The Dose-Related Effects of Extracorporeal Shock Wave Therapy for Knee Osteoarthritis

Abstract

ObjectiveTo investigate the dose-related effects of extracorporeal shock wave therapy (ESWT) for knee osteoarthritis.MethodsSeventy-five subjects were recruited, 60 of which met the inclusion criteria. The patients were randomly classified into two groups: group L, which was a low-energy group (n=30; 1,000 shocks/session; energy flux density [EFD], 0.040 mJ/mm2) and group M, which was a medium-energy group (n=30; 1,000 shocks/session; EFD, 0.093 mJ/mm2). For each group, 1,000 shock waves were delivered to the medial tibial plateau area, once a week, for 3 weeks. The main outcome measures were the visual analogue scale (VAS), the Roles and Maudsley (RM) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and the Lequesne index. Each assessment was performed at the baseline and at 1, 4, and 12 weeks after ESWT.ResultsIn both groups, the VAS, the RM and WOMAC scores, and the Lequesne index were significantly improved over time (p<0.001), and group M showed greater improvement over group L at the 1, 4 and 12 weeks assessments.ConclusionIn this study, medium-energy group (group M) showed greater improvement in regard to relieving pain and restoring functional outcome than the low-energy group (group L). Therefore, EFD can be considered to have significant influence when treating with ESWT for knee osteoarthritis.

Low-intensity Extracorporeal Shock Wave Treatment Improves Erectile Function: A Systematic Review and Meta-analysis

“…Some studies included in our review concluded that the biological efficacy of LI-ESWT was dosage dependent [25]. It seemed that more pulses would bring better biological efficacy.…”

Effects of Extracorporeal Shockwave Therapy in Chronic Stroke Patients With Knee Osteoarthritis: A Pilot Study

“…There are only 2 previous human studies, and these studies proved that ESWT is effective in reducing pain and improving knee function. However, only the clinical outcomes related to knee OA were assessed, and the substantial morphological or hemodynamic changes in the knee joints were not included [2021]. …”

“…A recently published study reported that medium energy (0.093 mJ/mm 2 ) ESWT was more effective in relieving pain and improving functional outcomes than low energy (0.040 mJ/mm 2 ) ESWT. However, histological or molecular safety evaluations were not carried out in that study [21]. …”

“…From the study, we have concluded that a dose of less than 0.06 mJ/mm 2 was an appropriate level for safety. In addition, a human study concerning the effect of different levels of energy revealed that ESWT energy above 0.04 mJ/mm 2 was more effective [21]. In consideration of these 2 studies, we applied an ESWT dose of 0.05 mJ/mm 2 in our study.…”

Men’s Power-Pressure Wave Erectile Regeneration-Therapy: an Early Assessment

“…The men's age and the length of time with ED did not affect the results. We acknowledge several limitations, including the lack of a placebo group and to date no long term follow up [23][24][25].…”