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Meta-Analysis
. 2022 Sep;36(9):1153-1169.
doi: 10.1177/02692155221097035. Epub 2022 May 9.

Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Haoqian Chen  1   2 , Zheng Wang  3 , Xinan Zhang  3 , Mingli Sun  3
Affiliations
Meta-Analysis

Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Haoqian Chen et al. Clin Rehabil. 2022 Sep.

Abstract

Objective: To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA).

Data sources: PubMed, Web of Science, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were used from inception to 18 March 2022.

Review methods: Meta-analysis was performed to evaluate pain and function recovery between control and LIPUS groups. Standardized mean difference (SMD) or mean difference (MD) and 95% confidence interval (CI) were calculated, and data were combined using the fixed or random-effect model.

Results: Thirteen studies involving 807 patients with KOA were included. Patients' outcomes treated by LIPUS were improved significantly, including Visual analog scale (VAS) score (MD = -0.95, 95% CI: -1.43 to -0.48，P < 0.001), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score (MD = -4.35, 95% CI: -8.30 to -0.40, P = 0.0309), Lysholm score (SMD = 1.59, 95% CI: 1.29 to 1.90, P < 0.001), Lequesne index (MD = -1.33, 95% CI: -1.69 to -0.96, P < 0.001), Range of motion (ROM) (MD = 2.43, 95% CI: 0.39 to 4.46, P = 0.0197) and 50 meter walking time (SMD = 1.48, 95% CI: 0.46 to 2.49, P = 0.0044). Subgroup analyses showed monotherapy of LIPUS produced a better effect on reducing VAS score (P = 0.0213), and the shorter therapeutic period (≤4 weeks) produced a more significant effect on raising the WOMAC score (P = 0.0083).

Conclusion: LIPUS was beneficial for pain relief and functional knee recovery and maybe as an alternative therapy in KOA rehabilitation.

Keywords: meta-analysis; Knee osteoarthritis; a systematic review; low-intensity pulsed ultrasound; physical therapy.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flowchart for the selection of included trials.
Figure 2.
Figure 2.
Risk of bias for the included randomized controlled trials. A.Risk of bias graph, B.Risk of bias summary.
Figure 3.
Figure 3.
Forest plots demonstrated the effect of low-intensity pulsed ultrasound on pain relief evaluated by the Visual analog scale score.
Figure 4.
Figure 4.
Forest plots demonstrated the effect of low-intensity pulsed ultrasound on functional recovery evaluated by several scores. A. Western Ontario and McMaster Universities Osteoarthritis Index score, B. Lysholm score, C. Lequesne index.
Figure 5.
Figure 5.
Forest plots demonstrated the effect of low-intensity pulsed ultrasound on joint mobility and walking ability by range of motion and walking tests. A.Range of motion, B. 20 meters walking time, C. 50 meters walking time.
See this image and copyright information in PMC

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