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Randomized Controlled Trial
. 2024 Mar 12:56:jrm13207.
doi: 10.2340/jrm.v56.13207.

Evaluation of treatment parameters for focused-extracorporeal shock wave therapy in knee osteoarthritis patients with bone marrow lesions: a pilot study

Hani Al-Abbad  1 , Jacqueline E Reznik  2 , Erik Biros  3 , Bruce Paulik  4 , Rob Will  5 , Samuel Gane  6 , Penny Moss  7 , Anthony Wright  8
Affiliations
Randomized Controlled Trial

Evaluation of treatment parameters for focused-extracorporeal shock wave therapy in knee osteoarthritis patients with bone marrow lesions: a pilot study

Hani Al-Abbad et al. J Rehabil Med. .

Abstract

Objectives: To evaluate the effect of different dosage parameters of focused-extracorporeal shock wave therapy on pain and physical function in knee osteoarthritis patients with bone marrow lesions. In addition, to investigate pathophysiological changes based on imaging and biomarker measures.

Methods: Using a single-case experimental design, a total of 12 participants were randomly allocated in 4 equal groups of 3 to receive different dosages of focused-extracorporeal shock wave therapy. Each group received either 4 or 6 sessions of 1500 or 3000 shocks over 4 or 6 weekly sessions. Participants underwent repeated measurements during the baseline, intervention, and post-intervention phases for Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, aggregated locomotor function score and pressure pain threshold. Imaging and inflammatory biomarker outcomes were measured at baseline and 3 months following the intervention.

Results: The group receiving the highest dosage of focused-extracorporeal shock wave therapy showed clinical improvements superior to those of participants in the other 3 groups. Statistically significant changes during the follow-up phase in contrast to baseline measurements for the WOMAC score (Tau-U= -0.88, p < 0.001), aggregated locomotor function score (Tau-U= -0.77, p = 0.002), and pressure pain threshold (Tau-U= 0.54, p = 0.03) were observed. Bone marrow lesion and inflammatory cytokines demonstrated no change.

Conclusion: A dose-dependent effect for focused-extracorporeal shock wave therapy on osteoarthritis-related symptoms was suggested. However, these improvements were not associated with changes in the underlying pathophysiological mechanisms.

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Conflict of interest statement

The authors have no conflicts of interests to declare.

Figures

Fig. 1
Fig. 1
Effect of focused-extracorporeal shock wave therapy (ESWT) on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score.
Fig. 2
Fig. 2
Effect of focused-extracorporeal shock wave therapy (ESWT) on aggregated locomotor function (ALF) score.
Fig. 3
Fig. 3
Effect of focused-extracorporeal shock wave therapy (ESWT) on pressure pain threshold (PPT).
See this image and copyright information in PMC

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