]. In our study, the ESWT group improved VAS, KOOS, WOMAC, and IKDC score statistically significantly one month after treatment, and the effect lasted for one year.…”