Dose-related effects of radial extracorporeal shock wave therapy for knee osteoarthritis: A randomized controlled trial.
Ya-Fei Zhang, Yang Liu, Shao-Wen Chou and 1 others
PMID 33367924WHAT IT FOUND
Higher intensity shock wave therapy worked better than lower intensity or placebo for knee osteoarthritis pain and function.
The number of shocks (2,000 vs 4,000) made little difference. No serious side effects occurred.
Key findings
01Higher energy flux density (0.24 mJ/mm2) was significantly more effective than lower density (0.12 mJ/mm2) and placebo in reducing pain and improving function.
02The number of shocks (2,000 vs 4,000) did not significantly differ in pain reduction, though it showed some effect on function scores.
03The trial was stopped early for efficacy after 89 patients, with no serious adverse effects reported.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Trial stopped early for efficacy, which may overestimate the treatment effect. Small sample size (89 patients). Short follow-up period (4 weeks). Placebo group used minimum intensity, which may not be a true inert control. Single-center study.
The easy way to misread this
Do not assume that doubling the number of shocks from 2,000 to 4,000 provides significant clinical benefit. The study found that intensity was the key driver of pain relief, while shock number had a negligible impact on pain outcomes.