The effects of various physical non-operative modalities on the pain in osteoarthritis of the knee

摘要

The purpose of this study was to evaluate theeffect of various non-operative modalities of treatment (transcutaneouselectrical nerve stimulation (TENS); neuromuscular electrical stimulation(NMES); insoles and bracing) on the pain of osteoarthritis (OA)of the knee. We conducted a systematic review according to the Preferred ReportingItems for Systematic Reviews and Meta-Analyses guidelines to identifythe therapeutic options which are commonly adopted for the managementof osteoarthritis (OA) of the knee.The outcome measurement tools used in the different studies werethe visual analogue scale and The Western Ontario and McMaster UniversitiesArthritis Index pain index: all pain scores were converted to a100-point scale. A total of 30 studies met our inclusion criteria: 13 on insoles,seven on TENS, six on NMES, and four on bracing. The standardisedmean difference (SMD) in pain after treatment with TENS was 1.796,which represented a significant reduction in pain. The significantoverall effect estimate for NMES on pain was similar to that ofTENS, with a SMD of 1.924. The overall effect estimate of insoleson pain was a SMD of 0.992. The overall effect of bracing showeda significant reduction in pain of 1.34. Overall, all four non-operative modalities of treatment werefound to have a significant effect on the reduction of pain in OAof the knee. This study shows that non-operative physical modalities of treatmentare of benefit when treating OA of the knee. However, much of theliterature reviewed evaluates studies with follow-up of less thansix months: future work should aim to evaluate patients with longerfollow-up.Cite this article: Bone Joint J 2016;98-B(1Suppl A):89–94.