The effects of extracorporeal shock wave therapy on the pain and function of patients with degenerative knee arthritis.
Ji-Hyun Lee, Sangyong Lee, SeokJoo Choi and 2 others
PMID 28356649WHAT IT FOUND
In 20 adults with degenerative knee arthritis, over four weeks, adding shock wave therapy to heat pack, interference current, and ultrasound produced greater reductions in pain and function scores than the same physical therapies alone.
Key findings
01After four weeks, the group receiving heat pack, interference current, ultrasound, and shock wave therapy had a post-treatment pain score of 2.9 ± 0.7, while the heat pack, interference current, and ultrasound group had a post-treatment pain score of 5.5 ± 1.72.
02After four weeks, the group receiving heat pack, interference current, ultrasound, and shock wave therapy had a post-treatment K-WOMAC score of 9.3 ± 3.0, while the heat pack, interference current, and ultrasound group had a post-treatment K-WOMAC score of 25.4 ± 9.1.
03Both groups showed statistically significant declines in VAS and K-WOMAC scores within each group after treatment, and the after-treatment comparison showed significant differences between groups.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 20 patients were studied, with 10 in each group, so the result could be unstable. The paper does not report how patients were allocated to groups, so the groups may not have been comparable. The paper does not report blinding of patients, therapists, or assessors. Follow-up was only four weeks, so longer-term effects and durability are unknown. The paper does not report dropout or adverse event information. Baseline scores were not equal: the ESWT group started with VAS 7.9 ± 1.5 and K-WOMAC 37.4 ± 8.5, while the conservative physical therapy group started with VAS 6.8 ± 2.0 and K-WOMAC 30.9 ± 11.8.
Declared interests
No funding or conflict-of-interest information is reported.
The easy way to misread this
Do not read the larger score reductions as proof that shock wave therapy by itself treats knee arthritis. The shock-wave group also received heat pack, interference current, and ultrasound, and the paper does not report randomization or blinding.