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Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: An umbrella review.

Acta reumatologica portuguesa
January 1, 2018
Ricardo Maia Ferreira et al. (3 authors)
Journal ArticleSystematic ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of Low-Level Laser Therapy (LLLT) for improving pain and physical function in patients with knee osteoarthritis, compared to other non-pharmacological and non-surgical interventions.

Results Summary

The study found that LLLT did not improve patients' pain or physical function, differing from previous umbrella reviews. The evidence quality for LLLT was insufficient to support its use for knee osteoarthritis.

Population

Humans with knee osteoarthritis

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Standard Exercise programs
decrease
pain
patients with knee OA
-
can reduce
#1
Standard Exercise programs
increase
physical function
patients with knee OA
-
improve
#2
Acupuncture
increase
patients' pain, stiffness, function and quality of life
patients with knee OA
-
improve
#3
Exercise interventions
increase
patients' pain, stiffness, function and quality of life
patients with knee OA
-
improve
#4
Transcutaneous Electrical Nerve Stimulation
no change
patients' pain and physical function
patients with knee OA
-
do not improved
#5
Low-Level Laser Therapy
no change
patients' pain and physical function
patients with knee OA
-
do not improved
#6
Abstract

Objective - Update the last known umbrella review and summarize the available high-quality evidence from systematic reviews on the effectiveness of non-pharmacological and non-surgical interventions for patients with knee OA. Methods - The systematic reviews were identified thought electronic databases such as, MEDLINE, Embase, Physiotherapy Evidence Database (PEDro), The Cochrane Library, SciELo, Science Direct, Google Scholar, Research Gate and B-ON. The studies selection respected the following terms to guide the search strategy using the P (humans with knee osteoarthritis) I (non-pharmacological and non-surgical treatments) C (pharmacological, surgical, placebo, no intervention, or other non-pharmacological/ non-surgical conservative treatments) O (pain, functional status, stiffness, inflammation, quality of life and patient global assessment) model. Results - Following the PRISMA statement, 41 systematic reviews were found on the electronic databases that could be included in the umbrella review. After methodical analysis (R-AMSTAR), only 35 had sufficient quality to be included. There is gold evidence that Standard Exercise programs can reduce pain and improve physical function in patients with knee OA. Additionally, there is silver evidence for Acupuncture, Aquatic Exercise, Electroacupuncture, Interferential Current, Kinesio Taping, Manual Therapy, Moxibustion, Pulsed Electromagnetic Fields, Tai Chi, Ultrasound, Yoga, and Whole-Body Vibration. For other interventions, the quality of evidence is low or did not show sufficient efficacy from the systematic reviews to support their use. Conclusion - Comparing to last known umbrella review, similar results were achieved on Acupuncture and Exercise interventions to improve the patients' pain, stiffness, function and quality of life, but it was found different results regarding the utilization of Transcutaneous Electrical Nerve Stimulation and Low-Level Laser Therapy as they do not improved the patients' pain and physical function.

Medical Subject Headings (MeSH)
HumansOsteoarthritis, KneeSystematic Reviews as Topic
Study Links
PubMed ID30414367
Quality Scores
SafetyNot Assessed
Efficacy20/10
Quality85/10
Citation Metrics
Total Citations41
Citations/Year5.9
Relative Citation Ratio3.00
NIH Percentile85%
Research Impact Scores
APT Score0.75
Weight Score2.33
Normalized Score0.45
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