The Effect of Acupuncture and Physiotherapy on
Patients with Knee Osteoarthritis: A Randomized
Controlled Study

Atalay, Sevgi Gümüş; Durmus, A; Gezgınaslan, Ömer

doi:10.36076/ppj.2021/24/e269

Cited by 19 publications

(11 citation statements)

References 18 publications

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“…For diseases such as tendinopathy (PHT), ESWT can signi cantly reduce pain by acting on soft tissues to improve function [31][32][33]. In addition to ESWT treatment, in some studies of maneuver, acupuncture and physiotherapy, they have reported that the therapeutic target within the soft tissue can still relieve pain and improve patient function in KOA patients by releasing and stimulating therapeutic targets inside soft tissues [34][35][36][37]. Therefore, the soft tissue is an important target for the treatment of disease using ESWT.…”

Section: Discussionmentioning

confidence: 99%

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Liu¹,

Wu²,

Chen³

et al. 2022

Preprint

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Background: Knee osteoarthritis (KOA) is the leading cause of knee pain in middle-aged and older individuals. In recent years, extracorporeal shockwave therapy (ESWT) has been applied to treat patients with KOA to reduce pain and improve function. We aimed to determine the association between the distribution of tissue around the knee joint and the efficacy of ESWT in KOA treatment. We were also interested in studying KOA pathogenesis from the perspective of imaging evaluation.Materials and methods: Patients (n=123) diagnosed with KOA who received ESWT were selected to participate in this study, and were grouped according to their body mass index (BMI). The treatment parameters were as follows: 8000 pulses, 2.0 bar, 0.25 mJ/mm2, and 6 Hz/s once per week for 8 weeks. The visual analog scale (VAS), Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were measured before and after treatment to assess knee pain and functional recovery in all patients and according to BMI groups. Radiographs were used to measure the richness of the soft tissue around the knee joint. The correlation between the distribution of tissue, pain, and functional improvement was analyzed using the receiver operator characteristic (ROC) curve. The effect of BMI and the distribution of tissue around the knee joint on the efficacy of ESWT treatment in KOA patients were evaluated.Results: A total of 123 patients were enrolled; 59 were in the normal or below normal BMI (<25 kg/m2) category (NBB group) and 64 were classified as overweight and above (BMI ≥ 25 kg/m2) (OAB group). All the patients showed a reduction in pain after treatment compared to that before treatment (P <0.01). As measured by VAS, after the intervention, pain in the OAB group decreased to a greater extent than that in the NBB group (P < 0.01). As measured by the Lequesne and WOMAC indexes, after the intervention, the functional index of the OAB group improved to a greater extent than that of the NBB group (P < 0.01). We determined through the area under the curve (AUC) that, with VAS as the demarcation criterion, when the tibial plateau soft tissue ratio (TPSTR), femoral intercondylar apex soft tissue ratio (FIASTR), and medial tibial soft tissue ratio (MTSTR) exceeded 1.538, 1.534, and 1.296, respectively, the patient's pain relief was more pronounced the ESWT treatment was better. With pain in WOMAC as the demarcation criterion, the TPSTR, FIASTR, and MTSTR also are positively correlated with pain relief in patients. When the Lequesne and WOMAC scores were the demarcation criteria, the patients' function improved significantly when the the patella apical soft tissue ratio (PASTR) exceeded 2.401 and 2.635, respectively. Conclusion: ESWT can effectively alleviate pain and improve knee function in patients with KOA, and the efficacy of ESWT is closely related to the abundance around the knee joint; the soft tissue around the knee joint should also be an important reference factor and the focus of research in KOA treatment.

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Section: Discussionmentioning

confidence: 99%

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Liu¹,

Wu²,

Chen³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…[29–31] In addition to ESWT treatment, in some studies of maneuver, acupuncture and physiotherapy, they have reported that the therapeutic target within the soft tissue can still relieve pain and improve patient function in KOA patients by releasing and stimulating therapeutic targets inside soft tissues. [32–35] Therefore, the soft tissue is an important target for the treatment of disease using ESWT.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31] In addition to ESWT treatment, in some studies of maneuver, acupuncture and physiotherapy, they have reported that the therapeutic target within the soft tissue can still relieve pain and improve patient function in KOA patients by releasing and stimulating therapeutic targets inside soft tissues. [32][33][34][35] Therefore, the soft tissue is an important target for the treatment of disease using ESWT. We observed that ESWT significantly relieved symptoms and improved function in patients with KOA; that the abundance of soft tissue around the knee joint was positively correlated with the treatment effect in patients with KOA.…”

Section: Discussionmentioning

confidence: 99%

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Liu¹,

Wu²,

Chen³

et al. 2022

Medicine

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Knee osteoarthritis (KOA) is the leading cause of knee pain in middle-aged and older individuals. Extracorporeal shockwave therapy (ESWT) has been applied to treat patients with KOA to reduce pain and improve function. Patients (n = 123) diagnosed with KOA who received ESWT were selected to participate in this study, and were grouped according to their body mass index (BMI). The treatment parameters were as follows: 8000 pulses, 2.0 bar, 0.25 mJ/mm 2 , and 6 Hz/s once per week for 8 weeks. The visual analog scale (VAS), Lequesne index, and Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were measured to assess knee pain and functional recovery according to BMI groups. Radiographs were used to measure the richness of the soft tissue around the knee joint. The correlation between the distribution of tissue, pain, and functional improvement was analyzed using the receiver operator characteristic curve. All the patients showed a reduction in pain after treatment compared to that before treatment (P < .01). As measured by the VAS, the Lequesne and WOMAC indexes, after the intervention, the pain and functional index of the overweight and above BMI group improved to a greater extent than that of the normal or below normal BMI group (P < .01). The area under the curve showed, with VAS as the demarcation criterion, when the tibial plateau soft tissue ratio, femoral intercondylar apex soft tissue ratio, and medial tibial soft tissue ratio exceeded 1.538, 1.534, and 1.296, respectively, the patient's pain relief was more pronounced the ESWT treatment was better. With pain in WOMAC as the demarcation criterion, the tibial plateau soft tissue ratio, femoral intercondylar apex soft tissue ratio, and medial tibial soft tissue ratio also are positively correlated with pain relief in patients. When the Lequesne and WOMAC scores were the demarcation criteria, the patients' function improved significantly when the patella apical soft tissue ratio exceeded 2.401 and 2.635, respectively. ESWT can effectively alleviate pain and improve knee function in patients with KOA, and the soft tissue around the knee joint should also be an important reference factor in KOA treatment.Abbreviations: BMI = body mass index, CT = computed tomography, ESWT = extracorporeal shockwave therapy, FAATL = fibula apical apex tibia line, FIASTR = femoral intercondylar apex soft tissue ratio, K-L = Kellgren and Lawrence, KOA = knee osteoarthritis, MRI = magnetic resonance imaging, MTSTR = medial tibial soft tissue ratio, NBB = normal or below normal BMI, OA = osteoarthritis, OAB = overweight and above BMI, PASTR = patella apical soft tissue ratio, ROC = receiver operator characteristic, TPJSL = tibial plateau joint surface line, TPSTR = tibial plateau soft tissue ratio, VAS = visual analog scale, WOMAC = Western Ontario and McMaster University Osteoarthritis.

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“…The higher the score, the better the health status. The SF-36 has high reliability and validity in the Chinese population 53 59 60…”

Section: Methods and Analysismentioning

confidence: 99%

Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol

Guo,

Wang,

et al. 2024

BMJ Open

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IntroductionKnee osteoarthritis (KOA) is still a challenging degenerative joint disease with high morbidity and disease burden. Early-stage KOA, the focus of this study, could present a Window of Opportunity to arrest the disease process and reduce the disease burden. Yijinjing exercise is an important part of physical and psychological therapies in Traditional Chinese Exercise and may be an effective treatment. However, there is no clinical efficacy assessment of Yijinjing exercise for patients with early-stage KOA. Therefore, we designed a randomised controlled trial to evaluate the effectiveness of Yijinjing exercise on patients with early-stage KOA.Methods and analysisThis is a parallel-design, two-arm, analyst assessor-blinded, randomised controlled trial. In total, 60 patients with early-stage KOA will be recruited and randomly assigned to the Yijinjing exercise group (n=30) and health education group (n=30) at a ratio of 1:1, receiving 12 weeks of Yijinjing exercise or health education accordingly. The primary outcome will be measured with the Western Ontario and McMaster Universities Osteoarthritis Index, and the secondary outcomes will include the Visual Analogue Scale, Short-Form 36 Item Health Survey Questionnaire, Beck Depression Inventory, Perceived Stress Scale, Berg Balance Scale, and Gait Analysis for a comprehensive assessment. Outcome measures are collected at baseline, at 12 week ending intervention and at the 12 week, 24 week and 48 week ending follow-up. The primay time point will be 12 weeks postintervention. Adverse events will be recorded for safety assessment.Ethics and disseminationThis study has been approved by the ethical application of the Shanghai Municipal Hospital of Traditional Chinese Medicine Ethics Committee (2021SHL-KY-78).Trial registration numberChiCTR2200065178

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The Effect of Acupuncture and Physiotherapy on Patients with Knee Osteoarthritis: A Randomized Controlled Study

Cited by 19 publications

References 18 publications

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Impact of soft tissue around the knee on the efficacy of extracorporeal shockwave therapy in knee osteoarthritis

Effectiveness of Yijinjing exercise in the treatment of early-stage knee osteoarthritis: a randomized controlled trial protocol

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