Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis
Abstract Objective To conduct a systematic review and meta-analysis to investigate the clinical efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis (KOA) individuals. Data sources PubMed, EMBASE, The Cochrane Library, Web of Science, C...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-04403-2 |
| _version_ | 1797414427701542912 |
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| author | Jia Chen Hong Guo Juanhong Pan Hongpeng Li Yongshen Wang Zhixiang Liu Yulong Xie Song Jin |
| author_facet | Jia Chen Hong Guo Juanhong Pan Hongpeng Li Yongshen Wang Zhixiang Liu Yulong Xie Song Jin |
| author_sort | Jia Chen |
| collection | DOAJ |
| description | Abstract Objective To conduct a systematic review and meta-analysis to investigate the clinical efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis (KOA) individuals. Data sources PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, Technology Periodical Database and China Biology Medicine were searched from their inceptions to April 5, 2023. Review methods We analyzed trials of acupuncture combined with active exercise training for KOA. The included studies were of high quality (Jadad ≥ 4) and RCTs. Study selection, data extraction, risk of bias and quality assessment were independently performed by two reviewers. We performed systematic analyses based on different outcome measures, including total efficiency rate, visual analogue scale (VAS), the Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), the Lysholm Knee Scale (LKS) and range of motion (ROM). We used Review Manager 5.3 and Stata/MP 14.0 to analyze the data. And it was verified by trial sequence analysis (TSA). If I 2 > 50% and p < 0.05, we performed sensitivity analysis and subgroup analysis to find the source of heterogeneity. Publication bias was studied by funnel plot and Egger’s test was used to verify it. Results Full 11 high-quality studies (Jadad ≥ 4) including 774 KOA individuals were included in this review for meta-analysis. The results showed that acupuncture combined with active exercise training (combined group) was superior to the acupuncture group in improving the total effective rate [RR = 1.13, 95%CI (1.05, 1.22), I 2 = 0%, P = 0.70], reducing the pain level (VAS) [MD = − 0.74, 95%CI (− 1.04, − 0.43), I 2 = 68%, P < 0.05], improving knee joint function (WOMAC) [MD = − 6.97, 95%CI (− 10.74, − 3.19), I 2 = 76%, P < 0.05] and improving joint range of motion (ROM) [MD = 6.25, 95%CI (2.37, 10.04), I 2 = 0%, P = 0.71]. Similarly, the combined group showed significant improvements in the total effective rate [RR = 1.31, 95% CI (1.18, 1.47), I 2 = 48%, P = 0.10], pain (VAS) [MD = 1.42, 95% CI (− 1.85, − 1.00), I 2 = 65%, P = 0.02] and knee function (WOMAC) [MD = 7.05, 95% CI (− 11.43, − 2.66), I 2 = 86%, P < 0.05] compared with the non-acupuncture group. Conclusion The combined effect of all studies showed significant benefits of acupuncture combined with active exercise training in improving the total effective rate, reducing pain, promoting recovery of knee function and expanding range of motion. However, some evaluation indicators are highly subjective and need to be further confirmed by more objective and evidence-based high-quality RCTs in future. Systematic Review Registration: [PROSPERO], identifier [No. CRD42023425823]. |
| first_indexed | 2024-03-09T05:32:53Z |
| format | Article |
| id | doaj.art-09503e8bc4a842edad3b6b6cf4eb9b26 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-03-09T05:32:53Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-09503e8bc4a842edad3b6b6cf4eb9b262023-12-03T12:30:41ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-12-0118112110.1186/s13018-023-04403-2Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysisJia Chen0Hong Guo1Juanhong Pan2Hongpeng Li3Yongshen Wang4Zhixiang Liu5Yulong Xie6Song Jin7School of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese MedicineRehabilitation Department, Hospital of Chengdu University of Traditional Chinese MedicineSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese MedicineSchool of Medical and Life Sciences, Chengdu University of Traditional Chinese MedicineSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese MedicineSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese MedicineSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese MedicineRehabilitation Department, Hospital of Chengdu University of Traditional Chinese MedicineAbstract Objective To conduct a systematic review and meta-analysis to investigate the clinical efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis (KOA) individuals. Data sources PubMed, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wan Fang Data, Technology Periodical Database and China Biology Medicine were searched from their inceptions to April 5, 2023. Review methods We analyzed trials of acupuncture combined with active exercise training for KOA. The included studies were of high quality (Jadad ≥ 4) and RCTs. Study selection, data extraction, risk of bias and quality assessment were independently performed by two reviewers. We performed systematic analyses based on different outcome measures, including total efficiency rate, visual analogue scale (VAS), the Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), the Lysholm Knee Scale (LKS) and range of motion (ROM). We used Review Manager 5.3 and Stata/MP 14.0 to analyze the data. And it was verified by trial sequence analysis (TSA). If I 2 > 50% and p < 0.05, we performed sensitivity analysis and subgroup analysis to find the source of heterogeneity. Publication bias was studied by funnel plot and Egger’s test was used to verify it. Results Full 11 high-quality studies (Jadad ≥ 4) including 774 KOA individuals were included in this review for meta-analysis. The results showed that acupuncture combined with active exercise training (combined group) was superior to the acupuncture group in improving the total effective rate [RR = 1.13, 95%CI (1.05, 1.22), I 2 = 0%, P = 0.70], reducing the pain level (VAS) [MD = − 0.74, 95%CI (− 1.04, − 0.43), I 2 = 68%, P < 0.05], improving knee joint function (WOMAC) [MD = − 6.97, 95%CI (− 10.74, − 3.19), I 2 = 76%, P < 0.05] and improving joint range of motion (ROM) [MD = 6.25, 95%CI (2.37, 10.04), I 2 = 0%, P = 0.71]. Similarly, the combined group showed significant improvements in the total effective rate [RR = 1.31, 95% CI (1.18, 1.47), I 2 = 48%, P = 0.10], pain (VAS) [MD = 1.42, 95% CI (− 1.85, − 1.00), I 2 = 65%, P = 0.02] and knee function (WOMAC) [MD = 7.05, 95% CI (− 11.43, − 2.66), I 2 = 86%, P < 0.05] compared with the non-acupuncture group. Conclusion The combined effect of all studies showed significant benefits of acupuncture combined with active exercise training in improving the total effective rate, reducing pain, promoting recovery of knee function and expanding range of motion. However, some evaluation indicators are highly subjective and need to be further confirmed by more objective and evidence-based high-quality RCTs in future. Systematic Review Registration: [PROSPERO], identifier [No. CRD42023425823].https://doi.org/10.1186/s13018-023-04403-2AcupunctureActive exercise trainingKnee osteoarthritisSystematic reviewMeta-analysis |
| spellingShingle | Jia Chen Hong Guo Juanhong Pan Hongpeng Li Yongshen Wang Zhixiang Liu Yulong Xie Song Jin Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Acupuncture Active exercise training Knee osteoarthritis Systematic review Meta-analysis |
| title | Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis |
| title_full | Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis |
| title_fullStr | Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis |
| title_short | Efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals: a systematic review and meta-analysis |
| title_sort | efficacy of acupuncture combined with active exercise training in improving pain and function of knee osteoarthritis individuals a systematic review and meta analysis |
| topic | Acupuncture Active exercise training Knee osteoarthritis Systematic review Meta-analysis |
| url | https://doi.org/10.1186/s13018-023-04403-2 |
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